Author: Dr. Ricardo Kotliroff
Macular degeneration is a disease causing loss of sharp, detailed central vision, which is needed for reading and driving.
Causes & Risk Factors
Macular degeneration, which is caused by death of light-sensing cells in the macula, a part of the retina located in the back portion of the eyes, tends to occur in individuals at least 50 years of age. Furthermore, macular degeneration is a main reason for vision loss in people who are at least 65 years of age. For these reasons, the disease also is called age-related macular degeneration.
Age-related macular degeneration may occur in families. Variants of certain genes, called complement factors, are related to development of age-related macular degeneration. Approximately 20 different genes may increase the risk of macular degeneration.
Furthermore, women, Caucasian people, and people with light colored eyes are at higher risk of age-related macular degeneration. Other risk factors for macular degeneration include smoking, exposure to certain medications, over-exposure to sunlight, high blood pressure, insufficient physical activity, and obesity.
Most new cases of macular degeneration occur in people over 80 years of age.
An estimated 30% of individuals 75 to 85 years of age have macular degeneration. An estimated 10% of people 66 to 74 years old have macular degeneration. Less than 1% of individuals who are at least 60 years of age have macular degeneration.
Types of Macular Degeneration
Types of macular degeneration include dry (also called non-neo-vascular), the more common form, or wet (neo-vascular, meaning abnormal presence of new blood vessels). An estimated 85% to 90% of patients with macular degeneration have the dry form.
Dry macular degeneration, which is an early stage of the illness, occurs due to aging and thinning of tissues of the macular, deposition of pigment in the macula, or both processes. Drusen, yellow spots, form inside and surrounding the macula.
In wet macular degeneration, retinal cells do not get enough oxygen, resulting in formation of new blood vessels that can leak blood and fluid beneath the retina. Light-sensitive retinal cells are permanently damaged by the leakage, leading to death of the cells, scarring, and the occurrence of blind spots in the central part of vision.
Stages of Macular Degeneration
In early stage macular degeneration, drusen of medium size are noticeable below the retina. In intermediate stage macular degeneration, drusen are larger, changes in pigmentation of the retina may have started, and some vision loss, including requiring more light to see or blurred vision, may have occurred.
In late stage macular degeneration, which can occur with either the dry or wet type of the disease, loss of vision is apparent.
Prevention of macular degeneration includes wearing sunglasses with lenses that protect eyes from UV rays and high-energy visible radiation from the sun; eating a healthy diet including green vegetables, fruit, olive oil, and fish; having normal blood pressure and normal levels of cholesterol in the blood; engaging in regular exercise; and not smoking cigarettes.
Symptoms of Macular Degeneration
Symptoms of macular degeneration may include difficulty seeing and reading and distinguishing colors.
In dry macular degeneration, patients may observe shadows, fuzziness, or distortions in central vision.
In wet macular degeneration, patients may have more severe loss of central vision.
Complications of macular degeneration can lead to inability to read, difficulty writing, difficulty seeing faces, inability to drive, problems performing close work, and loss of sight. Wet macular degeneration tends to cause more serious loss of vision than does dry macular degeneration.
In some cases, the disease progresses rapidly and may lead to a loss of vision in both eyes. Other patients experience slow progression of macular degeneration.
Diagnosis by an ophthalmologist includes evaluation of symptoms, vision, and the eye. Regular comprehensive eye exams, including determining vision at distances and retinal examination on dilated eyes, can detect macular degeneration before the disease causes vision loss. An Amsler grid can measure central vision.
If the ophthalmologist detects an accumulation of drusen, which are yellowish spots, in or surrounding the macula, dry macular degeneration is diagnosed. Moreover, the ophthalmologist looks for changes in pigmentation below the retina.
When blurriness or distorted central vision is detected, a fluorescein angiography test can examine blood vessels that surround the macula to determine if any of the blood vessels are leaking.
Optical coherence tomographic imaging utilizes light waves on dilated eyes to take an image of the tissues of the eye.
Traditionally, early dry macular degeneration is a watch-and-wait condition.
In patients with intermediate dry macular degeneration, conventional treatment with certain nutritional supplements may slow progression to the more serious type of macular degeneration and slow loss of vision in patients with dry macular degeneration. The nutritional supplements contain antioxidant vitamins, multivitamins, lutein, and zeaxanthin. Eating salmon and other coldwater fish containing high levels of omega-3 fatty acids is recommended. Also, eyeglasses may be prescribed. In addition, healthy changes in lifestyle, such as increasing physical activity, eating a healthy diet, not smoking, and avoiding exposure of the eyes to UV light from the sun may slow progression of dry to wet macular degeneration.
The goal of conventional treatment for advanced wet macular degeneration is the stopping of growth of new blood vessels in the retina. Treatment approaches towards this goal include photodynamic therapy (PDT) to destroy abnormal blood vessels; laser photocoagulation to destroy leaking blood vessels; and the injections of medications, Lucentis, Avastin, Eylea, Macugen, and Visudyne into the eye. Surgical implantation of a telescopic lens into one of the eyes can help vision. Magnification devices can help with reading, and keyboard commands and voice systems can help with using computers.
However, current conventional treatment does not cure macular degeneration.
Alternative therapies include homeopathy, which is an effective method of healing acute and chronic conditions, as claimed by millions of patients worldwide and thousands of homeopathic doctors.
Our proprietary therapeutic methods are based on a belief that all humans possess certain foundational energy sources within their core, and that a person’s energy balance is tied directly to his/her state of health and wellbeing. When these energy sources are disturbed, whether from internal or external forces, disease occurs.
Our homeopathic treatments seek to neutralize these disturbances and restore a person’s natural, optimal energy balance.
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