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Ask an Expert about Macular Degeneration

Latest Questions and Answers
How long has macular degeneration been around? [ 11/27/10 ]

Doctors and researchers have known about macular degeneration for a long time. If you check the National Institutes of Health record of publications, the first published case-reports on the disease appeared in 1904, and the number of published reports increased drastically starting in the 1920s. Symptoms and characteristics of age-related macular degeneration such as drusen deposits were described as early as 1854 by Franciscus Donders; however, I do not think the disease had been formally named as "age-related macular degeneration" at that time. At that time the disease was more commonly referred to as "senile" macular degeneration because physicians noted that it was an eye condition that appeared to predominantly affect elderly or aged individuals and so chose to use the term "senile" to describe the age-related eye condition that they were seeing.

Though it may not have always been referred to specifically as "age-related macular degeneration," scientists have been aware of this sight-threatening eye disease for more than a century. Though there is still no cure for the disease, tremendous advancements have been made in understanding its risk factors, and many novel therapies have been developed which aid in slowing or preventing its progression.

I am a 44-year-old woman, and was recently diagnosed with a progressive form of retinoschisis. My retina has not detached, but I am very concerned because it appears as though there is no treatment that is agreed upon for this condition. I want to know what questions I should ask my doctor and would like to know if I will go blind from this disorder. [ 11/26/10 ]

Retinoschisis is a splitting of the retina into two layers, and has two distinct subtypes—juvenile and degenerative. Since you said you are 44 and recently developed this condition, you most likely have degenerative retinoschisis. In general, retinoschisis is an asymptomatic and non-progressive disease. For example, in a large research study the retinal detachment rate was just over 2% over many years. You should ask your eye doctor about the symptoms of retinal detachment and have regular eye exams at least yearly. Retinal detachment can lead to blindness if untreated; however, the surgical rate of repair is above 95% for retinal detachments from retinoschisis.

My father suffers from macular degeneration. He just had a surgery to remove a cataract in one eye and is scheduled to have surgery in the other eye in a couple of weeks. However, since his surgery he sees a lot of black spots and is now not sure if he should get the other eye operated on. What is the cause of the black spot? Is it related to macular degeneration, and should he have the upcoming surgery? [ 11/25/10 ]

Black spots after cataract surgery can by caused by a variety of reasons, most commonly accelerated degeneration of the vitreous gel within the eye. We are all born with a solid vitreous gel in the eye, which begins to turn into liquid around 20 years of age. This degeneration progresses slowly over the next few decades and is the most common cause of these black spots or floaters. Cataract surgery accelerates the gel break down and can increase floaters. Typically the floaters will slowly disappear or a patient will learn to ignore them; however, a few patients remain bothered by these floaters for years. Macular degeneration is not related to black spots from floaters, but can cause black spots from other reasons. Please ask your ophthalmologist to evaluate the eye that was operated on for any progression of macular degeneration or other retinal problems prior to your next surgery.  You, your father, and your cataract surgeon should discuss the upcoming surgery. Be aware that there may be an increase of floaters in that eye as well, though this rarely is bothersome over the long term to most patients.

I was diagnosed with dry macular degeneration at the age of 39 and have had the disease now for 20 years. Recently, I noticed a lot of distortion in my right eye. The retina specialist told me that I have basal laminar drusen and that it is different than age-related macular degeneration. He stated the new macular treatments weren't effective for this disorder and there is nothing that can be done. I've looked everywhere and can't find information discussing the differences between these two conditions or how they are treated. I'm an RN and depend on my eyes to keep working. Could you please educate me about these issues? I was told that my vision is degenerating now and would like to know if there is any hope. [ 11/24/10 ]

It would be very unusual to develop age-related macular degeneration (ARMD) at the age of 39. At that time you probably had basal laminar drusen, which is a thickening of the layer underneath the retina (the retinal pigment epithelium or RPE). They can easily be confused with basal linear drusen, which are a focal detachment of a normally thick layer underneath the retina and associated with ARMD.  Basal laminar drusen become more common with age. However you can develop both basal laminar drusen and superimposed basal linear drusen after the age of 50. This signifies dry ARMD.  If this is your situation, it is important you use your Amsler grid, cease smoking, if applicable, and regularly follow up with your ophthalmologist concerning the dry ARMD. The majority of vision is lost with wet ARMD, and the Amsler grid will help monitor for conversion to that condition. If you have dry ARMD, vision can certainly be lost, but more slowly, through a process called geographic atrophy.  Fortunately, several medicines are undergoing clinical trials for this condition.

I have dry macular degeneration and can still do needlework with a lighted magnifier lamp. Do you know if it would be best to use incandescent or halogen lighting in the magnifying lamp? Incandescent lighting produces heat and LEDs may not be bright enough. Thank you for your input. [ 11/23/10 ]

I would recommend either full spectrum lighting (OTT-Lite or Verilux) or incandescent lighting for close sewing using a magnifier lamp. Halogen and fluorescent light often generate unacceptable glare, as well as heat in the case of halogen light. This is a general recommendation for patients with eye disease, so I would suggest that you try these options  until you find the light that you are most comfortable with.

Do you have a treatment to improve macula sensitivity after hypertensive retinopathy. My BP has been normal now for 10 months. But, my vision has not fully recovered yet. [ 11/16/10 ]

If you have your blood pressure under control, you are doing the best thing for the health of your eyes and the rest of your body. Vision is decreased for a variety of reasons after hypertensive retinopathy, so potential treatments will depend on the cause of your visual decline. Vision can be lost with hypertensive retinopathy from artery occlusion, vein occlusion, ischemic optic neuropathy, worsening of preexisting diabetes of the eye, or other reasons.

Please consult your eye specialist to determine if you have any of these conditions. Also be aware that damage done from certain types of hypertensive retinopathy may be very long lasting

I am 70 years old. About 15 years ago I was diagnosed with Macular Degeneration. I presently have wet AMD in my left eye and dry AMD in my right eye. There is no history of this my family. When I was in the Navy as an electrician at the age of 20, I had a 440 volt electrical control panel explode in my face burning the left side of my face and blinding me for a short time. I spent 6 weeks in the plastic surgery ward as a result. Could the trauma suffered in the explosion have caused the macular degeneration I have now? [ 11/15/10 ]

The only definite environmental association with age related macular degeneration (ARMD) is smoking. Other environmental factors such as diet have been suggested. However, no research has linked traumatic eye injury to triggering age related macular degeneration. Severe blunt injury can cause a disease that is similar to wet macular degeneration (choroidal neovascularization or CNV), however this would have occurred several decades earlier if your injury was 50 years ago.

Which form of macular degeneration is worse? [ 11/12/10 ]

Both dry and wet macular degeneration can lead to devastating consequences in terms of visual loss if they reach the more advanced stages. However, because wet macular degeneration is associated with factors such as leaking fluid/blood into the eye, possible scar formation, and can advance more rapidly than the dry form of the disease, the general consensus is that having wet form is "worse."

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Disclaimer: The information provided here is a public service of the BrightFocus Foundation and should not in any way substitute for the advice of a qualified healthcare professional; it is not intended to constitute medical advice. Please consult your physician for personalized medical advice. BrightFocus Foundation does not endorse any medical product or therapy. All medications and supplements should only be taken under medical supervision. Also, although we make every effort to keep the medical information on our website updated, we cannot guarantee that the posted information reflects the most up-to-date research.

Some of the content in this section is adapted from other sources, which are clearly identified within each individual item of information.

Last Review: 04/29/13

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