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Macular Degeneration

Macular Degeneration (MD) is caused by the deterioration of the central portion of the retina. This is the inside back layer of the eye that records the images we see and sends them via the optic nerve from the eye to the brain.

The retina’s central portion, known as the macula, is responsible for focusing central vision in the eye, and controls our ability to read, drive a car, recognize faces or colors, and see objects in fine detail.

Types of Macular Degeneration

Dry Macular degeneration

Dry MD is a wear process where waste accumulates in the retina during life and the function of the macula slowly goes down.

Wet Macular degeneration

Wet MD is a wear process in which new blood vessels start to grow in the macula. These blood vessels leak and cause fluid accumulation and bleeding in the macula.

MD usually does not appear on both eyes at the same time. That means that there can still be good vision for a few years. When the eyesight deteriorates in both eyes, everyday things that were previously self-evident, such as reading and driving, become increasingly difficult.

Symptoms of Macular Degeneration

In the initial phase of the condition there are no or few complaints. The abnormalities are then usually accidentally discovered in an eye check. In a more advanced stage, two types of complaints can arise:

Blurry spot or reduced vision

At the spot where you focus your eye, you will notice a blurry, dull or dark spot. This stain is constantly traveling with your eyes, so it is not possible to look next to the stain. You will also see less detailed information. This means you can no longer recognize people by their faces. Reading is also difficult because letters of a word seem to be missing. Blurred vision can not be corrected with normal glasses. These complaints generally fit with dry MD.

Distorted vision

Sometimes distortion of the image is the first thing you notice. Lines are no longer straight, but have a strange twist. For example, you see a dent or a bump in a door post or lamppost. Or you see 'contorted' faces. In a more advanced stage you see the world as in a kind of distorting mirror. These complaints generally fit with wet MD.

How is Macular Degeneration diagnosed?

A number of preliminary studies are required for the diagnosis of MD:

  • Determining the visual acuity (reading the card)
  • Examination of the eye by the ophthalmologist
  • Making retinal photos with contrast fluid (FAG) and without contrast fluid (OCT)

In general, the tests are not painful and only dilation of the pupil by means of drops is required. It takes 20 to 30 minutes for the drops to work. You will see blurry through these drops. It is therefore necessary that you take an accompanying person to the Eye Care clinic for these examinations to drive you back home. You are not allowed to drive by yourself after these dates.

Treatment of Macular Degeneration

The treatment options depend on the type of MD you have. Your ophthalmologist discusses with you the most optimal form of treatment. For both types of MD it is important that you stop smoking.

Furthermore the advice is to eat two pieces of fruit a day, 200 grams of fresh vegetables a day and consume fatty fish three times a week . Studies have proved that this might slow down the degeneration process. Wearing sunglasses is also advised.

Dry MD

Currently, there is no way to treat the dry form of MD. To slow down the process you should follow above mentioned advices.

Wet MD

With wet MD, the treatment options are:

  • Treatment with injections in the eye
  • Photodynamic therapy (PDT)
  • Sometimes surgery is also possible

With these treatments you can only stop or slow down the progress of the disease. Vision will not improve. But if you do nothing vision will get worse. Beside the treatment by the ophthalmologist, it is very important that you follow the advices mentioned above.

Who is at Risk for Macular Degeneration?

You are more likely to develop MD if you:

  • Eat a diet high in saturated fat
  • Are overweight
  • Smoke cigarettes
  • Are over 50 years old
  • Have a family history of MD
  • Are Caucasian (white)

Having heat disease is another risk factor for MD, as is having high cholesterol levels.

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