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| Age-Related Macula
Degeneration |
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| What
is the Macula? |
The
eye is shaped just like a ball. The pupil,
close to the front, is the opening, which
allows light to enter the eye. Just behind
the pupil is the lens, which focuses the light
on the retina at the back of the eye. The
retina is made up of a delicate tissue, which
converts the light into images, and sends
them to the brain. The Macula is a small
area at the very centre of the retina. The
Macula is very important and is responsible
for what we see straight in front of us, allowing
us to see fine detail for activities such
as reading and writing, as well as our ability
to see colour.What is Macula degeneration?Sometimes
the delicate cells of the Macula become damaged
and stop working, and there are many different
conditions, which can cause this. If it occurs
later in life, it is called the ‘ age-related
Macula degeneration’. Unfortunately
we do not yet know why this happens. There
are two main types of Macula degeneration,
usually referred to as ‘wet’ and
‘dry’.
This is not a description of what the eye
feels like, but what the eye specialist can
see when looking at the Macula. Only 10%
of people with Macula degeneration have the
‘wet’ type, all others are affected
by the ‘dry’ type. ‘Wet’
Macula degeneration results in a build up
of fluid under the retina. This causes bleeding
and scarring which leads to sight loss. It
can progress rapidly, normally within a few
months, and sometimes responds to laser treatment
in the early stages. ‘Dry’ Macula
degeneration usually develops slowly, often
over years, and there is as yet no treatment.
Many people find that the visual cells simply
cease to function, like colours fading in
an old photograph.Macula degeneration usually
involves both eyes, although one may be affected
long before the other.
This sometimes, makes the condition difficult
to notice at first because the sight in the
‘good’ eye is compensating for
the loss of the sight in the affected eye.
You cannot wear out your sight, so do not
be afraid to continue to use the ‘good’
eye as normal.And now the good newsMacula
degeneration is not painful, and almost never
leads to total blindness. It is the most common
cause of poor sight in people over 60 but
rarely leads to complete sight loss as only
the central vision is affected. Macula degeneration
never affects vision at the outer edges of
the eye. This means that almost everyone with
Macula degeneration will have enough side
(peripheral) vision to get around and keep
his or her independence.What are the symptoms?In
the early stages your central vision may be
blurred or distorted, with objects looking
an unusual size or shape and straight line
appearing wavy or fuzzy.
This may happen quickly or develop over several
months. You may be very sensitive to light
or actually see lights, shapes and occasional
discomfort but otherwise Macula degeneration
is not painful. Because Macula degeneration
affects the centre of the retina, people with
the advanced condition will often notice a
blank patch or dark spot in the centre of
their sight. This makes reading; writing and
recognising small objects or faces very difficult.
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| What
should I do if I think I have Macula degeneration? |
If
you suspect that you may have Macula degeneration
but there are no sudden symptoms, you should
see your optician or GP who will refer you
to an eye specialist if necessary. If there
is a rapid, significant change in vision,
then you should consult your doctor or local
hospital’s Accident and Emergency department
immediately.
If you have Macula degeneration in one eye,
and you start getting symptoms in your other
eye, then you should go to the hospital that
usually looks after you, or ask your GP to
arrange an emergency appointment, as soon
as possible. This will ensure that if treatment
can be done, you will get it within a few
days. |
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| What
does an eye examination involve? |
Firstly
there will be an assessment of your vision
in both eyes. Then you will be given eye drops
which enlarge your pupil so that the eye specialist
can look into your eye. The drops take about
30 minutes to work although their effect may
last for several hours.
Your vision will become blurred for a while
and your eyes will become sensitive to light,
but this is nothing to worry about. Many patients
with Macula degeneration do not meet the
visual requirements for driving and it is
preferable that you do not drive to the hospital
and if you could bring someone with you to
help you home. |
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| What
is fluorescein angiography? |
In
some cases your eye specialist may decide
that a fluorescein angiogram will also be
needed. This involves taking rapid series
of photographs of your retina with bright
flashes of blue light. These photographs give
an accurate map of the changes occurring in
the Macula and help your eye specialist to
decide what is the best treatment for you.
For the angiogram you will be given a small
injection of special dye in your arm, which
then works its way around to your eye. This
is not painful but you may feel a bit sick.
There are a few side effects, although some
people find that they are dazzled for a while
afterwards. You may also notice that the injection
has left your skin with a faint yellow tinge
from the flourescein dye but this soon passes
into your urine. |
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| Your
Feelings |
A
natural reaction to being diagnosed with Macula
degeneration is to feel upset and angry. Other
people may not understand the problem with
your vision because you will not look as though
you have a sight problem, and they may ask
tactless questions such as ‘why don’t
you just get better glasses?’
Adjusting to any major change in life is not
easy, and it may help to talk to a social
worker, telephone the RINB helpline on 0845
766 9999 or talk to someone from a local society
for people with sight problems. Your family
doctor or social worker will be able to find
a counsellor if you feel that would be helpful.
Talking about and sharing experiences can
be a good way of learning to cope with feelings
and problems that other people with the same
condition may have come across before. |
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Can I be helped to
see better? |
Don’t be
discouraged- you can be helped to see many
of the things you used to by making the best
use of your remaining sight. With Macula
degeneration, this means learning to use your
side (peripheral) vision.
Our Low Vision service can give you advice
and training on the many ways, quite often
simple, in which you can make the most of
your remaining sight. Ask one of our Optometrist
for more information. |
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