I am 61 years old and have been diagnosed with intermediate macular degeneration. My doctor wants me to take the AREDS formula, but I cannot tolerate it because it causes bruising and broken blood vessels. Also, I'm afraid of the “toxic” levels of some of the AREDS ingredients. My doctor gets very mad at me when I say I cannot tolerate the formula. Which of the vitamins in AREDS could be causing the bruising? My grandfather was a bleeder. Thank you for your help. [ 08/29/11 ]
You are correct in thinking that the AREDS trial used higher than normal levels of some vitamins. The most common side effects during the trial were slightly increased rates of urinary tract diseases, anemia, and tooth discoloration in patients using the AREDS vitamins. Increased bleeding or bruising rates were not reported in patients taking the AREDS compared to control group patients, however. The AREDS vitamins can also interact with other medicines you may be taking to cause the increased bruising and bleeding. Please discuss this matter of increased bleeding with both your primary care physician and ophthalmologist; it is possible that you may have a hereditary bleeding disorder than requires medical evaluation.
Is photodynamic therapy more helpful than Lucentis? [ 08/26/11 ]
For age related macular degeneration (ARMD), medicines injected into the eye like Lucentis are typically considered first-line therapies. Photodynamic therapy still is used for a certain subset of patients with ARMD who do not respond to Lucentis or other intravitreal* injection agents.
*Intravitreal refers to the eye's vitreous humor between the lens and the retina.
My mother is 84 years of age. She has wide-angle and narrow-angle glaucoma, dry macular degeneration in both eyes, and wet macular degeneration in one eye. She has now developed cataracts in both eyes, which will require surgery. However, they won't tell her when the procedure should be scheduled or which eye should be fixed first. She has had laser surgery for the glaucoma, and over the course of about two years, she has received 22 injections in her eye for the wet macular degeneration. She has had no bleeding or leaking in her eye for about ten weeks. Can you please provide information about the risks for blindness from cataract surgery (in light of her other eye problems), and information about which cataract should be removed first? [ 08/25/11 ]
Anyone considering cataract surgery should be aware of the risk of bleeding, infection, loss of vision, prolonged recovery of vision, and loss of the eye. These risks are very low, but not zero percent. The results of the cataract surgery can be limited by the macular degeneration and glaucoma. For example, the age-related macular degeneration can limit the final gain in central vision and the glaucoma can limit the final gain in peripheral vision, depending on the severity of each disease. Cataract surgery can also cause brief but intense elevations in eye pressure that can be vision threatening to patients with severe glaucoma. The optimal eye for initial surgery should be decided by your mother and an eye surgeon, who is aware of the severity of all disease processes in your mother's eyes.
My husband, who is 81 years of age, has been treated for macular degeneration with ketorolak, and recently he was also prescribed Acular. Are these drugs typically used for this eye disease? [ 08/24/11 ]
Acular is the brand name for ketorolac, and they are the same drug. These eye drops are typically used to treat retinal swelling from a variety of causes, and are not commonly used to treat age-related macular degeneration (ARMD), but your husband's eye doctor can more fully explain why he/she is prescribing this treatment.
I am 26 years old and have been diagnosed with wet age-related macular degeneration. I want to know how rare my condition is. Do you happen to have any data suggesting what percent of people with macular degeneration are young? [ 08/06/11 ]
There are several types of macular degeneration that affect young people (i.e., children, teens, and younger adults). Generally, these "early onset" or "juvenile" forms of macular degeneration appear to be hereditary (genetically linked) and are commonly referred to as "dystrophies" rather than "degenerative" diseases of the macula. Types of early-onset or juvenile macular degeneration include: Stargardt's disease (the most common form of early-onset or juvenile macular degeneration), Best disease, and Sorsby's macular dystrophy. According to one estimate found in a 2007 research report, approximately 10,000 people in the United States are affected by juvenile macular degeneration.
I have a couple of large drusen noted outside of the general macular region and granularity in the foveal avascular zone. My doctor suggested that I take an eye vitamin with lutein. I also had an OCT and there is some inferior and superior thinning. Does all this mean that I definitely have ARMD? [ 08/05/11 ]
Pigment changes and one or more large drusen inside the macula would be consistent with age-related macular degeneration (ARMD). Thinning on the OCT may also be consistent with atrophic changes observed in ARMD as well. Specific eye vitamins have been proven to decrease the progression of ARMD for a certain subset of patients, and other eye vitamins are still under investigation. Your eye doctor can provide you with your exact diagnosis and discuss appropriate treatment options.
Does daily use of bright lights (10,000 lux) increase the risk of macular degeneration? These lights are used for circadian rhythm sleep disorders (CSRD) and seasonal affective disorder (SAD). UV is filtered out, but the lights are typically full-spectrum otherwise. [ 08/04/11 ]
The relationship between light and age-related macular degeneration (ARMD) is not fully understood. It is known that ultraviolet and blue light (short wave length visible light) can cause damaging oxidative stress to the retinal pigment epithelium (RPE). The RPE is the same layer of the eye where some of the pathological changes occur in patients who have ARMD. It may be prudent for ARMD patients to talk with their eye doctor if they are undergoing bright light therapy for various disorders.
One month after epiretinal membrane surgery I developed a cataract in that eye. If I delay the cataract surgery for one year, will it have an impact on the chances of a full recovery? [ 08/03/11 ]
Delaying cataract surgery for one year should not substantially impact the prognosis of surgery. Waiting for an extended period of time can allow the cataract to become very hard and dense, and increase the rate of surgical complications, however. After retinal surgery, such as epiretinal membrane surgery, cataract formation is more common. However, cataract surgery is typically performed for 6 - 12 months after the retina surgery to give the eye a chance to fully heal.