AGE-RELATED MACULAR DEGENERATION
The tissue lining the back of the eye is called the retina, and is responsible for sensing light and sending images to the brain, where seeing takes place. The macula is the center of the retina and is responsible for all clear, central vision.
Age-related Macular Degeneration (AMD) is a process where the macula breaks down, therefore central vision is affected. Peripheral, or side vision is still retained, so people with AMD can still “get around”. AMD is the most common cause of visual loss over the age of 60. There are two types of Macular Degeneration, “wet” and “dry”. Only 10% of AMD is the “wet” type, called wet because abnormal blood vessels form at the back of the eye, then leak fluid or blood and blur central vision. This vision loss can be rapid and severe. The “dry” form is the result of the tissues of the macula aging and thinning. Vision loss is usually gradual.
Symptoms of AMD include:
- words on a page appear blurred
- a dark or empty area in the center of vision develops
- straight lines look distorted
Your Eye M.D. can diagnose AMD by doing a detailed eye examination. A special test called a fluorescein angiogram may be ordered to aid in diagnosis. Fluorescein dye is injected into the arm, then photographs are taken as the dye passes through the blood vessels in the back of the eye. Dr. Ranz and his staff perform this test in our office.
There is no cure as of yet for "dry" AMD. The National Eye Institute recently conducted a study that indicated certain nutritional supplements may slow the progress of macular degeneration. Dr. Ranz will prescribe these vitamins for AMD patients.
In its early stages “wet” macular degeneration can be treated with laser surgery to seal the leaking blood vessels that damage the macula. If Dr. Ranz thinks you would benefit from this or any other special treatments for “wet” AMD, he will refer you to a retina specialist.
Despite much research, people with AMD will experience some vision loss. However, there are many vision aids available to help people maintain a satisfying lifestyle in spite of visual loss. Magnifying devices, closed-circuit television, and large-print reading materials are a few of the items available, as well as support services and rehabilitation programs. Vickie, here at SREC, has a special interest in Low-Vision, and she and Dr. Ranz will prescribe optical devices and services to help patients cope with this disease.
The retina is a layer of nerves lining the back of the eye which senses light and transmits images through the optic nerve to the brain. When the retina is pulled out of its normal position, it is called a retinal detachment. This is a very serious condition, causing blurring of vision and possibly leading to blindness if left untreated.
As the eye ages, the vitreous gel that fills the eye may pull away from the retina. If it pulls away hard enough, this may tear the retina, allowing fluid to pass through the tear. Symptoms of a retinal detachment may include flashing light or new floaters in the visual field, or a gray "curtain" moving across the visual field. These symptoms do not always indicate retinal detachment, however a complete exam by Dr. Ranz will determine the cause of the problem.
Retinal tears can be treated with laser surgery to seal the retina to the back wall of the eye. This is an outpatient procedure that can be performed in our office. There are several surgical options for treatment of a retinal detachment. Dr. Ranz will explain the options and refer you to a retinal specialist if it is determined that surgery is needed.
Retinitis pigmentosa (RP) is a group of hereditary diseases which cause a progressive loss of vision, as the nerve cells in the retina are destroyed. Common symptoms of this condition are loss of peripheral vision and night blindness.
In the early stages of RP, daily administration of specific amounts of Vitamin A under a medical doctor’s supervision may slow progress of this disease. Regular eye exams by an Eye M.D. will ensure early detection and allow for treatments to begin as promptly as possible.
CYSTOID MACULAR EDEMA
Cystoid macular edema is a condition characterized by cysts that form on the macula (the central area of the retina) as a result of retinal swelling (edema). This may occur after cataract surgery, causing decreased vision. Symptoms develop slowly and include blurred or decreased central vision. Any change in vision after cataract surgery should be evaluated by an Eye M.D.
One treatment method having a high rate of success is the use of anti-inflammatory drugs. Research is still being conducted, which hopefully will lead to prevention and improved treatments.
FLOATERS & FLASHES
Floaters are small specks in the visual field. They are actually tiny groups of cells floating in the clear fluid (vitreous gel) that fills the eye. Although they appear to float in front of the eye, they are inside the eye, and can have different shapes. Floaters can be caused by a thickening of the vitreous gel, and are more common as people reach middle age. As the vitreous gel thickens, it can pull away from the back wall of the eye. This is known as posterior vitreous detachment, and can cause the retina to tear. A torn retina can lead to retinal detachment, and should be treated by your Eye M.D. immediately. If new floaters appear suddenly, it is important to see your Eye M.D. as soon as possible to determine whether the retina is torn.
Flashes, or flashes of light in the visual field, are caused by the vitreous gel rubbing or pulling on the retina. These are more common as the eyes age, but can also be caused by a torn retina.