My 30-year-old sister says that she has polar disc macular degeneration. All of the doctors say that this disease cannot be treated in India, where she lives. I live in Melbourne, and wonder if there are facilities there that can help my sister, or if I can donate an eye to her. [ 09/09/11 ]
The term “polar disk macular degeneration” is not a commonly used term in the United States. She may have degeneration of her macula from being nearsighted, commonly called myopic degeneration. In a variant of this condition, called “posterior polar degeneration” the eye slowly increases in length over time leading to a gradual degeneration of vision. This pathologic lengthening of the eye currently has no treatments. Myopic degeneration can also lead to other problems (such as new blood vessel growth) that can be treated, and these disorders can be treated by therapies available in India. Your sister is fortunate to have someone generous enough to offer her an eye transplant; however, the parts of the eye that are damaged in myopic degeneration cannot currently be transplanted.
I am a 73-year-old female with dry age-related macular degeneration (AMD), who was diagnosed in 2004. A recent deterioration of vision brought me to my ophthalmologist and subsequently to a retinal specialist who diagnosed pigment epithelial detachment. Are there clinical trials being conducted for this particular problem? What are the odds that this will progress to wet AMD? [ 09/08/11 ]
Age related macular degeneration (ARMD) has two forms: wet and dry. A pigment epithelial detachment typically signifies that you have the wet subtype. Pigment epithelial detachments can occur for other much less common reasons, such as central serous retinopathy, inflammatory disorders, or lack of blood flow to the back part of the eye. Please clarify with your retinal specialist if your pigment epithelial detachment is from ARMD, and if you have the wet subtype of ARMD. Many clinical trials are ongoing for wet ARMD.
Is there research suggesting that gluten can have an impact on the health of the retina? [ 09/01/11 ]
I find no research reports concerning gluten and retinal health. There are, however, a few case reports regarding patients with celiac disease, a disease characterized by gluten intolerance in the diet, which mentions that a number of patients with the disease also experience ocular problems. This may be due to the fact that patients with celiac disease often suffer from deficiencies in various vitamins, some of which are important for maintaining retinal health. Therefore, it may be plausible to assume that if a person suffers from gluten intolerance (a condition managed by following a gluten-free diet) and also has one or more known risk factors for age-related macular degeneration, then that individual may be more susceptible to the development of retinal problems such as macular degeneration. Again, this is only speculation, I've found no recent scientific reports demonstrating or suggesting a direct link between gluten and retinal health.
I took my 6 year old to the optometrist because she was complaining that her distance vision was blurry. He told me that it was not a refractive problem, but rather an issue with the macula. He said that the macula forms a “perfect picture” and that hers was just not able to do so. He said it was genetic, not an emergency, and then set up an appointment with a pediatric ophthalmologist. This information comes at you so fast that it is hard to take it all in at once. I can't seem to find anything about the macula that doesn't sound like a very serious disease, so I am very worried. I'm scared and confused, so I am hoping that you can you offer some advice. Thank you for your time. [ 08/31/11 ]
The macula is the center of the retina, and responsible for clarity of central vision. If your child has a genetic disease of the retina, he or she may have reduced clarity of central vision now or later in life. Whether this vision reduction is minor or major, stationary or progressive, will depend on the exact disease. Many people with genetic diseases of the macula live very full and productive lives. Your pediatric ophthalmologist can help determine the exact disease, and provide a referral to a physician specializing in ocular genetic diseases.
I have a retinal hole that is 2 millimeters in diameter. What's the distinction between a retinal hole and a retinal detachment? [ 08/30/11 ]
A retinal hole is an absence of retinal tissue surrounded by an adjacent region of normal retina. In contrast, a retinal detachment is caused by fluid between the retina and the retinal pigmented epithelium, which can result from a variety of causes. In some cases, retinal holes may cause retinal detachments by allowing fluid to reach the space underneath the retina. Not all retinal detachments are caused by retinal holes, however.
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 the reason that dry age-related macular degeneration (AMD) doesn't always progress to geographic atrophy (and severe vision loss) due to the fact that the disease progression in most cases is very slow, and people die of other causes first? Since I'm only 45 and have intermediate AMD, I'm hoping that the disease will not progress rapidly. The doctor feels that the early onset suggests a genetic predisposition, which makes sense to me. I also want to mention that I am taking Lamictal (lamotragine) to treat epilepsy, and I have read that melanin binding may be associated with this drug. Would melanin binding lead to or exacerbate AMD? [ 08/28/11 ]
Typically age-related macular degeneration (ARMD) is not seen in people younger than 45 years, so your age and exam findings could suggest a more aggressive disease process. Approximately 27 percent of patients with intermediate macular degeneration will progress to advanced ARMD during a period of five years (based on the AREDS trial), so not all patients progress rapidly. People with slowly progressive disease will often die prior to severe vision loss from either advanced dry ARMD or wet ARMD. Please discuss the long-term prognosis with your retina specialist.
Melanin may be involved in the pathological process of ARMD, but the effects of potential melanin binding agents like Lamictal (lamotragine) on ARMD have not been well studied to date.
I am a 65-year-old woman and was diagnosed with macular degeneration seven years ago. Recently, one eye developed the wet form of the disease, and I started the injection treatment. My vision with glasses is quite blurred; however, I can see fairly well with each eye alone. When I wear glasses, my eyes can't seem to focus properly; it's like double vision as opposed to blurriness. They just are not focusing correctly. I know that a new prescription won't correct the macular degeneration, but is there a suggestion as to whether or not it might improve the double vision? Would it help if I did not wear glasses for distance vision and only used them for reading? I appreciate your input. [ 08/27/11 ]
Injection therapy should not induce double vision. Double vision can be caused by a variety of reasons, some very benign and others very dangerous. While prisms placed in glasses can correct many types of double vision, it is more important to be evaluated by an ophthalmologist to see if you truly have double vision. If so, he or she can then determine its cause. Once your physician is sure that you do not have serious disorder causing the eye misalignment, corrective prisms added to glasses can be considered.