My 91-year-old mother-in-law has been taking Avastin injections for the past year or two to slow the progression of wet macular degeneration. Her vision has not improved; in fact she cannot even read the big “E” on the eye chart when she is at the eye doctor’s office. She is becoming discouraged because her eye specialist told her when she started the treatments that her vision should improve, yet it has not. She is now wondering if she should stop the injections. The eye specialist has told me that he would not recommend this because her vision would just get worse, yet I am also wondering how much worse it can get if she can't even see the big E! By the way, my mother-in-law is still driving her car and will not consider giving up her license. When I asked the eye specialist about this, his response to me was that her eye prescription, under Virginia law, made it legal for her to drive. I, of course, think this is crazy. Any suggestions you can offer would be welcome. [ 11/28/12 ]
The eye injections such as Lucentis, Avastin, and Eylea are the currently best available treatments for wet age related macular degeneration (ARMD). These injections have been shown in multiple clinical trials to prevent vision loss in 90 percent of patients, and to improve vision in about 30 – 40 percent. Your mother in eye may not be in the 30 – 40 percent of patients that observe significant visual improvement with the eye injections. The eye injections do not cure wet ARMD, they only control it. Stopping injections thus could lead to the worsening of ARMD and possibly permanent loss of vision. Even though she cannot see the big E now, her vision could certainly deteriorate without treatment and become worse.
Driving requirements varies from state to state; however, typically if the patient has one eye that can see at a designated level and has a specific amount of visual field remaining, he or she is legal to drive. Please confirm with your retina specialist that the vision in the eye that is not undergoing injections is sufficient for legal driving in Virginia.
My eight-month-old son’s eyes appear to look in different directions when he is focusing on something. Also, he doesn't cry and neither eye looks red. I am just concerned. Is there any problem with his eyes? [ 11/28/12 ]
Eye misalignment, called strabismus, is common in children. A very small degree of eye misalignment may not cause issues, but a larger degree of eye misalignment may cause permanent loss of vision in the deviating eye; this is called ambylopia. Your child should be examined by a pediatric ophthalmologist to test for strabismus and ambylopia. Both can be treated very successfully if caught early.
Do people ever lose vision completely due to macular degeneration? [ 11/28/12 ]
Many people can completely lose central vision due to age-related macular degeneration (ARMD). In advanced ARMD, though the central vision can become extremely blurry, typically side vision remains. The majority of vision in ARMD is lost in the wet subtype, however now treatments exist which can prevent vision loss in 90 percent of patients with wet ARMD, and can improve vision in 30 – 40 percent.
I am a healthy 56-year-old woman and have glaucoma in my left eye, which was treated with laser surgery approximately eight years ago. I see my ophthalmologist every three months. I was told recently that I have macular degeneration as well, but my sight is not affected as far as I can tell. Since I am relatively young for these diagnoses, is it possible that my sight will remain the same for many years? [ 11/28/12 ]
You are exactly correct in thinking that many people with age-related macular degeneration (ARMD) may not notice changes in vision for many years after the onset of the disease. The majority of vision is lost in patients with the wet form ARMD. Certain risk factors can identify patients at higher likelihood of development wet ARMD, so regular follow up visits with your retina specialist is very valuable in early detection of disease progression.
My husband is 38 years old and has seen two eye doctors who say that he has macular degeneration in his left eye and already has early signs of the disease in his right eye. They have said that there is nothing that can be done to help him or to slow down the progression of the disease. Is there anything that can help? And is there anything that could have caused this to happen to him? The doctors have said that with the way it's progressing in his left eye he will lose his sight in that eye within one year. I need any and all advice that you can provide. [ 11/28/12 ]
Age-related macular degeneration (ARMD) typically affects people older than 55 years of age. Your husband likely has another type of macular degeneration. Without knowing the specific type of macular degeneration it is difficult to better inform you about prognosis and treatments. Many of the non-ARMD types of macular degeneration are genetic in nature and rare. Please ask your retina specialist for the specific type of macular degeneration your husband has so that you can better inform yourself. Referral to a center that specializes in inherited retinal diseases may be worthwhile as well.
My mom has had macular degeneration for several years. The doctor performed laser surgery on one eye about ten years ago and she subsequently lost her vision completely in that eye. Now she receives Lucentis injections, but they do not help. What else can she do? [ 11/28/12 ]
In several large clinical trials, Lucentis stopped vision loss in 90 percent of patients, and improved vision in about 30 – 40 percent. You mother may not be in the 30 – 40 percent of patients that demonstrates an improvement in vision after taking Lucentis, especially if she has had prior laser treatment for age related macular degeneration. Laser treatment for wet age-related macular degeneration (ARMD) was minimally effective in stopping vision loss from ARMD, and sometimes resulted in scarring of the retina and worse vision. This unfavorable risk to reward profile is why laser treatment is not commonly used today to treat wet ARMD.
I have been diagnosed with early-stage dry macular degeneration. Sometimes, I have circles of light in the corners of eyes. What causes these bright halos? [ 11/28/12 ]
Intermittent bright halos can be caused from a variety of reasons. Common causes include dry eyes, cataracts, and optical aberrations from any glasses that are worn. Other rarer and more visually threatening causes also exist. Early-stage age-related macular degeneration typically does not cause patients to complain of bright halos. Please speak to your retina specialist about what might be causing your symptoms. Often this determination can be made after a clinical examination.
If one parent with brown eyes develops age-related macular degeneration (ARMD) and the other parent with hazel eyes does not, does this mean (genetically speaking) that the risk of developing the disease may be higher in the children who inherited the brown eyes of the affected parent than the children who inherited the hazel eyes of the non-affected parent? [ 11/28/12 ]
Certain iris colors have not consistently been associated with higher risk of age-related macular degeneration (ARMD). ARMD has a genetic component, and children of parents with ARMD are likely at higher risk of developing the disease themselves. The genetic component of ARMD does not follow Mendelian inheritance patterns, and also is likely not related to inheritance of iris color. A Mendelian inheritance pattern is defined by a condition resulting from two genes, one inherited from each patient, and these genes come randomly from each parent.