Andrew Greenberg, MD is a board-certified ophthalmologist skilled in advanced cataract and invasive glaucoma surgery.
Macular degeneration causes vision loss and primarily affects people age 65 and older. The condition affects the macula, the sensitive part of the retina responsible for sharp, central vision. There are two major types of age-related macular degeneration (AMD), dry and wet. The dry type is more common, accounting for about 90% of cases. For most patients with macular degeneration, vision loss is gradual. There is no known cure, so treatment focuses on delaying the progression of the disease.
While the precise cause behind macular degeneration remains unknown, there are factors that increase a person’s risk for developing this eye condition. Some of these factors include advancing age, having a history of smoking or heart disease, and having a family history of macular degeneration.
Patients with macular degeneration should consume a healthy diet rich in vitamins C and E, carotenoids, and zinc. This includes fruits and vegetables that contain green, orange, and yellow pigments. Processed and fried foods, high-fat meats, and refined carbohydrates like white bread and rice should be avoided.
The timeline to vision loss is variable and depends on factors like the stage of the disease—early, intermediate, and late-stage—and the type of macular degeneration a patient has (dry versus wet). The good news is that since most people with macular degeneration have the dry form and do not reach the late-stage, they are able to maintain good vision their entire life.
There are several things you can do to help prevent macular degeneration, such as quitting smoking, adopting an antioxidant-rich diet, maintaining a normal blood pressure, and scheduling regular eye exams.
There is a hereditary or genetic component to macular degeneration. This is supported by the fact that having a parent or sibling with macular degeneration doubles your risk for developing the disease compared to someone with no family history of macular degeneration.
The term atrophy means deterioration or wasting away that leads to a loss of function. Dry or "atrophic" age-related macular degeneration occurs when the layers of the macula gradually thin out, leading to a loss of central vision.
Central vision is needed for activities including driving, reading, watching TV, and seeing other details sharply and clearly. It is controlled by a small area of the retina called the macula. Macular degeneration causes central vision loss, resulting in difficulties seeing straight ahead (though one's side or peripheral vision remains intact).
Drusen are small yellow or white spots or deposits that form under the retina. They represent debris from cells in the eye and often cause no symptoms. However, the presence of a large number of drusen (detected on a dilated eye exam) may be an early sign of macular degeneration.
The macula is an oval-shaped area found in the center of the retina (the back layer of the eye that transmits signals to your brain). The macula is responsible for all of your central vision, allowing you to see sharply and clearly, and to perform everyday tasks such as reading, driving, and seeing objects in detail.
Vision loss refers to a loss of the ability to see. It may occur gradually or suddenly, affect one or both eyes, and involve a small or large part of a person's field of vision. Vision loss is common among older individuals and is most commonly caused by macular degeneration, cataracts, glaucoma, and diabetic retinopathy.
Age-Related Eye Disease Study 2 Research Group. Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration. JAMA. 2013;309(19):2005. doi:10.1001/jama.2013.4997
American Macular Degeneration Foundation. Dry vs wet age-related macular degeneration.
American Academy of Ophthalmology. Vision loss, central. Updated December 9, 2015.
Pelletier A, Rojas-Roldan L, Coffin J. Vision loss in older adults. Am Fam Physician. 2016 Aug 1;94(3):219-226.
Warwick A, Lotery A. Genetics and genetic testing for age-related macular degeneration. Eye (Lond). 2018;32(5):849-57. doi:10.1038/eye.2017.245
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