Macular Degeneration Evaluation

Macular Degeneration is an eye disease that destroys central vision through damage to the macula, a small part of the retina in the back of the eye. It is the leading cause of blindness over the age of 60 and currently affects approximately fifteen million people in the United States. As of 2020, more than 190 million people are affected globally, with projected numbers reaching 288 million by 2040. While there is no cure for AMD (Age Related Macular Degeneration), and its effects are irreversible, reducing the risk factors is the most effective way to control the vision loss that comes with this disease.

Risk factors:

• Family history
• Smoking (past or present)
• Age – over the age of 55
• Low macular pigment
• Light colored skin and eyes
• Female
• Unprotected exposure to sunlight
• Obesity
• Poor diet

Genetics account for the highest risk of developing AMD. Having a mother, father, sister or brother with AMD suggests you have a significantly higher risk of developing the disease. Macular DNA testing is available that will reveal patients with the highest risk.

Symptoms of Macular Degeneration

The symptoms of AMD are blurred central vision usually more advanced in one eye. The visual effect may also be a distortion or waviness in reading a printed line or looking at any straight edge. The onset may be gradual or sudden.

Testing for Macular Degeneration

The beginning point is always an individualized, preventative, comprehensive eye health examination. If AMD is suspected, other tests may be performed.

• Amsler Grid – The Amsler Grid is an important simple tool that tests macular vision and helps detect specific types of vision loss associated with AMD. This test uses a grid chart and can be administered in the office but also may be taken home for monitoring by the patient.
• Visual Field Testing – Sophisticated central visual field testing can show loss of central vision sensitivity even though visual acuity may not be affected.
• Optical Coherence Tomography (OCT) – This advanced technology allows Drs. Hansen, Pietigs, and Seelye to look below the surface of the retina and gain a 3D view of the inner retina. This can show damage or leakage in this area. The OCT is especially helpful in detecting change from visit to visit.
• Digital Photography – This advanced high-resolution camera allows our doctors to carefully exam the retina and preserve images to compare to later examinations.
• Biomicrosopy (Slit Lamp) – This instrument with special hand held lenses allows for highly magnified views of the macula and other parts of the retina.
• Quantify Macular Pigment Testing (MPOD) – Technology now allows us to measure the density of pigment (Zeaxanthin and Lutein) in the macula. This instrumentation is called the MPOD. A lower pigment level is a major risk factor in the development of AMD. We are one of a handful of optometric offices in the state that has this technology in house.

Treatment for Macular Degeneration

• Prevention – As previously stated, there is no cure for AMD, but reducing ones risk factors can go a long way in preventing the onset or the progression of the disease process. A recent study (AREDS – II) showed the effectivity of several nutrients but especially the two pigments, Zeaxanthin and Lutein. These two nutrients are present in food and can increase the pigment when eaten in large enough quantities. However, the fastest way to increase the macular pigment is through the EyePromise supplements, with the highest concentration of Zeaxanthin in any product sold today.
• Follow up – When AMD is detected, frequent follow up eye health examinations are recommended. If swelling in the macula is found, caused by leakage of vessels (Wet Macular Degeneration), our doctors will refer you to a retinal specialist. One of the treatments for this leakage is a medication injected into the eye which will reduce the swelling. At times laser treatment to the leaking vessel may be necessary.