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Ask an Expert about Macular Degeneration

Latest Questions and Answers
I am a 62-year-old female who has wet macular degeneration. My only symptom is slight distortion of vertical lines; I see no blind spot in central vision. Avastin injections have been recommended. Can I wait to start this invasive treatment? [ 12/20/10 ]

Without treatment, macular degeneration almost always leads to severe loss of central vision. While you can wait to start treatment, you may suffer irreversible visual loss in the interim. You are fortunate to have caught the disease at such an early stage. Please discuss with your retina specialist the risks, benefits, and alternatives to Avastin so that you can fully understand your treatment options.


I am a 74-year-old male with diabetes, but I am in good health otherwise. I have had macular degeneration in my left eye now for 7 years. In my good eye, my doctor has given me at least 10 Avastin injections to stop bleeding behind the eye. Now, I can see pretty well except at night; I suffer from low light vision, can't drive and mostly I am in need of a flashlight to see objects in the house (such as dials on appliances) even during the day. My doctor shrugs his shoulders when I ask him if there is anything else he can do to improve my vision. Is there any help out there for me? [ 12/18/10 ]

Currently no medicines are available to specifically improve low light vision in patients with macular degeneration. You may benefit from an evaluation by a low vision specialist, to help maximize your current night vision and help with strategies to maximize your function during the day as well. Trials are ongoing for medicines to treat dry macular degeneration, and these may one day help with some of the visual symptoms that you are experiencing.


I am 96 years old and have wet macular degeneration in both eyes. I was seeing quite well until I lost my balance and fell in the bathroom. I hit the side of my tub and fractured my rib. The doctor gave me some anti-inflammatory pills to take for 3 days. My eye sight has become very bad all of a sudden, and wanted to know if you think that the shock of falling and hurting my rib cage could have caused the change in vision? [ 12/16/10 ]

Your eye sight worsening could be caused by a variety of reasons. Trauma, more commonly to the head, can cause a number of eye problems such as retinal detachment, bleeding within the eye, or inflammation within the eye. An ophthalmologist can diagnose all of the above conditions, as well as other diseases not related to your fall that may have coincidentally occurred at the same time as the worsening of your wet macular degeneration. Significant injury to the chest can also cause a condition known at Purtscher's retinopathy, which can cause decreased vision as well.


What good alternative medicine or natural products can help with macular degeneration? [ 12/15/10 ]

Strong evidence to support alterative medicines or natural products does not currently exist. Smoking cessation and certain nutrients are the only two modifiable behaviors that have definitely been shown to slow down the progression of macular degeneration. If you are not already taking vitamin supplementation, please speak to your eye physician about taking a supplement of zinc, vitamin C, vitamin E and beta carotene. Do not start any vitamin supplementation without speaking to your doctor, as many of these vitamins can cause significant side effects. Omega 3 fatty acids, lutein, and zeaxanthin may be beneficial as well, and are currently undergoing evaluation in the Age-Related Eye Disease Study 2 (AREDS2).


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.


Has anyone found evidence of a link between dry macular degeneration and Sjögren's syndrome or iron deficiency anemia? [ 11/27/10 ]

No definitive link has been established between dry age related macular degeneration (ARMD) and Sjögren's syndrome. However, smoking and nutrition are increasingly linked to ARMD by a growing body of research as having an impact on dry ARMD. Smoking ceasation can decrease the chance that you will convert to the wet form of ARMD, and a diet high in antioxidants and omega-3 fatty acids may also be helpful. Iron levels may play a role in ARMD as well, but this relationship is from excessively high levels of iron rather than iron deficiency.


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.


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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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