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What is Macula?

Macula is located at the central area of your retina. It is a tiny part consisting of light sensing cells that are responsible for your sharp central vision. This part is responsible to send sharp images to your brain hence giving you clear vision that assists you in your daily activities like reading, driving etc.

What is Age Related Macular Degeneration?

The condition of your macula can deteriorate with age and can affect your sharp central vision. This deterioration process is called Age Related Macular Degeneration. As the name suggests, it usually occurs in people above 60 years of age.

It is one of the most common causes for decreased vision in old age. Available literature reveals that 8.7% of all cases of blindness globally contributed by AMD. It is the primary cause of visual impairment in industrialized countries. [1,2] It has been estimated that eight million people will be affected with AMD worldwide by the year 2020

What are the symptoms of ARMD?

  • The primary symptom of ARMD is distortion in your sharp central vision.

  • Other symptoms include dark spots appearing in your central vision

  • The peripheral vision is not affected to a great extent

  • In advanced stages of ARMD, it includes difficulty in recognising a person's face

  • In rare advanced cases, it may lead to permanent loss of vision.

What are the types of ARMD?

Dry Macular Degeneration (Atropic)

This is the more common type of Macular Degeneration that occurs because of thinning of the tissues of the Macula. It has almost no treatment options and can be more damaging. It has a direct effect on your central vision so it is advisable to consult your doctor if you find any changes in your central vision. In this case, the loss of vision is gradual.

 

Wet Macular Degeneration (Exudative)

This is a less common type of Macular degeneration and accounts for only about 10% of the cases. In the wet type of macular degeneration, the abnormal blood vessels form under the retina, near the macula and leak eye fluid or blood. The abnormal growth of these blood vessels is called Choroidal Neovascularization (CNV). The leakage of eye fluid or blood directly affects your central vision, thus leading to a rapid loss of vision.

How can we prevent ARMD?

  • The exact causes for Age Related Macular Degeneration are hard to determine, but it is highly recommended to visit a consultant eye surgeon regularly after the age of 40.

  • Although the exact cause of Macular Degeneration is not known, some activities that may cause it can prevent the development of macular degeneration

  1. Smoking - Excessive smoking is known to be one of the strongest causes for macular degeneration

  2. Hypertension - Uncontrolled Hypertension is also one of the leading causes for macular degeneration

  3. Direct Sunlight - Prolonged exposure to direct sunlight is considered as a direct cause for macular degeneration

  4. Unhealthy Diet - A healthy diet plays a very important role in avoiding macular degeneration.

  5. Genetics & Gender - Both these factors play a major role in macular degeneration. Transfer of genes in families can lead to macular degeneration. It is considered that females are more affected than men.

What are the tests to determine Macular Degeneration.

  • Macular Degeneration can be detected in its early stages during your routine eye check-ups. It is highly recommended that you get it treated in its early stages.
  • There are a couple of tests that help you determine the condition of your Macula

  1. Visual Acuity Test

  2. Amsler Grid

  3. Dilated Eye Check-up

  4. Optical Coherence Tomography

  5. Fluorescein Angiogram

What are the treatment options for Age Related Macular Degeneration?

  • All the treatment options for Age Related Macular Degeneration can only reduce the further impact to vision and prevent loss of Vision. It cannot restore the already lost vision. ​​

Dry ARMD

 

In the early stages of dry type, treatment options are limited but are known to slow the progression of degeneration. In this case, a combination of multivitamins and antioxidants such as lutein and Zeaxanthin are known to give good results in preventing further loss of vision. Some known fruits and vegetables for good source of  lutein and Zeaxanthin are spinach, tomatoes, carrots, broccoli and dark green leafy vegetables. In the advanced stages, there are almost no treatment options for macular degeneration.

Wet ARMD

 

Wet type of Macular Degeneration can be treated with laser treatments, certain medications or injections to the eye. But this can only reduce the loss of vision and cannot completely treat wet macular degeneration. New pharmaceutical treatments in the form of Anti-Vascular Endothelial Growth Factors (Anti - VEGF) have overtaken previous photocoagulation approaches.  

 

Anti VEGF Injections

 

These injections target and block a certain chemical in your body that is critical in aiding the growth of abnormal blood vessels called Vascular Endothelial Growth Factor (VEGF). Avastin, Lucentis and Macugen are a few common anti-VEGF drugs that are effective in preventing further vision loss. This is an advanced and recent development in the field of eye care.

 

Laser Photocoagulation

 

Laser therapy can only be used in wet macular degeneration cases. It uses a high energy beam of light to target the leaking blood vessels and prevent further growth that leads to prevention of loss of vision. However, the laser can affect a few surrounding healthy tissues and a part of your vision. Hence it can be recommended on case to case basis if it proves a viable option of treatment.