What is macular Degeneration?
Age-related Macular Degeneration (AMD) is the commonest cause of blindness in Australia. It affects central vision and makes it difficult to read or recognize faces. It is a degenerative disease of the central retina (called the macular) that generally affects people older than 50.
- Dry macular degeneration: causes gradual loss of vision over years, however, it can convert to the wet form. A select group of patients may benefit from taking vitamins to slow the progression of dry macular degeneration- ask Dr Wright if you should take vitamin supplements.
- Wet macular degeneration: can cause rapid loss of vision as abnormal vessels grow into the retina and bleed. This can be treated with injections into the eye that cause the abnormal vessels to regress and help the blood to clear. However, unless treatment is commenced promptly scar tissue will form and vision loss will become permanent.
Early presentation to your ophthalmologist after
Noticing the signs of
Wet macular degeneration is the key to maintaining vision
Patient vigilance is the most important aspect of the management of macular degeneration. It is vital that patients present to their ophthalmologist when they notice the symptoms of wet macular degeneration. The sooner the diagnosis is made and treatment is commenced the better the chance of restoring vision.
- Symptoms to monitor for:
- if macular degeneration converts to the wet form it will be completely painless.
- The initial symptoms will be a faint central blurring or distortion in one eye.
- If the other eye has good vision this is difficult to notice.
- For this reason it is important to monitor your vision with an Amsler Grid.
How do I do the Amsler test?
- Perform the test once a week.
- Use your reading glasses to perform the test.
- It is vital that you cover one eye at a time during the test.
- Hold the Amsler Grid at a comfortable reading distance.
- Stare at the dot in the centre of the grid.
- Continue to stare at the central dot and confirm that the lines around it are straight and that there are or are no crooked or missing lines or blurred areas?
- Repeat the test with the other eye.
Normal Amsler Grid.
Changes in the Amsler Grid may appear like this.
If you notice changes in the Amsler Grid you need to arrange to see your ophthalmologist within the week.
How is the diagnosis confirmed?
Your ophthalmologist will undertake a complete examination of your eye. In particular two investigations help make the diagnosis.
- Fluorescein Angiogram: must be performed to make the diagnosis. A special dye is injected into a vein in your arm. The dye travels to the eye and a camera takes photos of the dye as it reaches the small blood vessels at the back of the eye. If the dye leaks from the abnormal vessels it confirms the diagnosis of wet macular degeneration.
- Ocular Coherence Tomography: is a high tech laser-scanning device that can detect fluid that has leaked out of abnormal vessels and is causing swelling of the retina. It is vital to monitor the effect of treatment.
Dr Wright will perform the above tests
with NO OUT-OF-POCKET expense to you
Lucentis is a new medication that is highly successful in treating up to 90% of cases of wet Macular Degeneration. It inhibits the growth of the abnormal blood vessels and helps dry up the fluid that has leaked into the macular.
Lucentis must be given as an injection into the eye. This injection is performed in the clinic. Most patients experience some mild discomfort for about 24 hrs after the injection. However, the injection itself is generally painless.
Unfortunately Lucentis is not a cure. It is a treatment and must be given every month. Some patients will eventually be able to stop having injections or may be stablised with 3-4 a year. However, other patients may need an injection every month for the rest of their life in order to avoid going blind.