Macula of the eye

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The word macula comes from a Latin term meaning "spot." This article will help you learn about a very important spot in the retina of your eyes called the macular lutea — more commonly called the macula of the eye.

What is the macula?

The macula is the most sensitive spot in the center of the retina, which is the light-sensitive tissue that lines the inside of the back of the eye. Also called the macula lutea, this small (less than a quarter inch in diameter) spot is responsible for our central vision and color vision.

“The macula is the area of the retina that allows us to see 20/20,” says Maria Richman, OD, spokeswoman for the American Optometric Association. “It is the small and highly sensitive part of the retina that’s responsible for detailed central vision. The macula allows one to appreciate detail and perform tasks that require central vision, such as reading.”

The macula makes it possible for us to see in great detail while the rest of the retina provides peripheral (side) vision.

There is a very high concentration of cone photoreceptor cells in the center of the macula — in an even smaller spot called the fovea centralis. These "cone" cells are responsible for our ability to see fine details and our color vision.

Outside the macula, the retina contains significantly higher numbers of a different type of photoreceptor cell called rods. Rod photoreceptor cells don't "see" colors, but they provide peripheral vision and detection of movement, and they can function in low-light conditions.

The macula (specifically, the fovea within the macula) is the only area of the retina where 20/20 vision is attainable and where color and fine detail can be distinguished.

Consequently, the macula is responsible for enabling the sharp visual detail that's so important for activities like driving, recognizing faces, watching TV, using a computer and engaging in all other visual tasks that require an ability to see details.

Conditions that affect and can permanently damage the macula include age-related macular degeneration and diabetic retinopathy.

Age-related macular degeneration (AMD)

Macular degeneration is deterioration of the macula that affects a person's central vision. Peripheral vision is not affected.

The most common type of degeneration of the macula is age-related macular degeneration, or AMD.

AMD usually progresses as a slow, painless loss of vision, although in some cases it may be sudden. Early signs of AMD are shadowy areas in your central (“straight ahead”) vision. Straight lines appearing curved or broken and blurred-out spots of text when reading are other common symptoms of AMD.

Age-related macular degeneration is the leading cause of vision loss in people 60 years and older in the United States, and the leading cause of irreversible blindness and visual impairment worldwide. It affects more people than cataracts and glaucoma combined.

The primary risk factor for AMD is aging. According to the Bright Focus Foundation, the risk of getting advanced AMD increases from 2 percent for people in their 50s to nearly 30% for people over the age of 75.

Other common risk factors for AMD include obesity, inactivity, heredity, high blood pressure, smoking, lighter eye color and side effects from drugs.

Diabetic retinopathy

Diabetic retinopathy is a complication of diabetes that causes vision problems. It can develop whether you have type 1 or type 2 diabetes, particularly if you’ve had the disease for a long time or if your blood sugar levels aren’t well controlled.

Diabetic retinopathy occurs when diabetes damages blood vessels that nourish the retina. The retina tries to grow new blood vessels, but these tiny new vessels are fragile and leak easily, causing fluid accumulation, swelling and bleeding in the retina and inside the back of the eye.

If the macula becomes swollen — a condition called diabetic macular edema — treatment is required to prevent permanent vision loss.

Both eyes are usually affected by diabetic retinopathy. Symptoms include blurred or fluctuating vision, spots or dark vitreous floaters, dark or empty areas in the field of vision, impaired color vision and vision loss.

See an eye doctor immediately if any of these diabetic retinopathy symptoms develop.

SEE RELATED: Treatment of diabetic retinopathy and macular edema

Cherry red macula

Cherry red macula is a rare condition. The term describes a reddish area at the center of macula caused by certain health issues.

One of the most common conditions causing a cherry red macula is a lipid storage disorder that leads to central retinal artery occlusion, Richman says.

When lipids (fatty acids) accumulate in harmful amounts in various tissues and cells in the body, they can cause health problems. Symptoms may appear early in life or develop in the teen or even adult years.

“Over time, this storage of excessive fats can cause permanent damage to cells and tissues in the brain, the peripheral nervous system and in other parts of the body,” Richman says.

“Retinal artery occlusion refers to blockage of the retinal artery carrying oxygen to the nerve cells in the retina at the back of the eye. The lack of oxygen delivery to the retina may result in severe loss of vision,” she adds.

Management of cherry red macula depends on the cause. In addition to retinal artery occlusion, causes include Tay-Sachs disease and several other diseases or conditions.

See an eye doctor for regular eye exams

The best way to protect the health of the macula of your eyes for a lifetime of good vision is to have routine eye exams.

To book an eye exam, find an eye doctor near you.

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