Macular degeneration is the most common cause of blindness in older individuals.
In the ideal circumstances light entering the eye is focused at the back of the eye on the retina. The retina is the visual membrane that covers the back of the eye, much like the film of a camera. Right in the middle of the retina is a small area responsible for the central fine vision, and this is called the macula. This small area is the most sensitive visual area of the macula and responsible for our central fine vision. When we focus straight at an object, i.e. reading, driving or watching TV, we use the macula.
When the macula is involved in disease, our central vision is affected, making daily life very difficult. This is the unfortunate situation in macular degeneration. The macula is affected by age related changes that causes permanent damage to the macula. Due to the fact that central vision is affected patients usually present early, but it is sometimes only found incidentally when a person closes one eye for some reason.
Although all of us are at risk of developing macular degeneration, there is also a genetic predisposition where your risk of developing macular disease is significantly increased if you have a family history of macular degeneration. Lifestyle activities like smoking also increase your risk significantly; just another reason to stop smoking.
Specifically formulated vitamins, minerals, anti-oxidants and omega fatty acids help to lower the risk of visual loss in predisposed individuals. Ocuvite Complete is one example, and should be taken daily. The difficult question though is who will benefit from taking Ocuvite Complete. People who already lost vision in one eye due to macular degeneration should take the medication. Certain changes in the macula like large confluent drusen are also significant risks, and those individuals should also take the medication. Whether family members of patients should take the medication is uncertain, but there are indications that the use of the medication can provide a protective effect of approximately 50 percent.
Macular degeneration includes a whole spectrum of changes at the level of the macula. At the one end is thinning or atrophy, which is largely not amenable to treatment. At the other end of the spectrum is swelling or foveal edema. The swelling leads to progressive loss in central vision due to the enlarging swollen area around the macula. The most common treatment is the use of injections of anti-VEGF (vasco-endothelial growth factor) medication, like Avastin and Lucentis. Repeated injections are indicated in order to prevent vision loss, but the treatment is painless and can be administered in the consulting rooms. The treatment intervals are tapered according to the individuals’ response to treatment, but the underlying fact is that the visual result is better with more frequent injections.
Research is ongoing to improve the treatment modalities for macular degeneration, with the hope of improving the visual outcome of treatment for this very common condition.