Macular degeneration is a common condition, often asymptomatic, which affects older individuals increasingly after the age of 60. Less commonly it can affect younger people, especially if they are very nearsighted. The macula is the center of the retina in the back of the eye and is responsible for the central part of the vision allowing us to read and see fine detail. With age, this central portion of the retina can undergo degenerative changes which, if severe, can lead to loss of central vision.
Recently it has become clear that genetics plays a major role in the susceptibility to macular degeneration and a family history of it in parents and siblings is a risk factor. Other risk factors include smoking, female gender, light-colored eyes, and farsightedness.
Macular degeneration is usually divided into two categories: wet and dry. The dry form is more common and usually has much less effect on the vision. In this case, the pigment layer behind the macula undergoes atrophy and can accumulate deposits of waste material, called “drusen”, which are visible to Dr. Greenberg as yellowish spots in the back of the eye.
Many times, dry macular degeneration may not affect the vision, but in more severe cases the vision can become blurred or blind spots or blank areas may appear in the central vision. There is no known effective way of improving dry macular degeneration, but it has been proven that antioxidants lutein and zeathanthin, Zinc and vitamins E, and C, in specific doses, can slow its progress and reduce the risk of vision loss.
Wet macular degeneration is the result of tiny abnormal new blood vessels that grow and break into the space behind the macula, causing leakage of blood and fluid. It is often preceded by dry degeneration, and Dr. Greenberg can identify people who may be asymptomatic but at risk for the development of this more severe form of the disease. Wet macular degeneration is less common, but when it occurs can cause more serious loss of vision. Symptoms may begin as gradual progressive blurring or distortion of the vision. Straight objects such as telephone poles or venetian blinds may appear crooked. Sometimes the loss of vision occurs abruptly and with no warning.
Macular degeneration can be diagnosed by Dr. Greenberg with a dilated fundus exam in the office. Many times other in-office testing, such as angiography, a photographic test involving the injection of intravenous dye, or ocular coherence tomography, a sophisticated digital imaging test of the macula, may be necessary to diagnose and formulate the appropriate treatment, if any, for the problem.