An Eye Specialist Cites Progress in Our Understanding of Macular Degeneration

Gayatri S. Reilly, MD, an ophthalmologist with The Retina Group of Washington, enjoys helping people understand their eye health. She’s also an optimist when it comes to looking at the big picture of improved macular degeneration research and treatment over the last 15 years.

A key to that improvement is early detection, said Reilly during January’s BrightFocus Chat, a free monthly teleforum on vision disease.

“We know, clinically, that the earlier you detect macular degeneration, the more vision you preserve and the less treatment you need.  It is truly vision-saving.”

Gayatri Reilly, MD

That’s one reason her first recommendation for protecting one’s eye health is to schedule a regular eye exam with an eye doctor, to make sure there are no early signs of conditions like cataracts, glaucoma, or macular degeneration. 

There are also improvements in self-monitoring tools. The Amsler grid is a small chart of crisscrossing straight lines that individuals can use to see if their vision is changing.  If one sees wavy lines, distortion, or darkness on the chart, it may indicate that dry macular degeneration is changing to wet macular degeneration, a more serious form of the disease. 

Another device, now covered by Medicare, is the ForeseeHome monitor.  It detects a change toward wet macular degeneration even before patients are symptomatic, by assessing if there are any changes to the macula.

Reilly points out that another positive development is genetic research.  “Macular degeneration is highly genetic,” says Reilly. “We have identified major eye genes implicated in macular degeneration.” These discoveries help scientists understand the disease and search for potential treatments. 

Dr. Reilly notes that gene therapy and understanding the genetics for all of the major diseases has really changed over the past five years or so. There are even genetic tests available for patients. 

Reilly also recommends that persons with macular degeneration keep their children informed, so that family members will be aware of their own need for regular eye screening, given the family history.

Tips for Healthier Living

Reilly says certain lifestyle changes may allow persons to help themselves, and improve their quality of life.

“Exercise is definitely helpful,” she says.  Exercise has mental benefits, and it also helps avoid problems like obesity.

“We know that obesity, hypertension, and cardiovascular risk factors play a role in macular degeneration.  All of these things are inflammatory to the body, which in turn is inflammatory to the eye.”

Reilly reassures her patients that exercise does not have to be highly aerobic or high impact to be effective or beneficial. Things like “yoga and stretching, or lower-impact, steady-state exercise are just as helpful.”

There’s also good news on the positive effects of diet. Notes Reilly:

“For overall vision, particularly the macula, green leafy vegetables are really key.  Spinach is great, kale is great.  Basically, if it is green, it is good for your eyes!”

See this BrightFocus resource for more details on a healthy diet.

Reilly touts the benefits of the AREDS-2 supplements. Clinical trials found that having vitamins C and E and some antioxidants – like lutein, zeaxanthin, and zinc-- decreased the risk of progression to wet macular degeneration by about 25 percent.

When Reilly’s patients ask what they can do, “that is the first thing I mention: diet and thinking about taking these vitamins.”

She also reminds her patients what to avoid. Excess alcohol and excess tobacco use can cause damage to the optic nerve.  Called “the power cord to the eye” by Reilly, the optic nerve connects the eye to the brain. 

Too much sunlight can also harm the eye.  Even in winter, make sure your sunglasses block UV-A and UV-B rays that the sun emits all year round. “You don’t need to spend a lot of money, they don’t have to be polarized, just block UV-A and UV-B.”

Looking Back, Looking Ahead

When it comes to macular degeneration research and treatment, Reilly clearly sees the glass as half full, not half empty.

“I think with macular degeneration, so much has changed—fortunately for the better—over the past 15 years. Back in 2000, we didn’t have any good treatments for wet macular degeneration. A lot of times, patients still think back that maybe their mom went blind because of macular degeneration. That is really not the norm anymore.”

Read or listen to Dr. Reilly’s comments on healthy living and macular degeneration.