Welcome to Envision!

Welcome to Envisionus.com!

Main Menu:
[Home]
[Vision Rehabilitation]
[Education and Resources]
  [Advocacy]
  [Op/Eds]
  [Vision Loss]
    [Vision Loss Overview]
    [Diabetic Retinopathy]
    [Glaucoma]
    [Macular Degeneraion]
    [Vision Loss from Stroke]
    [Vitamins and AMD]
  [Grants]
  [Mailing List]
[Employment]
[How You Can Help]
[Media Center]
[About Envision]

Sitemap

Site Navigation:
Home > Education and Resources > Vision Loss

Macular Degeneraion

At age 89, celebrated artist Georgia O'Keefe described her vision loss.

"It's like there are little holes in my vision," she said. "I can't see straight on very well. But around the edges are little holes where I can see quite clearly."

O'Keefe had age-related macular degeneration (AMD), the most common cause of vision loss for older Americans. As many as 13 million people in the U.S. age 40 and older have signs of the disease, and 1.8 million Americans older than 65 have vision loss from it. The National Eye Institute projects 2.9 million Americans will be affected by AMD by the year 2020.

While there is no cure for most forms of AMD, vision rehabilitation can help affected individuals get the most from their vision. Vision rehabilitation begins with an assessment by an optometrist who specializes in low vision, then uses that information to create a rehabilitation program. This may involve training and use of optical devices, lighting and other techniques to make the most of the "little holes" where the patient can see "quite clearly."

How Macular Degeneration affects your vision

Macular degeneration is a retinal disorder. The retina is at the back of your eye and functions like film in a camera. It is here that visual information is collected and then sent on to the brain for processing. At the center of the retina lies the macula. This is where central vision and fine detail are resolved.

Many people with vision loss have blank spots, or scotomas, on their retinas. With macular degeneration, the scotomas are over the macula, creating the frustrating loss of central vision that characterizes the disease.

"The problem with scotomas is that you can't identify where they are," said Steve Stambaugh, Envision Rehabilitation Center director. "Your brain ‘fills in' the information missing from scotomas. You may perceive a loss of acuity, or vision sharpness. But no glasses can improve what you can't see at all."

The first step in managing macular degeneration is identifying the scotomas. At Envision, this is done with a diagnostic tool called the scanning laser ophthalmoscope. It takes a picture of the retina, and the patient responds to a series of stimuli from a laser light to identify exactly where they can – and can't – see.

Once this map of the retina is created, the doctor can begin to teach you where the vision loss resides, and can create a plan of care for you. This may involve a new eyeglass prescription, use of other optical devices and magnifiers, lighting, filters, contrast enhancement and new viewing techniques.

"While we can't cure macular degeneration, we can help our patients maximize their functional vision," said Stambaugh. "We can preserve independence and greatly enhance the patient's quality of life."

Two Kinds of Macular Degeneration

"Dry" macular degeneration accounts for 90 percent of all cases of AMD. It occurs when small deposits of drusen, a yellowish material, accumulate on the macula. The accumulation interferes with the macula's ability to sense light, which leads to distortion and loss of central vision. This accumulation may begin as many as ten years before you notice any vision loss, and its progression is subtle and painless.

Wet macular degeneration is caused when tiny, abnormal blood vessels begin to grow behind the retina near the macula. These vessels can leak and damage the macula, leading to rapid and sometimes severe vision loss. Wet macular degeneration almost always occurs in people who already have dry macular degeneration. If you ever experience sudden changes in your vision, you should see your eye doctor immediately. You may also want to look at an Amsler Grid every day to watch for changes in your vision.

Your eye doctor may be able to treat wet macular degeneration. There are different technologies available that use lasers to destroy leaking blood vessels. This treatment is typically done on an outpatient basis and may require followup visits.

Risk Factors and Prevention

Age is the largest predictor of getting macular degeneration. While it is rare in middle age, almost a third of those older than 75 have it. Additionally, women are at greater risk than men, and Whites are more likely to get it than other ethnic groups. If others in your family have had macular degeneration, you have slightly increased odds of getting it yourself.

Prevention is mostly a matter of living a healthy lifestyle. Some studies have shown that taking vitamins and eating a diet rich in fruits and leafy green vegetables can offer some protection from the disease. You should limit fat intake, keep your blood pressure down and avoid excessive alcohol use. And you should wear sunglasses or eyeglasses with ultraviolet light protection and wear a brimmed hat while outside.