It started gradually — your eyesight was a bit blurred and wavy, and then you noticed objects in the central part of your field of vision seemed to disappear. A visit to your ophthalmologist confirmed you had macular degeneration – now the leading cause of vision loss in Americans, 60 years of age and older.
Macular degeneration is caused by the deterioration of the central portion of the retina, the inside back layer of the eye.
Washington University ophthalmologist, Rajendra Apte, MD, specializes in macular degeneration. He explains, “One can compare the human eye to a camera. The macula is the central and most sensitive area of the so-called camera film. When it is working properly, the macula collects highly detailed images at the center of the field of vision and sends them up the optic nerve to the brain, which interprets them as sight.
When the cells of the macula deteriorate, images are not received correctly.
In early stages, macular degeneration does not affect vision. However, as the disease progresses, the irreversible destruction of the macula leads to loss of the sharp, fine-detail, central vision required for activities like reading, driving, recognizing faces, and seeing the world in color.
Peripheral vision is usually retained, but that is not as clear as central vision.”
Risk factors
Age: The biggest risk factor for macular degeneration is age. Risk increases with age, and the disease is most likely to occur in those 60 and older.
Genetics: People with a family history of macular degeneration are at a higher risk than those with no family history.
Race: Caucasians are more likely to develop the disease than African-Americans or Hispanics/Latinos.
Smoking: Smoking doubles the risk of macular degeneration.
Other risk factors include high blood pressure and lighter eye color.
Treatment
Dr. Apte says, “There is currently no known cure for macular degeneration, but some treatments and lifestyle changes may delay its progression.
For ‘wet’ macular degeneration, we began a therapeutic approach that focused on blocking one molecule called VEGF. We use drugs that are essentially antibodies or fusion proteins that block this excess protein and prevent abnormal blood vessel growth and bleeding in the eyes.
I am confident in 10 to 15 years the next frontier will have therapies to help maintain optimal functions for a lifetime. These therapies will not only give patients short-term and long-term vision gains, but also stop the slow decline of visual function by targeting normal physiology.
In addition, we will also have therapies for the advanced forms of dry macular degeneration to prevent vision loss.”
Lifestyle changes include:
- Don’t smoke
- Exercise regularly
- Keep blood pressure in a normal range and control other medical conditions
- Maintain a healthy weight
- Eat a diet high in fruits, vegetables and fish
- Protect eyes from overexposure to sunlight with sunglasses and hats
Living with low vision
Because low vision varies from person to person, specialists have different tools to help patients deal with vision loss. They include:
- Reading glasses with high-powered lenses
- Handheld magnifiers
- Video magnifiers
- Computers with large-print and speech-output systems
- Large-print reading materials
- Talking watches, clocks, and calculators
- Computer aids and other technologies, such as a closed-circuit television, which uses a camera and television to enlarge printed text.