Macular Degeneration: Types, Symptoms, Causes, Risks, Complications, Diagnosis, Treatment and Prevention

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Women at the doctor that make a test to check if she has macular degeneration

1Overview

The eyes are responsible in the sense of sight. It has many parts that work together to create a good and clear vision. As time passes by and when people reach adulthood,
the vision will slowly undergo the process of aging. There are many conditions linked to increasing age. One of the most prevalent eye disorders in seniors is macular degeneration.

This condition usually affects people more than 65 years old. It creates a reduced central vision and blurred vision, caused by macular thinning. The macula is an eye part that is vital for clear vision in the direct line of sight.

The bad thing is, macular degeneration could potentially lead to permanent blindness. In fact, it is the leading cause of vision loss, affecting more than ten million people in the United States. That’s more than the cases of glaucoma and cataracts combined. Today, macular degeneration is considered an incurable eye disorder.

2Types

Dry macular degeneration

Dry macular degeneration happens when the macular cells become damaged by the build-up of certain deposits dubbed as drusen. This type of MD is the most common and least serious. It happens in about nine in 10 patients. The loss of vision progresses slowly over several years.

Wet macular degeneration

On the other hand, wet macular degeneration happens when there are abnormal blood cells that have formed under the macula. The cells in the macula become damaged. This is more serious and requires immediate intervention to prevent blindness.

3Symptoms

Macular degeneration develops slowly and it does not cause pain. It is sometimes mistaken for normal age-related vision changes. The symptoms include:

  • Seeing straight lines
  • Seeing faces appearing wavy
  • The objects appear smaller
  • Objects looking farther away
  • Doorways appear crooked
  • Reduced brightness or color intensity
  • Hard time recognizing faces
  • Increasing vision haziness
  • More difficulty in adapting to low light levels
  • Appearance of blind spots in central vision

4Causes

The exact cause of macular degeneration is still unclear, but the condition develops as the personages. Age-related macular degeneration (AMD) is usually caused when the macula encounters a problem.

When macular degeneration is age-related (AMD) it is caused by an alteration in the part of the eye called the macula. This is the area in the middle of the retina, which is considered the nerve tissue that lines the hind area of the eye.

The macula helps people see the front area directly and it’s responsible for focusing on close and detailed activities such as writing and reading.

Dry macular degeneration

As a person grows older, the macular cells, which are light sensitive begin to suffer wear and tear, which leads to breaking down. Though it happens progressively, it may eventually lead to vision loss in the future. It also takes many years to progress.

As a result, certain waste products build-up in the retina, creating drusen, which are common small deposits linked to macular degeneration. As the disease progresses, the size of the drusen also increases. Dry macular degeneration has been tied to hereditary and environmental factors, such as diet and smoking.

Wet macular degeneration

Wet macular degeneration is characterized by the formation of small and new blood vessels underneath the macula. Some experts say that these blood vessels develop as an attempt by the body to remove the drusen from the retina.

However, despite the fact that the blood vessels form in an attempt to solve the problem, they may grow in the wrong locations and cause harm. Eventually, they may cause damage and scarring to the macula.

The damage leads to the severe symptoms associated with wet macular degeneration such as blind spots and disrupted vision.

5Risk Factors

Here are factors that may increase the risk of macular degeneration:

Age – Macular degeneration usually affects older people, particularly those who are more than 65 years old. The older an individual gets, the more likely they are at risk of developing AMD.

Genetics and family history – People with relatives or family members who have the condition are at a higher risk of developing macular degeneration, too.  AMD is known to run in families because certain genes people inherit from the parents may heighten the risk of AMD. However, it is not clear which exact genes are involved.

Race – Macular degeneration is more common in Caucasians than in other people.

Smoking – Smoking cigarettes and tobacco heightens the risk of AMD. Even those who are regularly exposed to cigarette smoke are at risk. An individual who smokes is up to four times more likely to have AMD than someone who never smoked. Also, the longer the person has smoked, the higher the risk.

Cardiovascular diseasePeople with heart disease and illness that affects the blood vessels are more likely to have macular degeneration.

Obesity – People who are overweight or obese have a higher tendency to develop macular degeneration.

Other possible risk factors:

Aside from the factors stated above, these could also increase the risk of AMD but they haven’t been proven yet.

Alcohol – Studies have shown that drinking alcohol in excessive amounts over the years may increase the risk of developing AMD and in some cases, the condition may develop early.

High blood pressure – In people with increased blood pressure, they are at a higher risk of developing macular degeneration.

Sunlight – studies are claiming that exposure to sunlight during the lifetime may affect the risk of developing macular degeneration. To protect oneself, wear eyewear that can protect against the harmful UV lights.

6Complications

In some cases, when people hear that they have macular degeneration, they might feel frustrated because the condition may eventually lead to vision loss. The complications of the disease include:

Depression and anxiety – People who can’t cope with the illness or the possible loss of vision may lead to depression and anxiety. The patients may become anxious about the loss of some of the independence in the future, affecting the mental health. It is estimated that about one-third of people with AMD may have some forms of these mental health disorders.

Problems with driving – People with macular degeneration may suffer from vision loss or blurred vision, affecting the ability to drive. Central vision is essential in driving and since it’s the one affected with AMD, it could lead to accidents.

Visual hallucinations – Some people with macular degeneration may experience visual hallucinations due to vision loss. This condition is dubbed as Charges Bonnet syndrome. About one in 10 individuals with AMD experiences this complication.

Usually, the hallucinations experienced may include seeing faces, animals or even an entire scene. It could be colored or even black and white and may last for a few minutes to many hours.

Vision loss – One of the common complications associated with macular degeneration is vision loss.

7Diagnosis

Macular degeneration is mostly seen in people who are more than 60 years old and it affects central vision. Here are the common diagnostic tests used:

Visual acuity test – This test uses an eye chart to measure the person’s distant vision.

Amsler grid – This test is used wherein the patient will look at the grid and if the straight lines become wavy or distorted, the patient may have AMD.

Dilated eye exam – The pupils of the patient is diluted with eye drops placed. The doctor will assess and examine the optic nerve and retina. When there is a mottled effect, there are drusen underneath.

Tomography – Retinal thinning or thickening linked to AMD can be seen with this test.

Angiogram – This test uses a special camera to capture photos of the eye after the dye is injected into the arm vein. The dye goes to the blood vessels in the eye and may show the presence of blood vessels and other retinal abnormalities.

8Treatment

Today, there is no cure for either type of macular degeneration. The treatment aims to help the person making the most of the remaining vision.

Dry AMD

For dry AMD, the only is to manage the condition and cope with the remaining vision. This can be done through using magnifying lenses, reading large-print books, using a screen reading software, reading under very bright lights, and changing the home to help the patient move freely without accidents and falls.

Also, diet and nutrition are important in the management of dry AMD. Taking foods and supplements high in vitamins A, C and D are significant.

Wet AMD

In wet AMD, the two major treatments are anti0VEGF medications to prevent the new growth of blood vessels under the eye and laser surgery, to destroy the abnormal blood vessels in the eyes.

9Prevention

Prevention is still better than cure. Though in some people, macular degeneration may become inevitable, there are ways to reduce the risk of developing the disease, including:

  • Have regular eye exams
  • Manage other conditions such as cardiovascular disease and hypertension
  • Protect the eyes from the harmful rays of the sun.
  • Avoid smoking or stop smoking
  • Maintain a healthy weight through regular exercise
  • Choose a diet rich in fruits and vegetables.
  • Live a healthy lifestyle by avoiding vices and eating healthy options.