Macular Degeneration

Macular Degeneration

Macular degeneration is an eye disease that comes with aging. The center of your eye - the macular - slowly deteriorates, which blurs vision and causes blind spots. There are treatments for macular degeneration - but it's also possible to help prevent it with good sunglasses.

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    Macular degeneration can have complications. Legal blindness can result from advanced macular degeneration, and wet macular degeneration can lead to a detached or scarred retina. This retinal detachment is called subretinal neovascularization and it affects about 20 percent of people who have macular degeneration; it is very damaging to your central vision. Treatment can help prevent complications.
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    Some other illnesses may increase your risk for macular degeneration. Cardiovascular diseases such as heart attack and coronary artery disease as well as a history of stroke or high blood pressure can increase your risk of developing macular degeneration. Managing your cardiovascular disease and other conditions will help prevent macular degeneration.

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    Macular degeneration is an age-related vision problem and the leading cause of blindness in adults over age 60. 
    Today, findings show that macular degeneration affects about 12 million people in the United States. This is about one in four older adults. Worldwide, macular degeneration affects about 50 million adults.
    Macular degeneration is the result of the breakdown or deterioration of the macula, the central part of the retina.  In the eye, the macula works to control central vision. In fact, without the macula, you could not read a book, drive a car, recognize colors or see the intricate details on paintings. 

    With aging, the chances of macular degeneration increase. Also, people who smoke have a higher chance of getting macular degeneration as those who do not smoke. Many feel that long-term exposure to sunlight contributes to this condition. Heredity and nutrition are also thought to play a role.
    Wet age-related macular degeneration (AMD) may be treated with laser surgery, photodynamic therapy, and injections into the eye, although there is no cure for wet AMD. Dry macular degeneration has no effective treatment.
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    In most cases, cataract surgery will not make macular degeneration get worse, especially with dry macular degeneration. With wet macular degeneration, there is a chance that the amount of swelling in the macula can be made worse, but special drops can be used to reduce this risk. The visual improvement may be disappointing if the cataract is minor and the main cause of the decreased vision is macular degeneration. Usually, the retinal specialist can help the patient decide if the cataract is the main problem causing the poor vision or if the macular degeneration is the main problem. In most cases, it is some of both, and it is not always possible to predict how much improvement will take place if the cataract is removed.
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    Cystoid macular edema, commonly called CME, is a disorder that affects the retina, the layer of light- sensing cells lining the back of your eye.

    The retina converts light rays into signals, which are sent through the optic nerve to your brain where they are recognized as images. CME is the presence of multiple fluid-filled, cyst-like (cystoid) structures in the macula, the central part of the retina responsible for central (detail) vision. The result is swelling (edema) of the macula.

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    Although the exact causes of CME are not known, it can be associated with: 
    • Retinal vein occlusion (blockage of a blood vessel in your retina)
    • Uveitis (inflammation of the uvea, the outermost layer of your eye)
    • Diabetes
    • Eye surgery
    • Eye trauma
    • Side effects from medication
    It most commonly occurs after cataract surgery. About 3 percent of all cataract surgery patients will experience decreased vision due to CME, usually within a few months after surgery. If CME occurs in one eye, there is an increased risk that it will also occur in your other eye.
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    Your ophthalmologist (Eye M.D.) may discover you have CME after a thorough medical eye examination, usually after taking special photographs of the eye using fluorescein angiography or optical coherence tomography (oct).

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    The most common symptom of CME is blurred or distorted central vision. CME does not affect peripheral (side) vision. Other symptoms can include pink-tinted or dim vision, or sensitivity to light. Sometimes CME may be present when no visual loss occurs.
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    Depending on the cause of CME, treatment may include some of the following methods:

    • Anti-inflammatory medications, including steroid eyedrops, pills or injections
    • Laser surgery to repair leaky blood vessels
    • A surgical procedure called vitrectomy to remove a substance in the eye called the vitreous (a gel-like substance that fills the body of your eye)

    Fortunately, most patients with CME are successfully treated and vision improves, though the healing process may be slow and take up to several months.


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    A , Geriatric Medicine, answered
    Macular degeneration does not have an age at which it starts. However, age-related macular degeneration is most common in individuals 50 years of age and older. If you have a family history of AMD, a history of smoking, or are of Caucasian race, then your chances of developing AMD are higher. It is important to get regular check-ups with your optometrist to detect any changes.