 | Dr. Bruce A. Kater is medical director at the Envision Rehabilitation Center, a clinic primarily serving patients with low vision. He earned his O.D. degree from the University of Houston, and has worked in low vision optometry since 1995. Dr. Kater can be reached at Envision Rehabilitation Center (316) 267-2244 , toll free (800) 685-7959 or visit www.envisionus.com |
Vision
2004-06-01 16:14:00
What can be done for AMD?
ANSWER: Age-related macular degeneration (AMD) is a condition in which the patient loses central vision and the ability to see fine details. It affects almost two million older Americans. There is no cure for AMD, but through vision rehabilitation, affected individuals can learn to get the most from their vision. Macular degeneration is a retinal disorder. The retina is at the back of your eye and functions like film in a camera. It is here that visual information is collected and then sent on to the brain for processing. At the center of the retina lies the macula. This is where central vision and fine detail are resolved.Many people with vision loss have blank spots, or scotomas, on their retinas. With macular degeneration, the scotomas are over the macula, creating the frustrating loss of central vision that characterizes the disease. It's difficult for the patient to describe this loss of vision because the brain "fills in" the missing information, resulting in distortion.The first step in managing macular degeneration is identifying the scotomas. This is done with a diagnostic tool called the scanning laser ophthalmoscope. It takes a picture of the retina, and the patient responds to a series of stimuli from a laser light to identify exactly where they can - and can't - see. Once this map of the retina is created, the doctor can begin to teach you where the vision loss resides, and can create a vision rehabilitation plan. This may involve a new eyeglass prescription, use of other optical devices and magnifiers, lighting, filters, contrast enhancement and new viewing techniques.Dry macular degeneration accounts for 90% of all cases of AMD. It occurs when small deposits of drusen, a yellowish material, accumulate in the macula. The accumulation interferes with the macula's ability to sense light, which leads to distortion and loss of central vision. This accumulation may begin as many as 10 years before you notice any vision loss, and its progression is subtle and painless.Wet macular degeneration is caused when tiny, abnormal blood vessels begin to grow behind the retina near the macula. These vessels can leak and damage the macula, leading to rapid and sometimes severe vision loss. Wet macular degeneration almost always occurs in people who already have dry macular degeneration. If you ever experience sudden changes in your vision, you should see your eye doctor immediately. Your eye doctor may be able to treat wet macular degeneration. There are different technologies available that use lasers to destroy leaking blood vessels. This treatment is typically done on an outpatient basis and may require follow-up visits.Age is the largest predictor of getting macular degeneration. While it is rare in middle age, almost a third of those older than 75 have it. Additionally, women are at greater risk than men, and whites are more likely to get it than other ethnic groups. If others in your family have had macular degeneration, you have slightly increased odds of getting it yourself.Prevention is mostly a matter of living a healthy lifestyle. Some studies have shown that taking vitamins and eating a diet rich in fruits and leafy green vegetables can offer some protection from the disease. You should limit fat intake, keep your blood pressure down and avoid excessive alcohol use. And you should wear sunglasses or eyeglasses with ultraviolet light protection and wear a brimmed hat while outside.
