Dry macular degeneration is a common eye disorder among people over 50. It causes blurred or reduced central vision, due to thinning of the macula (MAK-u-luh). The macula is the part of the retina responsible for clear vision in your direct line of sight.

Macular degeneration is the leading cause of vision loss in North America.It affects probably about 10 percent of people over the age of 75, and so it’s the major cause of vision loss that we deal with as ophthalmologists. It is a very common condition from the standpoint of symptomatology that patients experience at that age.   

There tends to be a very slow onset of distortion possibly, or just gradual diminution of vision over time. And it can be subtle. People may not even know they have it. So it is something that needs to be evaluated periodically by an ophthalmologist as you start to get older.

There’s a – perhaps I’ll tell you a little bit about what macular degeneration is as well because macular degeneration, people don’t really understand what it is because it’s inside the back of the eye, and it’s not a part of the body that we can just look at in the mirror or you can examine on yourself, so it is something that is often forgotten.

But inside the back of your eye is a very thin film called the retina, and that’s what turns light into vision. It’s like the film in a camera. And as we get older, the central part, the most detailed part of that retina starts to degenerate. The cells are very metabolically active, and they provide a lot of vision throughout our life, and over time, that starts to break down. And we see two types of macular degeneration develop over time. The first kind develops very slowly. It’s called dry macular degeneration. And it occurs as sort of a deposition of some of the chemicals that are in the back of your eye that get deposited.   Often seeing a local Ophthalmologists or Optometrist in conjunction with your family physician or a registered dietician is a great option to dealing with eye conditions and symptoms. 

Often little spots can be seen called drusen, and over time, that layer underneath your retina can break down and cause vision loss. That’s about 90 percent of the cause of macular degeneration. It tends to happen slowly, gradually, but it can be devastating in terms of the long-term vision status of the eye.

The other type of macular degeneration is called wet macular degeneration. It has a much more explosive onset. Sudden loss of vision, there’s often bleeding in the back of the eye, and patients can have a profound, sudden loss of vision with that type of macular degeneration, that requires much more rapid identification and treatment.

And that’s the kind that we often are worried about people coming in for, especially because sometimes when you lose vision in one eye, the other eye can compensate, and people might not identify the fact that they’ve got a problem.

We might not get them in on time. So those are the two main types, and we really have to be cognizant that they can present in different ways because the timelines are much different for the two and how we get in there and take care of people.

So if you have a concern that you may have macular degeneration or you might be at risk for macular degeneration, talk to your family physician, and they can refer you to an  local ophthalmologist.

Alternatively, if you already have an ophthalmologist, maybe you can ask them during your next examination to have your eyes dilated with dilating drops and a proper macular degeneration examination performed. Often seeing a local Ophthalmologists or Optometrist in conjunction with your family physician or a registered dietician is a great option to dealing with eye conditions and symptoms. Smart Food Now and exercise is also important for overall health. Presenter: Dr. David Maberley, Ophthalmologist, Vancouver, BC

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Well the management of macular degeneration involves a few different steps. The first thing we can talk about once you’ve been diagnosed with macular degeneration is prevention. And the easiest thing to do is, if you’re a smoker, is to do whatever you can to reduce your smoking and eliminate it. Because that’s a big trigger for a lot of macular degeneration. There may also be a role to wearing light protection for UV and bright light that wouldn’t hurt in the setting of macular degeneration.

Now there’s another piece in terms of early detection, and the early detection of macular degeneration is essential because the sooner a patient is diagnosed with the disease, especially in the form of wet macular degeneration, the sooner the treatment can be initiated, and the better the visual outcomes.

And there’s a number of ways you can test your eyes at home to be sure that you’re hopefully not developing macular degeneration that’s progressive. The first of those is called an Amsler grid, which is a grid paper, much like a piece of graph paper, that you can look at and look for areas where the lines start to become wobbly or distorted, or perhaps the lines are even missing.

And that’s a very simple test that you can even do. You can look for an Amsler grid on the Internet and find a version of that and test that on your own computer every day.

The second type of testing is a home monitoring device that are starting to become available throughout North America, where it’s almost like a small computer device you would keep at home, and it can help you to diagnose early macular degeneration as well.    Healthy eyes depend on regular visits to your optometrist for eye exams, and if necessary, an ophthalmologist for certain eye conditions and surgeries like diabetic retinopathy . You can also protect your eyesight with proper nutrition, eating foods that contain the right vitamins. Local Optometrists may prescribe eyeglasses and contact lenses, provide laser eye surgery consultations, and test for diseases.  Local Ophthalmologist  can help with many facts of eye diseases. Getting a referral from your optometrist to a local ophthalmologist is crucial to eye care.  

Or simply just paying attention to your reading or any fine, detailed work you do with your eyes. If you start to lose letters when you’re reading or you notice lines, for example, straight lines, doorways, start to become bumpy or wobbly in the middle.

Those would be good signs to get your eyes examined by a local ophthalmologist to make sure that nothing’s going on. Presenter: Dr. David Maberley, Ophthalmologist, Vancouver, BC

Macular degeneration is primarily caused by genetics, and this information was not available a decade or more ago. Many cases of macular degeneration are predetermined at birth, meaning there is little that can be done to prevent it.

However, certain lifestyle factors such as smoking and exposure to sunlight or UV rays may modify the genes that cause macular degeneration and increase the risk for certain types of gene problems. Individuals with a strong family history of macular degeneration may choose to undergo genetic testing to determine their risk.

To diagnose macular degeneration, an ophthalmologist will examine the eyes after dilating the pupils with drops. The eyes will be carefully examined for changes in the macula or hemorrhaging. Further tests may be done to confirm the diagnosis, such as a fluorescein angiogram, an optical coherence tomograph, or an auto-fluorescence test.

Most testing and treatment can be done on the same day, and the goal is to diagnose and treat macular degeneration as quickly as possible to prevent further damage.

If you have questions or concerns about macular degeneration, speak to your family physician or ophthalmologist for more information.Dr. David Maberley, MD, MSc. (Epid), FRCSC, Ophthalmologist, discusses macular degeneration and its symptoms.