Macular degeneration affects more than 10 million people in the United States. Most people fear blindness more than any other disabilities known to mankind.

Macular degeneration can happen early in life but commonly starts at age 60. In fact, it is the leading cause of vision loss in seniors in the United States. You may notice that your senior loved ones begin to have difficulty recognizing faces. This may be a frightening experience for them, worsened by other issues on senior age.

Macular degeneration is a disorder affecting the eyes, resulting to irreversible loss of central vision. Central vision allows us to see objects and is therefore needed so we could perform activities such as reading, watching TV and driving. Macular degeneration affects the part of the eye known as macula lutea, a yellow spot at the center of the retina that allows us to see things in very fine detail. Aside from providing a high acuity vision, it also absorbs excess light entering our eyes, very much like sunglasses. The macula is housed by the retina, the part of the eye that converts light or an image into nerve impulses and sends them to the brain.

There are two types of macular degeneration – wet and dry. Both dry and wet macular degeneration do not cause pain. Between the two, the dry form is more common, accounting for over 85% of macular degeneration cases.

Dry macular degeneration results when the macula in the affected eye breaks down, causing a slow blurring of the central vision. This blurred vision, however, may disappear in bright light. After some time, a blurred spot can be seen in the center of your eyesight. Thus, blurred vision is the hallmark symptom. Both eyes are usually involved. Carers should watch for yellow deposits called drusen under the retina of their loved ones. Drusen are common in seniors but do not actually cause blindness. However, the increase in size and quantity of these substances predisposes seniors to macular degeneration. These can be detected through a dilated eye exam performed by an eye specialist.

Wet macular degeneration, on the other hand, results when blood vessels of the retina grow under the macula. These abnormal blood vessels are weak and have a tendency to burst. When this happens, blood leaks into the macula and damages it. The damage is more rapid and severe compared to dry macular degeneration. Because of its rapid progression, seniors should therefore watch out for early signs of wet macular degeneration. When they see straight lines as wavy, consult an eye care professional for an eye exam.

Risk Factors

Age is the most significant risk factor. Macular degeneration affects mostly adults over age 60 and the risk increases by 30% in adults over age 75. Women are also at a higher risk than men. People who have family members with the condition also have a high risk of developing macular degeneration. Obesity and smoking increase the risk and promote rapid progression of the disease. Studies also reveal that smoking increases the risk for recurrence of the disease.

Prognosis

Macular Degeneration is progressive, thus it will worsen over time. The rate and extent may vary. Some cases involve slow degeneration while some involve rapid progression, and may even result to blindness in both eyes.

Diagnosis

Diagnosis is done by an eye care specialist who will conduct comprehensive eye examinations. One type is a visual acuity test, a procedure wherein a person is asked to read letters on a standardized chart held a few feet away. Visual acuity test is a method familiar to many since it is often included in general physical examinations. Results of visual acuity test are expressed as a fraction. The normal score is 20/20. The top value refers to the distance where you stand from the chart while the lower number is the distance where a person with normal eyesight can read the same line you read correctly on the chart.

Another diagnostic test is the dilated eye exam. Eye drops are used prior to performing this test, to dilate or enlarge the eyes. A special lens is used to look into the affected eye to thoroughly examine the retina for symptoms of macular degeneration. To confirm diagnosis, fluorescein angiogram is performed. This makes use of a special dye injected into the arm that highlights the blood vessels in the retina. Pictures are then taken to detect leaking blood vessels.

Treatment

Damage to the macula is irreversible. However, patients should still undergo treatment in order to prevent further destruction and eventual loss of vision. Treatment includes laser surgery, photodynamic therapy and eye injections. Laser surgery makes use of a laser that destroys leaky blood vessels. However, this procedure is a little invasive and may destroy nearby healthy cells. Photodynamic therapy uses a drug called verteporfin, injected into the arms and settles in abnormal blood vessels and destroys them upon light activation. However, this procedure offers temporary results. Thus, eye injections are preferred over the first two treatment plans. Eye injections block growth factors responsible for growth of abnormal blood vessels. They may be given monthly until vision improves.

These procedures are especially recommended for patients with wet macular degeneration since they may significantly slow down the rapid progression of this type of degeneration. Both wet and dry macular degeneration can progress into an advanced stage. At this stage, no amount of treatment can prevent loss of vision.

Care Plan

Lifestyle changes can help prevent the disease by lowering the risk factors. Caregiving families can start by adapting a healthy diet such as green leafy vegetables, fruits and fish. These food groups are rich in zinc and antioxidants such as vitamin A, C, E and beta-carotene which are important for healthy eyes. These vitamins and minerals are sometimes difficult to obtain from the food we eat. Consult your physician before taking nutritional supplements.

Maintain your weight within normal limits through regular exercise and diet. Advise your loved ones to quit smoking. If your loved ones are already diagnosed with macular degeneration, a dilated eye exam is yearly recommended.

Encourage your loved ones to join support groups and take part in group discussions and counseling. These activities may help loved ones and caregiving families cope with difficulties and challenges of vision impairment. Information on assistive devices may be provided to help loved ones live more independently. Check your community for special services to the blind or vision impaired. There are organizations that provide support services such as vocational rehabilitation, mobility training and referrals to state agencies.