What is Macular Degeneration?
Macular Degeneration: Everything You Need to Know
Macular degeneration is the number one cause of vision loss in the senior population. It affects primarily Caucasian women but can affect others as well.
What causes the condition, who is at risk, and how is it treated?
Macular degeneration is an eye disease that causes a partial or complete loss of your central vision. A person's central vision allows them to see things directly in front of them, such as faces, books, or screens. The macula is located in the retina's central portion, in the back of the eye, and contains cone photoreceptors. These densely packed photoreceptors give us sharp, detailed vision. The rest of the retina contains some cones but mostly rod photoreceptors and allows us peripheral vision for mobility.
When the macula is damaged, your ability to enjoy clear vision is negatively affected. Everyday activities like reading or driving can become difficult.
There are two types of AMD: wet and dry. The cone cells die off in dry macular degeneration, and no treatment exists. They cannot be replaced, transplanted, or regrown.
Wet AMD involves leaking fluid from the blood vessels behind the macula. Treatment is directed at stopping those leaks with injections such as Avastin, Leucentis, or Eyelea. Treatment does not restore the lost vision, unfortunately.
Although this condition is irreversible, there is hope. A wide range of optometric low-vision glasses and devices can help AMD patients regain their independence and enjoy a high quality of life.
How IALVS Low Vision Doctors Can Help
The earlier the condition is found, the sooner treatment can begin. That's why an early diagnosis is vital for you or your loved ones.
You can do some things independently to decrease your risk of developing macular degeneration. Quitting smoking, eating healthy meals with green vegetables and "eye-healthy" foods (i.e., orange peppers, kale, and spinach), exercising, and wearing UV-blocking sunglasses are a few examples.
If you have wet macular degeneration, medicated injections or laser therapy may slow down the progression of vision loss. However, these options won't reverse your vision loss; they merely stop it from worsening.
Several low-vision glasses and devices can help improve your vision so that you can enjoy reading, driving, watching TV, running errands, and recognizing the faces of your friends or family. Low vision glasses and devices have proven extremely helpful for patients with macular degeneration.
Macular Degeneration – Helping Patients Perform Tasks
How the IALVS Helps Patients with Macular Degeneration
The Amsler Grid
Your vision might change slowly, so you may not be aware of subtle changes to your vision. Your doctor might ask you to use a special tool called an Amsler grid to check your vision at home.
The Amsler grid below is a simple square containing a grid pattern and a black dot in the middle.
When used correctly, it can show the early signs of changes in your vision.
How do I use an Amsler Grid?
To use the Amsler grid, follow these steps:
- Wear any glasses you normally use to read
- Look at the grid from 12 to 15 inches away and in good light.
- Cover your left eye with your left hand.
- Look directly at the center dot with your uncovered eye, and always keep your eye looking at the dot.
- Do not move your eye while looking directly at the center dot. Notice in your side vision if all grid lines look straight or if any lines or areas look blurry, wavy, dark, or blank.
- Now, follow the same steps by covering your right eye with your right hand.
What should I do if I notice changes on the Amsler grid?
If you notice any areas of the grid that appear darker, wavy, blank, or blurry, contact a low-vision eye doctor immediately.
They will provide a comprehensive low-vision eye exam. Doing this simple at-home eye test can help save your vision.
Treatment for Macular Degeneration
Unfortunately, there is no cure or procedure to replace the damaged macula. The goal of treatment is to stop the breakage and prevent the macula from deteriorating even more. IALVS low vision skilled and caring doctors use their years of experience and state-of-the-art optics and technology to manage your condition so that you can continue doing the things you love.
Evidence suggests that several nutritional supplements, including omega-3 fatty acids, lutein, and zeaxanthin, may help prevent the progression of AMD and may also reduce the chance of dry AMD changing to the wet form.
The medical community and scientific researchers continue to study macular degeneration and run clinical trials, so there is hope for the future. Let the IALVS team of experienced low-vision eye doctors help you get back to doing what you enjoy and continue living independently.
Low-Vision Glasses and Devices for Macular Degeneration
Low-vision glasses and devices can help you manage the condition by enhancing your remaining vision using magnification, filters, and prisms. Telescope and microscope glasses enlarge objects so they can be seen. Prisms sometimes move light away from the macula and onto the peripheral retina. Low-vision devices, such as handheld, mounted, or stand-alone magnifiers, help with reading prices, labels, and other tasks.
Deciding which ones are best depends on what tasks and activities are most important to you. Certain aids help you read a book or watch TV, while other devices help you drive and recognize faces. Your eye doctor will discuss your daily activities and help determine which low vision glasses and devices are right for you.
