Age-Related Macular Degeneration
Macular degeneration is a breakdown of the macula—the small area lining the inside back of the eye that allows us to see straight ahead. The macula is used for seeing fine details and is important for reading, writing, threading a needle, or driving. Macular degeneration can make any activity that involves fine detail difficult or impossible.
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Two Forms of Macular Degeneration
Dry Macular Degeneration
Symptoms of Dry
- The “dry” type is the most common causing gradual vision loss over several years.
- Printed words appear increasingly blurry
- Colors appear less bright
- Recognizing faces becomes more difficult
- Overall vision becomes increasingly hazy
- A blurred or blind spot in the center of vision appears, and the sharpness of central vision decreases dramatically
- Scanning eyes all around an object becomes necessary to provide a more complete image
Wet Macular Degeneration
Symptoms of Wet
- Vision becomes distorted — straight lines appear wavy or crooked, objects appear farther away than they are
- Central vision is decreased or lost
- A blurry spot appears in the center of vision
- However, one out of six people that have the dry kind will convert to the “wet” kind, which can cause severe vision loss in a short time, often just a few weeks. Fortunately, vision loss can often be limited if wet macular degeneration is caught and treated quickly.
People with macular degeneration may notice rapid onset of symptoms, slight symptoms that progress gradually, or no symptoms at all. Physicians may decide to test for the disease based on family history and any symptoms the patient is experiencing. A thorough eye examination is performed in which the physician looks for abnormalities in the back of the eye, in a portion of the retina called the macula.
Shoreline Vision offers the latest treatments for patients with macular degeneration, including new injectable drug therapy. The goal of these treatments is to preserve current eyesight and prevent future vision loss.
A retinal detachment is commonly preceded by a posterior vitreous detachment which gives rise to these symptoms:
- flashes of light (photopsia) – very brief in the extreme peripheral (outside of center) part of vision
- a sudden dramatic increase in the number of floaters
- a ring of floaters or hairs just to the temporal side of the central vision
- a slight feeling of heaviness in the eye
Although most posterior vitreous detachments do not progress to retinal detachments, those that do produce the following symptoms:
- a dense shadow that starts in the peripheral vision and slowly progresses towards the central vision
- the impression that a veil or curtain was drawn over the field of vision
- straight lines (scale, edge of the wall, road, etc.) that suddenly appear curved (positive Amsler grid test)
- central visual loss
Retinal detachment is a disorder of the eye in which the retina peels away from its underlying layer of support tissue. Initial detachment may be localized, but without rapid treatment the entire retina may detach, leading to vision loss and blindness. It is a medical emergency.
The retina is a thin layer of light-sensitive tissue on the back wall of the eye. The optical system of the eye focuses light on the retina much like light is focused on the film in a camera. The retina translates that focused image into neural impulses and sends them to the brain via the optic nerve. Occasionally, posterior vitreous detachment, injury or trauma to the eye or head may cause a small tear in the retina. The tear allows vitreous fluid to seep through it under the retina, and peel it away like a bubble in wallpaper.
Shoreline Vision offers the latest treatments for patients with a detached retina including Cryotherapy (freezing), Scleral buckle, Pneumatic retinopathy, and Vitrectomy.
Special Testing for Macular Degeneration
How to Use the Amsler Grid
- Wear your normal reading glasses or wear bifocals, using the portion for near vision.
- Place the grid on a flat surface you see frequently, such as the bathroom mirror or refrigerator door.
- Cover one eye and look at the central black dot with the other eye.
- While looking at the central dot you should be able to see the four corners of the square. Note that the large square is made up of many smaller squares.
- The first day you look at the grid, mark with a pencil any distorted areas and any blank, gray, or blurry spots. This is your baseline pattern.
- Then look at the center of the grid every day. It is very important that you call for an appointment the very day you notice any changes in the pattern: wavy lines, distortions, enlargements of blank spots, and new blank spots. Our receptionists are aware of these kinds of problems and will arrange to have you seen as soon as possible.
Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness in American adults. It is caused by changes in the blood vessels of the retina.
In some people with diabetic retinopathy, blood vessels may swell and leak fluid. In other people, abnormal new blood vessels grow on the surface of the retina. The retina is the light-sensitive tissue at the back of the eye. A healthy retina is necessary for good vision.
If you have diabetic retinopathy, at first you may not notice changes to your vision. But over time, diabetic retinopathy can get worse and cause vision loss. Diabetic retinopathy usually affects both eyes.
Optical coherence tomography (OCT), is a novel, non-invasive, non-contact diagnostic modality that produces high resolution images of the retinal architecture.
In patients with choroidal neovascularization (CNV) OCT images can show the choroidal neovascular membrane adjacent to the retinal pigment epithelial (RPE) layer. The membrane usually appears as a highly reflective, multilayered area disrupting the RPE/choriocapillaris layer and the photoreceptor outer segments. The focal increase in retinal thickness, subretinal fluid, serous retinal detachment, and RPE detachment can be visualized with OCT.
Fluorescein Angiography is a diagnostic test that provides visualization of the retinal blood circulation. This test provides the ophthalmologist with information that can be obtained with no other testing modality.
Sodium fluorescein dye is injected into a vein in the arm or hand of the patient. As the dye travels through the circulatory system of the body, a retina camera with special filters in place is used to photograph the transit of the dye through the retinal circulation.
WHAT ARE THE SIGNS AND SYMPTOMS?
Likely to have blurred vision, making it hard to do things like read and drive. In some cases, the vision will get better or worse during the day.
As new blood vessels form at the back of the eye as a part of proliferative diabetic retinopathy (PDR), they can bleed (hemorrhage) and blur vision. The first time this happens, it may not be very severe. In most cases, it will leave just a few specks of blood, or spots, floating in a person’s visual field, though the spots often go away after a few hours. These spots are often followed within a few days or weeks by a much greater leakage of blood, which blurs vision. In extreme cases, a person will only be able to tell light from dark in that eye. It may take the blood anywhere from a few days to months or even years to clear from the inside of the eye, and in some cases the blood will not clear. These types of large hemorrhages tend to happen more than once, often during sleep.
WHAT ARE THE TREATMENTS OF DIABETIC RETINOPATHY?
Shoreline Vision offers the latest treatments for patients with a Diabetic Retinopathy including panretinal photocoagulation, scatter laser treatment and vitrectomy.
Shoreline Vision’s Retina Doctors
Shoreline Vision’s doctors have vast experience in detecting and treating retinal diseases. In addition, they are equipped with the latest tests that can detect retina issues as early as possible. If you have a family history of retina issues, see one of our doctors.