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HEALTH - EYESIGHT

Macular Degeneration -- Silent Vision Loss

by Richard O. Aichele

For most people, the ability to see the world around them is taken for granted. But increasingly, for people especially after the age of 55, macular degeneration may be a silent thief stealing their eyesight possibly leaving them increasingly visually impaired.

Macular degeneration is a degenerative eye disease that can result in the loss of vision by spreading outward as a growing black spot from the normal center of vision. As the disease takes hold, according to the Mayo Clinic, "People with macular degeneration may notice either a rapid onset of symptoms, slight symptoms that progress gradually, or no symptoms at all. Doctors may decide to test for the disease based on family history and symptoms the patient is experiencing. A thorough eye examination is performed by the doctor to identify any abnormalities in the back of the eye, in a portion of the retina called the macula."

The Mayo Clinic further explained the two types of macular degeneration:

"Dry macular degeneration is a chronic eye disease that causes vision loss in the center of your field of vision. Dry macular degeneration is marked by deterioration of the macula which is in the center of the retina — the layer of tissue on the inside back wall of your eyeball. Dry macular degeneration doesn't cause total blindness, but it worsens your quality of life by blurring or causing a blind spot in your central vision. Clear central vision is necessary for reading, driving and recognizing faces.

Wet macular degeneration is a chronic eye disease that causes vision loss in the center of your field of vision. Wet macular degeneration is marked by swelling caused by leaking blood vessels that affect the macula. Wet macular degeneration almost always begins as dry macular degeneration. It's not clear what causes wet macular degeneration to develop. Early detection and treatment of wet macular degeneration may help reduce the extent of vision loss and, in some instances, improve vision."

RISK FACTORS and TREATMENT APPROACHES

The American Academy of Ophthatmology publication explained some of the risk factors associated with macular degeneration: "The main risk factor for the development of advanced AMD is increasing age. Although a number of risk factors have been investigated, cigarette smoking is the only risk factor other than age and ethnicity that has been consistently identified in numerous studies. Smoking doubles the risk of Age-related Macular Degeneration (AMD) and there appears to be a close response whereby increasing odds are associated with an increased number of pack-years smoked. Smoking cessation was associated with a reduced risk for AMD; the risk of developing AMD in those who had not smoked for over 20 years was comparable to the risk in nonsmokers. Other factors that may play a role in AMD are hypertension and other underlying atherosclerotic disease processes.

Additional risk factors may include low levels of antioxidants. Data from observational studies have been inconsistent in identifying low levels of plasma and dietary antioxidants of vitamins C and E, carotenoids, lutein/zeaxanthin, and zinc as risk factors for AMD. The AREDS results show a beneficial effect of high doses of antioxidant vitamins (vitamins C, E, beta-carotene) and zinc supplementation in reducing progression of intermediate AMD or advanced AMD in the fellow eye to advanced AMD by 25 percent."

According to an American Health Assitance Foundation report, "There is currently no specific treatment for dry macular degeneration, however, taking a specific high dose of formula of vitamins and mineral supplements from the Age-Related Eye Disease (ARED) Study's formula can significantly reduce the risk of progressing from intermediate dry macular degeneration to advanced or wet macular degeneration." Other studies to determine causes and possible cures using the AREDS concept by the Federal government's National Eye Institute determined that development of advanced AMD could be potentially reduced by about twenty-five percent with a patient on a diet that includes high levels of antioxidants.

The various study results indicate that the AREDS formulation including high levels of antioxidants and zinc while not a cure for AMD, could play a key role in helping people at high risk for developing advanced AMD by close to twenty-five percent improving the chance of keep their remaining vision," reported by the National Eye Institute. Specifically the Institute's research indicates, "The specific daily amounts of antioxidants and zinc used by the study researchers were 500 milligrams of vitamin C; 400 International Units of vitamin E; 15 milligrams of beta-carotene (often labeled as equivalent to 25,000 International Units of vitamin A); 80 milligrams of zinc as zinc oxide; and two milligrams of copper as cupric oxide. Copper was added to the AREDS formulations containing zinc to prevent copper deficiency anemia, a condition associated with high levels of zinc intake."

THE IMPORTANCE OF EYE EXAMINATIONS

Receiving regular eye examinations by a optometrist or ophthatmologist is the best approach to monitor a person's eye health. Ideally, the examination may determine there are no indications of macular degeneration.

However, if the examinations determines a presence of macular degeneration indicators, the American Academy of Ophthatmology publication explained several levels of the disease. "People with early AMD have either several small drusen or a few medium-sized drusen. At this stage, there are no symptoms and no vision loss. People with intermediate AMD have either many medium-sized drusen or one or more large drusen. Some people see a blurred spot in the center of their vision. More light may be needed for reading and other tasks. People with advanced dry AMD in addition to drusen have a breakdown of light-sensitive cells and supporting tissue in the central retinal area. This breakdown can cause a blurred spot in the center of your vision. Over time, the blurred spot may get bigger and darker, taking more of your central vision. You may have difficulty reading or recognizing faces until they are very close to you."

Furthermore, according to the publication, while determining the extent of the disorder of the macula, the physician will consider one or more of the following: "Drusen formation; retinal pigment epithelium (RPE) abnormalities such as hypopigmentation or hyperpigmentation; geographic atrophy of the RPE and choriocapillaris; and neovascular (exudative) maculopathy."

For a person diagnosed with any level of macular degeneration, it is important to work closely with both their optometrist and ophthatmologist to understand the technical issues of eye disease and also with their regular physician to monitor overall health issues and diet that could have an affect on the progression of the macular degeneration disease.

Notice: The information provided in this article is for general information only and does not in any way represent to be professional medical advice. The best personal procedure for individuals is to consult their physicians for any and all health issues. They are the experts.