Using Telescopes to Perform Tasks with Macular Degeneration
Handheld and Desktop Magnifiers
Magnifiers enlarge images and objects, allowing you to see them clearly and in more detail. Many patients find magnifiers excellent for reading, writing, or using a computer. There are also handheld and desktop video magnifiers. These low-vision magnifiers have various strengths, light, color contrast, and magnification capabilities. While some are handheld, others can be connected to the computer.
OrCam is another device changing how people with macular degeneration and other low vision issues perceive the world. The OrCam features a camera, speaker, and a cable connected to a larger device. This tiny device is attached to the patient's eyeglasses. OrCam uses AI technology to help people with visual impairment read texts, recognize faces, identify products, etc. OrCam will give you the secret power over your macular degeneration issues.
Special Binoculars or Telescopes
Special prescription binoculars or telescopes that are mounted on the glasses are useful for various activities such as watching the grandchildren play sports, enjoying the theater, watching television, taking in a baseball or football game, recognizing faces, appreciating the scenery, exploring a museum, reading a menu and lots more.
Full-diameter telescopes are ideal for doing something without too much movement. They are usually excellent devices for enjoying television or seeing and recognizing people's faces in a room. That's because they cover the entire area of the lens, giving you a magnified view with greater detail. This is especially helpful because the inability to identify the people you care about can be pretty painful. After all, there's nothing more satisfying than seeing the faces of the people you love.
Bioptic telescopic glasses magnify and make distant objects more visible. Think of them like miniature binoculars in your eyeglasses above your line of sight. Simply lowering your chin to view through the telescope gives you the magnification you need to see objects or images better.
IALVS low vision doctors often recommend bioptic telescopic glasses to help macular degeneration patients with vision needs while driving. They are also excellent for going to the movies, sitting at a baseball game, or watching a play at the theater.
IrisVision is a wearable device that comes with advanced virtual reality technology. With this, patients with macular degeneration can carry out their daily activities easily. IrisVision offers about a 70-degree field of view. With this, patients can see the world clearly and fully. One disadvantage of iris vision is the inability to walk around while wearing the device. Above all, this low-vision device features multiple view modes depending on the activity you intend to do. Whether you want to watch television, read texts, or have a general view, you can switch between TV, reading, or scene modes. IrisVision provides a cost-effective and efficient way to live a quality life with macular degeneration.
Prismatic eyeglasses is an excellent example of low-vision magnifying reading glasses. Prismatic eyeglasses are extra strong reading glasses. They provide space for a natural, comfortable focal point. Prismatic eyeglasses feature optical quality spherical lenses that magnify and converge the image concurrently. They are helpful as reading aids.
Closed Circuit Television (CCTV) Magnifiers
CCTV magnifier combines a camera and TV screen to provide low vision aid for macular degeneration patients. The camera is pointed at an object while a magnified image will appear on the screen. The patient can see the magnified image on the screen and use it to work in real time.
E-Scoop glasses are specially designed lenses that offer several benefits. They offer 3 to 6 percent magnification, allowing clearer vision. The yellow tint improves contrast, while the orange tint reduces glare. The built-in prisms will shift light away from the central area of the macula to the periphery, where there is often less damage.
Personalized Optical Systems
Our low-vision doctors can recommend customized, prescription optical systems for macular degeneration patients. These optical systems feature microscopic, telescopic, prismatic, and filter lenses to maximize images and objects.
Q&A - A Detailed Look at Macular Degeneration
Can I Drive With Macular Degeneration?
Central vision is essential for driving. Unfortunately, since macular degeneration causes central vision loss, driving becomes difficult or impossible with a central blind spot. Nonetheless, there are low-vision glasses that can help enhance your vision.
This involves mounting a miniature binocular, a bioptic telescope, on your eyeglasses. This will help you drive as you can recognize the color of traffic lights and see street signs. However, it is essential to undergo a specialized training program before you are allowed to drive.
Macular Degeneration and Driving at Night
Can I Read with Macular Degeneration?
Macular degeneration causes a central blind spot, making it challenging to read small print. Moreover, your eyes will continue struggling as you focus on new words. Hence, reading will be very slow. Our low-vision doctors will recommend the right low-vision glasses to enhance your reading abilities. This can include low-vision magnifying reading glasses or prismatic eyeglasses. These low vision glasses will provide high-powered magnification that will lessen the effect of the central blind spot.
How Can I Watch TV With Macular Degeneration?
Furthermore, macular degeneration patients may find it hard to watch TV. Their options are sitting closer to the TV to enlarge and spread the image across a peripheral retina and purchasing a TV with a huge screen and sharper quality for clearer images. Using a telescopic system or other low-vision aids to provide magnification when viewing the television is also an option. These aids feature special tints and coatings to help reduce glare, improve light transmission, and improve contrast.
How Can I See My Phone Better If I Have Macular Degeneration?
