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Macular disease
Age related macular degeneration
Macular degeneration is a disorder leading to the loss of central vision (the ability to see straight ahead). It is the most common cause of vision loss in people over sixty. By the age of seventy-five, it is thought that nearly fifteen per cent of people are affected. Macular degeneration does not lead to total blindness as it only affects central vision and not peripheral vision.
Macular degeneration occurs when there is damage to the cells of the macula (the central part of the retina). Light enters the eye through the pupil and is focused on the retina. The retina sends the messages it receives to the brain. In the centre of the retina is an area called the macula. The function of the macula is to allow people to see straight ahead. When there is damage to the cells of the macula, this ability is impaired and people cannot see the fine detail that is required for reading, writing and colour perception.
Normally, both eyes are affected by Macular Degeneration but a diagnosis may be delayed by only one eye being affected before the other and the loss of central vision not being so obvious.
There are two main types of Macular Degeneration: 'wet' and 'dry'. They can be detected by an optometrist but are not perceived as wetness or dryness by an affected individual. In wet Macular Degeneration, there is a build up of fluid under the retina. It is the resulting scarring that leads to a rapid deterioration of central vision. Dry Macular Degeneration progresses over a longer period of time and results from the cells of the macula gradually ceasing to act.
The first signs of loss of central vision can include :
Whilst there is no cure or reliable therapy for dry Macular Degeneration, there are approved treatments for some people with wet Macular Degeneration. These may involve various types of laser, one of which, used in photodynamic therapy (PDT), combines the injection of Visudyne with cold laser treatment. Others include surgical operations on the macula and injections into the eye of substances which can halt the progress of scar formation.
The effects of Macular Degeneration have a major impact on the life of the affected individual who cannot drive or continue to carry out ordinary every day tasks. For younger people with Macular Degeneration who are of working age, the impact on their ability to work is very profound.
Optometrists, GPs and ophthalmic specialists can advise on ways to maximise the visual abilities of affected people. Among the ways of doing this is effective use of peripheral vision and use of vision aids such as magnifiers.
Inheritance patterns
Macular Degeneration may occur in certain families, but the inheritance pattern is variable and at present usually unpredictable.
Prenatal diagnosis
None.
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