Ask an Expert about Macular Degeneration

The eye chart measures distance vision, which is different from near or reading vision. After the age of 40 – 60, aging of the natural lens causes near vision to slowly decline. This can typically be corrected with reading glasses. If your mother cannot read despite a current spectacle correction including a reading correction, something else may be going on with her eye. She could have changes from age-related macular degeneration that were not noted during the eye examination, but do limit her ability to read. Please talk further with your mother's eye doctor as to why she cannot read while using corrective eyeglasses.

Myopic degeneration is a poorly understood change that occurs in eyes of very nearsighted individuals. In both myopic degeneration and age-related macular degeneration (ARMD) new blood vessels can form in the center of the retina (called the macula). These blood vessels can leak and bleed causing a rapid decrease in clarity of central vision, which is often treated with eye injections such as Avastin. Usually the new blood vessels in myopic degeneration are less aggressive than those found with ARMD. To monitor for recurrence of these blood vessels you should use an Amsler grid as instructed by your eye doctor at least once weekly. The growth of these new abnormal blood vessels cannot be prevented, but can be treated with Avastin injections if they recur. No vitamins or nutrition programs have been identified as helpful for people with myopic degeneration to prevent loss of vision.

The fluid leaking out of the eye can cause changes in the eye pressure. If the eye pressure falls beneath a certain point, the eye will start to lose the normal shape, which can cause blurred vision. If the fluid is no longer leaking from the cataract surgery wound, the eye will quickly regain normal pressure and the blurred vision will resolve. No definitive link as been established between cataract surgery or wound leaks after cataract surgery and progression of age-related macular degeneration.

Visual distortion in patients with dry age-related macular degeneration (ARMD) is frequently related to the conversion to the wet form of the disease. You might have early ARMD and may benefit from evaluation by your eye doctor. A small region of distortion can be caused by a variety of reasons, but several of them are vision threatening. The possibility of a vision threatening process such as wet ARMD merits an evaluation to help you sort out what exactly might be causing your distortion.

Yellow-white spots, called drusen, are a common finding in macular degeneration. A type of drusen can also be found in eyes without age-related macular degeneration, and these particular drusen are considered normal. Age-related macular degeneration typically does not present before 55 years of age, so your wife may have these drusen. The white spots could be from a variety of other processes, some harmless and others very concerning. Please speak to your eye doctor about the white spot finding and its significance.

It is clear that age-related macular degeneration (ARMD) has a genetic component. If your mother has ARMD, you are most likely at increased risk of eventually developing the disease, and this risk may extend to your children when they get older as well. The exact amount of increased risk from a family member with ARMD is not conclusively known, and depends on the severity of disease in the affected family member. The closer the family member and the more advanced the disease, the higher the risk to close relatives.

The OCT test has minimal risk and is very comfortable. You will place your chin on a chin rest and be asked to look at a light. The actual OCT picture taking process should take less than a minute, and involves a dim light focused in your retina. An OCT test is a valuable ancillary test for management of a variety of retinal diseases and will be very helpful to your retina specialist.

The fluorescein angiography test involves the injection of a dye into your veins to monitor for any problems of the retinal blood vessels. The procedure involves a small needle stick. Side effects to the dye or procedure are rare, but most commonly involve nausea. Very rarely someone can have an allergic reaction to the dye which can be life threatening. Please speak to your retina specialist about the risks of any study prior to undergoing the actual test.

The question you ask is a great source of controversy among the scientific community. In some clinical trials involving Lucentis, receiving the injection was associated with a slightly higher risk of vascular events such as heart attack and stroke. This risk was not seen in other trials. After discussing this with your retina specialist and cardiologist, you will have to weigh the substantial benefits of Lucentis therapy for the eye with the potentially increased risk of another vascular event. Alternative therapies to Lucentis exist, and you can talk with your eye doctor concerning these options.