Eye Education

A Deep Dive Into Macular Degeneration

Macular Degeneration is the leading cause of vision loss, affecting more people than glaucoma and cataracts combined. So what exactly is it, and who’s at risk?

What is macular degeneration?

Macular degeneration is an eye disease that occurs when an integral part of your retina called the macula is damaged. Once the macula begins to degrade, you begin to lose your central vision—or, the center of your field of view. This means if you were looking at a clock, you’d be able to see the numbers but not the hands pointing to the time.

There are two basic types of macular degeneration.

  • Dry: This is by far the most common form of macular degeneration, comprising 85-90% of all cases. “Dry” macular degeneration doesn’t involve any leakage of fluid in the eyes, but does involve small yellow deposits called drusen. These drusen dry out the macula, gradually making it unable to function properly.
  • Wet: The wet type of macular degeneration makes up 10-15% of all cases. In this type, abnormal blood vessels grow under the retina and macula. When these blood vessels bleed or leak fluid, the macula is moved from it’s normal flat position. This can either lead to distorted or destroyed central vision. Wet macular degeneration is typically more rapid and severe.

Macular degeneration is generally associated with aging, but Stargardt disease is a form of macular degeneration found in young people. Stargardt disease is caused by a rare recessive gene and is only found in 1 in every 20,000 cases of macular degeneration.

What causes macular degeneration?

The exact causes of macular degeneration aren’t known, but the three biggest factors appear to be age, genetics and lifestyle.

  • Age: Macular degeneration is the leading cause of vision loss for those aged 50 and up, though it’s most likely to occur after age 60. The disease is often referred to as age-related macular degeneration (AMD) because the older you get, the more likely you are to experience it.
  • Genetics: The extent that family history plays a part in causing macular degeneration isn’t clear. However, it’s estimated 15-20% of people with age-related macular degeneration have at least one sibling or parent with the condition. Caucasian people are also more likely to develop age-related macular degeneration than their counterparts.
  • Lifestyle: Studies have shown smoking can double your risk for macular degeneration. High glycemic and high saturated fat diets have also been associated with developing age-related macular degeneration, as well as helping it progress further.

What are the symptoms of macular degeneration?

The symptoms of age-related macular degeneration can vary depending on which of the three stages you’re in.

  • Early: In this stage of AMD, vision loss likely hasn’t occurred yet but there are medium-sized drusen under the retina. Detecting these drusen early is another reason why getting a yearly eye exam is crucial to the health of your eyes.
  • Intermediate: This stage of AMD is marked by larger drusen and discoloration of the retina. Noticeable vision loss may or may not be present.
  • Late: Once AMD has reached the late stage vision loss has become noticeable.

Along with your recommended yearly eye exam, taking a trip to see our friends with “O.D.” after their names is a good idea if you’re experiencing any of the following warning signs:

  • Noticing your vision field become smudged, distorted or lost altogether
  • Needing brighter light for day-to-day tasks
  • Impaired depth perception
  • Trouble seeing precise detail both up close and at a distance
  • Trouble adjusting to changing light
  • Trouble noticing contrasts in colors or textures

How is macular degeneration treated?

Once someone has been diagnosed with macular degeneration, treatment varies depending on if it’s dry or wet AMD.

Dry macular degeneration is usually treated with the following steps:

  • Increasing antioxidant-rich foods in your diet
  • Eating at least one serving of fatty fish per week
  • Avoiding packaged foods and artificial fats
  • Increasing exercise
  • Quitting smoking and avoiding secondhand smoke

Wet macular degeneration usually requires more drastic steps for treatment. In the past, a process called laser photocoagulation was used to seal the abnormal blood vessels and prevent them from leaking. Now a process called anti-VEGF therapy where injections into the eye to prevent bleeding is the most common treatment.

Is there a cure for macular degeneration?

As it stands right now, there is no cure for macular degeneration. Doctors use the treatments above as a way to slow or reduce the progression of AMD. If you’ve been diagnosed here’s a list of 10 questions you should ask your doctor.

While there is no cure yet, progress is being made through the work of researchers and non-profits like the American Macular Degeneration Foundation.