If you are interested in seeing what having macular degeneration looks like, here is a great link to the sight simulator on the Fred Hollows Foundation website, which offers you a sense of what it is like to have visual impairment.
What is the macula?
The macula is the central area of the retina, the nerve tissue lining the back of the eye. The special cells of the macula, called cones, allow us to see colour, faces, and fine detail. They are some of the most metabolically active cells in the body, so over time, they can wear out. This process of ageing is also known as oxidative damage and may be accelerated by smoking, drinking, eating harmful foods and other forms of physical, mental and emotional stress.
What are drusen?
As the cells of the macula become less efficient, their waste products, called drusen, can build up under the cells. We can see this when we look into the eyes.
What is dry macular degeneration?
Over time, this wear and tear can lead to dry macular degeneration, which is the more common, but currently untreatable condition.
Dry macular degeneration usually develops quietly and slowly, over years to decades. There is no known treatment at this stage, but the process may be prevented or slowed with the use of anti-oxidants and anti-inflammatories. These include the water soluble vitamins A, C and E. Lutein, zeaxanthin and astaxanthin may also be of help, as may trace elements and minerals such as selenium and zinc, and anti-inflammatory agents such as bilberry.
Supplements have been shown to be of benefit if taken when drusen – the yellow spots which are the early signs of macular degeneration – are present, but not if you have no sign of macular degeneration at all.
What is wet macular degeneration?
Less commonly, blood vessels can grow in to the macula, and can leak or bleed, causing wet macular degeneration. This can be treated, but the treatment consists of laser or regular injections into the eye, so it is a treatment you would rather not need!
Wet macular degeneration can develop quite quickly and dramatically. Prevention with regular anti-oxidants is important. Early detection is key, as treatment is now available if the process is detected in the early stages. Tests are available to detect macular degeneration in its early stages – OCT, fundus photography and fluorescein angiography – and treatment is now available, in the form of injections of anti-VEG-F (Vascular Endothelial Growth Factor) hormones that shrink the abnormal blood vessels in the retina and allow the body to resorb any blood and fluid.
This is why regular eye examinations are important as we age, so that we know if we are at risk of this condition and so that we know what to seek help for. Symptoms include blurring or distortion of the central vision, particularly for reading and seeing faces.
Injections for macular degeneration
If you need injections for wet macular degeneration, we offer these in our office. They are given with local anaesthetic, so there is a slight feeling of pressure, but they don't hurt. The idea of having an injection in your eye can be scary, but the reality is not so bad. We take our time to take care of you and make you feel comfortable and settled before we begin, and you are welcome to stay with us as long as you like afterwards until you feel ready to go.
It is important that someone bring you to the appointment as your vision may be blurry for a while afterwards and you should not drive yourself home. It is also lovely just to have the support of someone who cares while you are having this procedure done.
Afterwards, there may be some slight discomfort for a day or so and if you have any unusual symptoms (pain, worsening vision, flashing lights or loss of vision) you need to contact us so we can make sure you are ok. Very rarely, the injections can cause haemorrhage, retinal tears or infection, but if attended to promptly, these can be treated.
What can I do?
You can test your macula at home every day using an Amsler grid, testing each eye separately with your glasses on, and if you notice any change, let your eye doctor know promptly.
Prevention is key, and if you are really interested in preventing eye disease, the best thing to do is to care for the whole of you, as your eyes are part of you!
The diet that is good for the eyes, is also the best diet for the whole of us: Lean meat, oily fish, green leafy vegetables, nuts, seeds and a little fruit (not too much, as it’s full of sugar!)
Taking supplements can help, if your diet is poor or if you have early stage disease.
You can stop smoking, drinking, eating margarine and other engineered fats and oils, and limiting your intake of high carbohydrate processed foods (which can be inflammatory).
You can look in the mirror and learn to love what you see, accepting yourself as you are and appreciating what you have now, without focussing on what was or might have been. You can look out and appreciate life, making the most of every day and what it offers... you are here, so why not enjoy it!
Please Contact the Clinic if you would like to know more.