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Macular Degeneration

Macular degeneration is a chronic eye disease that causes vision loss in the center of your field of vision. There are two types of age-related macular degeneration, wet and dry.

Dry macular degeneration, the more common of the form of the disease, may case blurred vision or a blind spot in your central vision. This may make a difficult to read, drive or recognize faces. The severity of dry macular degeneration usually worsens gradually. You may notice these vision changes:

  • The need for brighter light when reading or doing close work
  • Increasing difficulty adapting to low light levels, such as when entering a dimly lit restaurant
  • Increasing blurriness of printed words
  • A decrease in the intensity or brightness of colors
  • Difficulty recognizing faces
  • A gradual increase in the haziness of your central or overall vision
  • Crooked central vision
  • A blurred or blind spot in the center of your field of vision
  • Hallucinations of geometric shapes or people, in case of advanced macular degeneration

Dry macular degeneration may affect one or both eyes. If only one eye is affected, you may not notice any changes in your vision because your good eye may compensate for the weak eye.

The exact cause of dry macular degeneration is unknown but there are several factors that may increase your risk of macular degeneration:

  • Age. Your risk of macular degeneration increases as you age, especially after age 50. Macular degeneration is most common in people older than 65.
  • Family history of macular degeneration. If someone in your family had macular degeneration, you’re more likely to develop the condition.
  • Race. Macular degeneration is more common in whites (Caucasians) than it is in other races.
  • Smoking. Smoking cigarettes increases your risk of macular degeneration.
  • Obesity. Being severely overweight increases the chance that early or intermediate macular degeneration will progress to the more severe form of the disease.
  • Unhealthy diet. A poor diet that includes few fruits and vegetables may increase the risk of macular degeneration.
  • Cardiovascular disease. If you have had diseases that affected your heart and blood vessels (cardiovascular disease), you may be at higher risk of macular degeneration.
  • Elevated cholesterol. Elevated cholesterol may be associated with a higher risk of macular degeneration.

Dry macular degeneration is categorized in three stages based on the progression of damage in your eye:

  • Early stage. In early macular degeneration, doctors may detect several small drusen or a few medium-sized drusen under the retina in one or both eyes. Generally, you won’t experience any vision loss in the earliest stage.
  • Intermediate stage. In intermediate macular degeneration, doctors detect a large number of medium-sized drusen or one or more large drusen in one or both eyes. At this stage, you may not have symptoms. However, you may notice your central vision is blurred, or you may need extra light for reading or doing detail work or it may take you longer to recover your vision when entering a room that is not well illuminated.
  • Advanced stage. In advanced macular degeneration, doctors detect several large drusen, as well as extensive breakdown of cells in the macula. You may have a well-defined area of blurring in your central vision, which may gradually grow larger.

Treatment can’t reverse dry macular degeneration. But this doesn’t mean you’ll eventually lose all of your sight. Dry macular degeneration usually progresses slowly, and many people with the condition can live relatively normal, productive lives, especially if only one eye is affected. Your doctor may recommend annual eye exams to see if your condition is progressing.

For selected people with advanced macular degeneration in both eyes, one option to improve vision may be surgery to implant a telescopic lens in one eye. The telescopic lens, which looks like a tiny plastic tube, is equipped with lenses that magnify your field of vision. The telescopic lens implant may improve both distance and close-up vision.

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