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Macular Degeneration

The retina is a thin membrane (like wet tissue paper) that lines the back of the eye. Its purpose is to turn the light into a picture that can be sent to the brain through the optic nerve.

The retina is divided into 2 parts: a central part, called the macula, and an outside or peripheral part.

The central part is the most important as we look straight ahead to see most things. As such, this central part gets more use than any other area. It is more prone to aging changes.


Dry Macular Degeneration

We often see yellow deposits under the central retina or macula, and we call these deposits DRUSEN.

When significant DRUSEN is present, we call this dry macular degeneration. It is very common, slowly progressive, and usually affects your vision mildly or sometimes not at all. Sometimes, dry macular degeneration can lead to a loss of the key vision cells called rods and cones in a condition called atrophy. Many companies are working on medication to treat this atrophy. We look forward to a better future with this condition.

Dry macular degeneration is the better kind to have.


Sometimes, this dry macular degeneration switches to the more serious kind of macular degeneration: wet macular degeneration. In this case, abnormal blood vessels start to grow under the macula, and they can leak fluid or blood and cause SUDDEN, SIGNIFICANT loss of vision.

Wet Macular Degeneration


Symptoms of macular degeneration include wavy lines, central blurring, and distorted vision.

They are often best seen with an Amsler Grid. This test displays vertical and horizontal straight lines in front of the patient. Bent, missing, or distorted lines often signal the onset of macular degeneration. It should be used with 1 eye at a time.

Who Gets Macular Degeneration?

The biggest risk factors for macular degeneration are a family history, smoking, and age.


High doses of Vitamin E (400 units/day), C (500 mg/day), lutein (10 mg), Zeaxanthin (2 mg), and Zinc (60 mg/day) have been shown to slow the progression of macular degeneration. These vitamins can be found in a combined formulation called AREDS 2. It stands for Age-Related Eye Disease Study #2. Many companies make this formulation, and all are helpful, as long as it says AREDS 2.

The mainstay of treatment for wet macular degeneration is intraocular injections. Many exceptional options include Avastin, Lucentis, Eylea, and Vabysmo. All these medications work to cause the abnormal blood vessels to shrink and stop leaking. They are well-tolerated but often have to be repeated frequently (initially monthly and then sometimes less often). The main risk of these injections is an intraocular infection. Fortunately, it is exceptionally rare but can be very serious.

Click here to see the Amsler Grid.