Q&A on Age-Related Macular
Degeneration or AMD
Q: My mother has macular degeneration. She saw information on TV about an injection that helps the eyes get somewhat better, but not heal completely. She also saw something about a pill that you could take. Is this true? If so, can you help me find someone who has this treatment? J.N.
A: Your own eye doctor should be able to determine whether your mom is a candidate for the treatments that you saw on TV. There are many types of macular degeneration. Typically, the type of macular degeneration that responds to the injection is the "wet" form. The pill is probably a multivitamin; certain eye vitamins have been shown to reduce the chance of getting macular degeneration. Dr. Trattler
Q: Is it true that macular degeneration of the eyes is a growing problem? J.S.
A: Yes. Experts think there are a number of reasons for this, including more ultraviolet light in our environment due to a thinning ozone layer, people living longer, environmental pollutants, smoking, poor diet, obesity, etc. Another factor may be our aging population, since the risk for macular degeneration rises with age.
Although there are no sure ways to prevent macular degeneration, steps you can take that might reduce your risk of macular degeneration include wearing sunglasses that provide 100 percent UV protection and a brimmed hat when outdoors, exercising, not smoking, eating a healthy diet that is high in dark green leafy vegetables (spinach, kale, collard greens, etc.) and visiting your optometrist or ophthalmologist on a regular basis for exams. Dr. Dubow
Q: How genetic is macular degeneration, and are there any precautions to take to prevent it or lower the chances of having it? B.C., Washington
A: At one time, it was thought that no specific genetic patterns were associated with macular degeneration. However, recent research may indicate otherwise. But mostly, macular degeneration is associated with aging changes. The amount of reduced vision is directly related to the severity of the disease.
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There are many theories about precautions: for example, wearing good ultraviolet-filtering sunglasses when outdoors. Recent research suggests some antioxidants might reduce one's risk of developing macular degeneration. Dr. Slonim
Q: I have premacular fibrosis in my right eye (I no longer have centre vision). I have had surgery, which did not help. I have 100 percent peripheral vision. However, that peripheral vision won't allow my left eye to focus. I've had all of my glasses opaqued to block the peripheral vision. This works fine for my left eye being able to see. Will I eventually lose my peripheral vision in the right eye as a result of blocking it out? E.B., Canada
A: Sounds like you are describing macular degeneration with fibrosis (scarring). This disease, which affects central vision, usually does not affect peripheral vision. Dr. Slonim
Q: I am a 73-year-old male who had 20/20 vision until about two years ago. My mother died at age 86 and never needed eyeglasses. Then, almost suddenly, I started losing vision from my right eye, which was diagnosed as age-related macular degeneration.
However, I noticed, while taking prescribed Prevacid, but double the recommended doses, that I started to see halos with the affected eye. Have you heard of drug-related (or induced) macular degeneration?
Also, it seems to be getting worse. How much worse can it get? Could I go totally blind from that eye? Is the other eye in danger? Thank you. J.V., Puerto Rico
A: Certain drugs can affect the macula. I am not aware that Prevacid is one of them. Macular degeneration can cause blindness. However, at age 73 you would be a potential candidate to also have cataracts. Both age-related macular degeneration and cataracts tend to affect both eyes. Sounds like you need an updated eye exam. Dr. Slonim
[See also: free eye exams for qualifying individuals.]
Q: My father is 83 years young and was told he has macular degeneration. Is he a candidate for LASIK surgery? My dad lives in Florida and is scared out of his wits. Joanie, New Jersey
A: At 83 years old, your father is not a candidate for LASIK except under some rare circumstances.
Cataract surgery would have the same effect as LASIK in reducing your father's refractive error. When the cataract (cloudy lens of the eye) is removed, the surgeon replaces it with an artificial intraocular lens (IOL). The power of the IOL is calculated preoperatively, usually to eliminate the need for distance glasses.
If your father has a visually debilitating cataract, the degree of his macular degeneration will determine whether he is a good candidate for cataract surgery. Dr. Slonim
Q: What are the best measures to take to help prevent macular degeneration? Is there a genetic factor associated with being at a higher risk of getting it? J.G., Pennsylvania
A: Macular degeneration is becoming much more prevalent as people live longer. It is also believed that exposure to UV light is a major factor in its development.
New research strongly suggests that many (not all) people with a family history of macular degeneration are more at risk. Studies also show that many people can help protect themselves by eating dark green leafy vegetables, like spinach, kale or collard greens, four times a week. Other leafy veggies, cauliflower, broccoli and Brussels sprouts also might be useful.
It's also important to exercise regularly and avoid smoking.
There are eye supplements available that contain the essential elements found in dark green leafy vegetables primarily lutein and zeaxanthin. Taking these supplements as directed may help forestall the effects of macular degeneration. Dr. Dubow
Q: Can age cause your eye to have a hole in it behind the cornea? Laura, Alabama
A: The hole "behind the cornea" is the pupil, which is an opening in the iris that allows light to pass through to the retina. Retinal holes are possible and occur with a higher frequency as we get older. Small holes in the macula (area of central vision) can seriously affect one's central vision while the peripheral portion of the retina remains intact and normal. Dr. Slonim
Q: My left eye is seeing straight lines as wavy. The vision in that eye also tends to have blind spots come in and out, like things are morphing. What is this condition, and is there a treatment for it? R.Z., California
A: If straight lines are wavy, then you need to see an ophthalmologist (probably a retinal specialist) to rule out a problem in your macula or other ocular structures. Dr. Slonim
[Editor's note: One way to tell if lines are wavy or there are spots in your vision is to view an Amsler grid. This is a chart of black lines arranged in a graph pattern. Click here to see how an Amsler grid works. Keep in mind that the Amsler grid is not a complete visual test, and an ophthalmologist who specializes in the retina will have much more sophisticated tools for detecting serious vision problems such as macular degeneration.]
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[Page updated September 2011]
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