Like other activities that require light, patients with macular degeneration may find it difficult to operate their phones. You may have to move your mobile devices very close to your eyes. You can also magnify your fonts to use the phone. When you visit our low-vision center, we recommend low-vision glasses to help enhance your vision while improving light transmission and reducing glare.
How Can I Better Make Out Faces If I Have Macular Degeneration?
Another serious challenge you can face as an AMD patient is making out faces. Due to the central blind spot, every image, object, or face in front of you will appear blurry. Although you can recognize those familiar with using their voice, shape, or walking posture, you will need special low-vision glasses to make out new faces.
What Advanced Technology Is Available For Macular Degeneration?
Technological advances have enabled patients with low vision conditions, such as macular degeneration, to live and work just like individuals with normal vision with the development of telescopic implants called Implantable Miniature Telescope (IMT). These IMTs will help to enhance visual acuity by reducing the effect of the central “blind spot” caused by macular degeneration. In the future, the condition may be managed by using advanced stem-cell treatment procedures.
How Do I Cope With or Manage Macular Degeneration?
Patients with AMD often find it very difficult to adapt to the dark after prolonged exposure to sunlight. Hence, it is advisable to put on dark glasses and hats anytime you go out during the day. Your lenses should also contain special tints and coatings. This will help reduce glare, improve light transmission, and improve contrast. Other tips include:
- When indoors, sit far from the window and shut the curtains.
- Put on sun filters to reduce glare and light sensitivity.
- Read print materials that have fonts of large sizes.
- Reduce direct sunlight exposure.
- Avoid places with second-hand cigarette smoke.
When a Macular Degeneration Patient is Told Nothing Else Can Be Done
Common Symptoms of Macular Degeneration
Perhaps one of the most challenging parts of having macular degeneration is that the symptoms can be attributed to something else or go unnoticed. That’s why it’s essential to be aware of slight changes to your vision.
The most common symptoms of macular degeneration are:
- Blind spots
- Cloudy vision
- Dark spots
- Distorted images
Patients with this condition may experience situations where they see pale colors when the actual colors of the image are brighter or sharper. Straight lines may appear wavy; they may see a gray or dark spot on an image, or the size of an object can seem smaller than its actual size.
The Two Types of Macular Degeneration
As stated above, there are two forms of the disease, known as wet and dry.
Dry macular degeneration is the more common of the two, affecting up to 90% of all patients. In these cases, the cells inside and around the macula become thin and eventually break down. When this happens, small proteins called drusen begin to form. Drusen are a common sign of macular degeneration and are often used to diagnose the disease.
Wet macular degeneration, the less common type, occurs when blood vessels under the retina leak fluid between the layers of the macula. This leakage causes blind spots and central vision loss. Wet macular degeneration is the more serious of the two types because it can develop quickly and causes permanent scars in the eye.
Who is at Risk of Developing Macular Degeneration?
Seniors have a higher risk for developing the condition than other age groups, commonly referred to as age-related macular degeneration, or AMD for short. Although doctors don’t know exactly why, one possible reason is that the eyes change as part of the natural aging process. As the body changes, certain aspects of our health can change with it. The CDC estimates that 1.8 million Americans over the age of 40 have AMD and that this is likely to increase to 2.9 million by 2020. If you’re over 60 and have significant visual impairment, you may have AMD. This eye disease is the primary cause of low vision for seniors. If left untreated, the condition can deteriorate and cause blindness.
Gender is a factor in age-related macular degeneration cases. According to the American Academy of Ophthalmology, women comprise 65% of AMD patients. Some suggest this is because women generally live longer than men, while others believe that a lack of women’s healthcare in certain regions is to blame. Patients with a family history of the disease are also far more likely to develop it. Genetics often plays a crucial role in various health issues, and eye health is no exception.
Other risks for developing AMD include:
- Excessive exposure to UV rays
- Poor diet
- Lack of physical activity
If you or a loved one is experiencing any of these symptoms or there is a history of the disease in your family, speak to an IALVS eye doctor to request a consultation. Our eye doctors can run several diagnostic tests and recommend a personal course of treatment or visual devices to help you.
Although AMD is common among seniors, young children and teenagers can develop a version of the disease, called juvenile macular degeneration, also known as Stargardt’s disease. It is a genetic condition inherited from one or both parents and usually begins in childhood or early adolescence. Stargardt’s disease causes central vision loss.
Juvenile retinoschisis, a form of juvenile macular degeneration, is more prevalent in boys and young men. It can be dangerous because it can lead to retinal detachment. If left untreated, that can lead to permanent vision loss. Vision loss can be particularly traumatic for children and teens because the inability to learn, play sports, or participate in extracurricular activities on par with their peers can seriously impact their lives.