Ask an Expert about Macular Degeneration

No definitive link has been established between progression of age-related macular degeneration (ARMD) and antibiotics or Plavix. Smoking, certain dietary factors, and genetic factors have been linked to ARMD progression, however. Please speak to your ophthalmologist to find out if any of these factors are applicable to you, and what steps you can take to minimize the progression of this eye disorder.

If pain is common, what can the doctor do to minimize the discomfort? Finally, is it common for vision to become increasingly "blurry" during Lucentis injection treatment, even though central vision remains preserved? Thank you so much for your help.

Lucentis injections are given literally hundreds of thousands of times yearly in the United States for wet age-related macular degeneration (ARMD). The injection process itself has risks, including infection and retinal detachment, but the actual medicine is thought to be generally very well tolerated by the eye.

Please speak to your doctor about the indication for Lucentis injection into the right eye to clarify why it was given. Typically, fluid from wet ARMD can be clearly seen on either clinical examination or optical coherence tomography (OCT) imaging, and this can minimize diagnostic dilemmas.
Patients can experience pain during the Lucentis injection and some soreness afterwards. Usually, the eye is anesthetized with a local anesthetic, which minimizes the discomfort. Your mother should not experience extreme pain during or after the injections, so speak to your retina specialist about minimizing the discomfort during and after the procedure. Without knowing more specifically what you mean by blurry, I am sorry that I cannot comment about your final question.

Concerning wet ARMD, Lucentis has been shown in numerous clinical trials to preserve central vision in approximately 90 percent of patients, and provide significantly improved vision in 30 – 40 percent. Thus about 10 percent of patients will still lose vision even while receiving Lucentis injections.

Olive oil has not been established as treatment or preventative for any ocular condition such as age-related macular degeneration (ARMD). Please speak to your primary doctor if you are using olive for other medical conditions such as cardiovascular disease. The AREDS II vitamin formulation is still undergoing study, and no definitive benefit has yet been proven for patients with ARMD. The AREDS I formulation was proven beneficial only for a select group of patients with ARMD, so please ensure that you speak to your eye physician about any vitamin supplementation you might be considering for ARMD or any other eye condition.

Any crack in Bruch's membrane predisposes an eye to growing new blood vessels from the layer underneath Bruch's membrane, called the choriocapillaris. These cracks can occur in patients with myopic degeneration and are called lacquer cracks. Regular eye exams and frequent use of an Amsler grid* will allow you to quickly notice the development of CNV, however these new blood vessels cannot be prevented. The AREDS formula has only been proven to be beneficial for certain patients with dry age related macular degeneration.

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If you cover your left eye when reading, it is safe and will do no damage to your “good” eye. However, you will need to be cautious when covering the eye while driving. Please understand that covering your left eye may reduce your peripheral vision and the ability to accurately judge distances, so it is important to practice driving in controlled environment at first. Most importantly, talk with your eye doctor to learn how to properly cover your eye and to obtain other suggestions or strategies that can help your driving experience. He or she can also provide you with important information concerning your state's vision requirements for driving while using only one eye.

LASIK surgery is performed on the cornea, the clear structure on the front of the eye. Damage during LASIK surgery to the macula is very uncommon. Very rarely, patients have had retinal problems after LASIK surgery, such as a retinal detachment or a very serious infection, called endophthalmitis, which occurs in the back part of the eye near the retina.

The operation that you may be describing is called macular translocation. It was performed more frequently for patients with age-related macular degeneration (ARMD) until about five years ago, when medications like Avastin proved to be a very efficacious alternative treatment. The macular translocation surgery is extremely involved and performed only at a few centers across the world. Since the development of medicines like Avastin, macular translocation is only rarely used to treat ARMD. Additionally, macular translocation is performed for diseases affected the area underneath the retina. Branch retinal vein occlusion is a disease inside the retina, and would not likely benefit from macular translocation. The injection therapies are currently the best available treatments for swelling due to macular degeneration.

No definite link has been established between age related macular degeneration (ARMD) and sinus surgery. Though the cause of ARMD is not completely known, the current belief is that genetics and inflammatory processes contribute to development and progression of ARMD.