During my latest eye exam, my doctor said that there are changes to the pigment in my eyes and this means that I might develop macular degeneration in the future. Can you explain this to me? I have no symptoms other than this pigment change [ 03/19/11 ]
Early signs of age-related macular degeneration (ARMD) include pigment changes in the central part of the retina known as the macula. However, a certain quantity of pigment change, or other factors (or other signs) is required to make a formal diagnosis of ARMD. The exact cause of ARMD is not known, but pigment changes may be a sign of irritation or injury to the part of the eye underneath the retina, called the retinal pigment epithelium. Not all people with pigment changes go on to develop ARMD, however. It is important that you continue your yearly eye exams so any potential eye disease can be caught early.
Is it possible for an individual who has been diagnosed with age-related macular degeneration to have days on which vision temporarily improves? [ 03/18/11 ]
Visual clarity varies based on a variety of factors. While dry age-related macular degeneration (ARMD) is typically expected to cause very gradual worsening of central vision in the eye, other factors can cause vision to temporarily improve. One example of such a factor is hydration of the cornea. A better hydrated cornea can result in temporary visual improvement, and this effect can be mimicked by the use of artificial tears. Also, if a person has diabetes, vision may appear better on days when blood sugar is properly controlled and in a healthy range.
My husband has macular degeneration in both eyes. Should he have eye injections only when bleeding starts, or should he have shots every 6 – 8 weeks to prevent the bleeding from starting in the first place? [ 03/17/11 ]
If your husband has the wet type of age-related macular degeneration (ARMD) he can be treated with Lucentis or Avastin eye injection. The treatment schedule varies, and can be from 2 – 8 weeks, depending on a variety of factors. The most common schedule involves treatment once monthly for 3 months and then extended per the instructions of the retina specialist. No one treatment schedule is appropriate for all patients. Waiting for recurrent bleeding before retreatment would likely result in lower vision when compared to preventing bleeding with scheduled treatments.
My mom was diagnosed with macular degeneration and has been receiving eye injection treatments. The doctor hopes to contain the disease in her right eye; however, she says there is no hope for the left eye at all. Would it also make sense for her to have injections in the left eye in an effort to prevent the degeneration from getting worse? [ 03/15/11 ]
The wet type of age related macular degeneration (ARMD) is typically treated with eye injections with Lucentis or Avastin. If the wet ARMD has progressed to the point where a scar has formed, the eye injections will not have any further benefit. Since every injection can be uncomfortable and is associated with a small risk of complications, it is important not to undergo treatments that do not provide any definitive advantage. Please clarify with your retina specialist if the eye injections would have any beneficial impact on the expected slow central visual deterioration in your mother's left eye.
My daughter is 20 years old, and she developed a blind spot, so I took her to see an optometrist. He said that an artery was pushing through her retina, and was seeping blood. He said that it was like macular degeneration. I would like to know what would cause these symptoms in such a young person. [ 03/14/11 ]
Age-related macular degeneration is extremely uncommon before the age of 50. Bleeding in the retina can signify many problems, some of which are serious, such as blood cell disorders, clotting problems, inflammation of the blood vessels etc. If your daughter truly has bleeding in the back of the eye it is important that you promptly have her evaluated by an ophthalmologist to determine the cause, provide advice concerning further medical tests that are needed, and to what treatment(s), if any, are appropriate.
I am confused and frightened! Approximately 12 years ago I was told that I had age-related macular degeneration (ARMD) and was immediately given the dye test. Then, 4 years ago, I was told that I did not have ARMD, but rather an epiretinal membrane. After my eye surgery for the epiretinal membrane, I then developed a macular hole, which only closed somewhat. This was followed by an injection of a gas bubble into my eye, and 12 days of lying face down. This trauma was followed by cataract surgery on both eyes. The vision in my right eye is 20/50, and 20/20 in my left eye. I was recently told that I was developing ARMD and given a prescription for progressive lenses. I can see no better; small letters and the computer give me particular problems. In view of the above, would you recommend a second opinion? [ 03/10/11 ]
You describe several issues with your eyes, including possible age-related macular degeneration (ARMD), epiretinal membrane surgery, macular hole surgery, cataract surgery, and need for progressive lenses (presbyopia). Your underlying complaint sounds like it is related to having a difficult time reading and using the computer, which could be due to a variety of reasons that are related to your ocular history. Your bothersome visual symptoms may be due to something as simple as your glasses prescription, or to something more complicated like progressive ARMD. It is very reasonable to get a second opinion from a local retina specialist or from a university medical center. Provide the new doctor(s) with all of your previous records as that will expedite the process of obtaining their advice.
I am seeking a cure for a longstanding case of diabetic cystoid macular edema. Can you tell me about any treatments or cures that are available for this eye disease? [ 03/03/11 ]
Longstanding diabetic cystoid macular edema can be very difficult to reduce or eliminate. Treatments include tight control of blood sugar, laser therapy, steroid injection, anti-VEGF injections, or a combination of one or more of these options. Many have these therapies have demonstrated moderate levels of success for patients with diabetic macular edema. However, in cases of longstanding diabetic edema, even if the fluid resolves there can be permanent damage to the retina that prevents much visual improvement. Currently, no treatments exist to repair this structural damage to the retina after longstanding macular edema.
I have wet macular degeneration and have received 6 Avastin injections thus far. At the end of December, I suffered a stroke, which was described as a right ventricular infarct. My primary care doctor has told me to stop the injections immediately as he believes they are the cause of the stroke. My retina specialist told me that it is my choice as to whether or not I wish to continue the treatments. I am 57 years old and drive for a living. If I stop the injections, do I have other options that will help save my sight? Thanks. [ 03/02/11 ]
The question you ask is extremely complex and currently the research does not exist to give a definite answer. Intraocular injections of anti-VEGF agents such as Avastin and Lucentis have been linked to a slightly increased risk of stroke. To say that Avastin was the only cause of your stroke however would likely not be accurate.
There are other alternatives to Avastin and Lucentis injections for wet macular degeneration, such as Macugen injections and photodynamic therapy; however, the results in preserving and improving vision with these therapies are not as good. Please discuss with your retina surgeon if a temporary cessation of Avastin might be in order, so that you might try an alternative therapy, such as Macugen.