Dr Farokh Irani (MBBS, Dip Anat, FRANZCO) - Ophthalmologist at EYE SURGEONS BENDIGO provides expert commentary on this important condition. This is the second part of a series on eye diseases affecting vision.
Writer: Dr Farokh Irani MBBS (Melb), Dip Anat, FRANZCO – ophthalmic surgeon – Eye Surgeons Bendigo
What is macula degeneration?
Macular Degeneration is a degenerative disease that erodes the Macula. This is the central part of the retina at the back of the eye and is responsible for providing clear, sharp, detailed vision, that is tasks such as reading, driving, and recognising faces. The condition may manifest gradually or acutely.
In Australia, this disease affects 1 in 7 people over age 50 and is the leading cause of irreversible blindness in the developed world.
What are the symptoms?
Gradual progression may not be noticed for a while and vision loss may take years to occur. Initial problems may be the need for more light to see small print or difficulties adjusting from light to dark. Later, the vision starts to fail and there may be distortion where straight edges appear crooked. In advanced cases there is total loss of central vision and legal blindness. Peripheral vision often remains intact. This may occur in one or both eyes.
Who is at risk?
The main risk factors for this disease are family history, cigarette smoking and age.
Are there different types of macular degeneration?
There are two types of this disease. These may coexist in any individual.
The Dry form is where the macula wastes away at a rate than can be gradual or fast. An eye test before this stage can identify people at high risk for this condition by the appearance of yellow deposits or pigment at the macula. The Wet form of age-related macular degeneration is associated with severe vision loss that can worsen rapidly. This form of the condition is characterized by the growth of abnormal, fragile blood vessels underneath the macula. These vessels leak blood and fluid, which damages the macula and makes central vision appear blurry and distorted. It may occur on its own or be a complication of the dry form.
What Treatment is available?
In early macular changes before much visual loss, the advice given will include: cessation of smoking, a good diet with fresh green vegetables and some fish, regular exercise and monitoring the central vision with a special grid. This may help to prevent or slow down the condition. Sometimes tablets containing nutritional micro supplements are offered. Any acute changes to vision should be reported promptly. In established cases, management is directed at other co-existing treatable eye diseases, such as cataracts. Low vision aides such as magnifiers may be of value. Of recent there has been profound advances in the treatment of the wet form. The mainstay of treatment for wet macular degeneration is monthly or two monthly injections into the eye of a drug that causes the new vessels to involute and regress. In 95% of people this will stabilize and most gratifyingly, 40% of patients actually gain vision. In onn eye disease, the other eye must be monitored carefully as the risk of macular degeneration is high.
Eye Surgeons Bendigo is very experienced and fully equipped to diagnose, treat and monitor macula degeneration. They are based at the Bendigo Day Surgery
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