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MACULAR DEGENERATION

Ever wondered why you prefer to look at people with your eyes facing them, why you  can’t see them clearly with the side of your eyes? Well that is easy, because at the front position you are seeing the person with your macula.
 
The macula is the region in the retina (i.e. the back of the eye) with which you see the clearest image. The vision you get at the macular is very clear, bright, and colorful and has good contrast. It constitutes the central vision of the field of the eye.
 
Macular degeneration as the name implies is a condition where the macular is damaged. It is often times called age related macular degeneration (ARMD) because it usually affects older adults (>50years). It can make it difficult or impossible to see fine details e.g. reading, recognizing faces. It results in the loss of the centre vision.
 
There are 2 types of ARMD
  •  Dry ARMD (non-exudative)
  •  Wet ARMD (Exudative)
Symptoms are
  • Distorted vision ( metamorphosia) i.e. straight lines appear wavy.
  • Slow recovery of vision after exposure to bright light.
  • Decrease in visual acuity by at least by 2 levels.
  • Blurred vision.
  • Central scotoma- shadow or missing areas of vision.
  • Trouble discerning colours.
  • Loss of contrast sensitivity.
Most signs are:
  •   Drusen- characterized sign
  •  Atrophy
  • Exudative changes- hemorrhages in  the eye, hard exudates etc
  • Pigmentary changes
ARMD does not lead to total blindness. You still get to see with other parts of the retina-the periphery, but the vision lost is irreversible.
Some predisposing factors are:
  •  Aging
  •  Family history
  • Obesity
  • High fat intakes
  • High cholesterol
  • Being Caucasian
  • High exposure to sunlight
  • Low vitamin D levels
  • Smoking
  • Light iris
 
       Diagnosis
  • Use the Amsler’s grid for metamorphosis
  • Snellen chart for visual acuity
  • Angiography- see if there is any hemorrhage in the retina
  • Colour sensitivity test
  • Contrast sensitivity test
  • Optic coherence tomography
 
Management
1.       Dry ARMD is managed with the use of antioxidants
2.       Wet ARMD is managed with the use of intravitreal injection, surgery- laser treatment
3.       Rehabilitative tools-low vision devices
 
Preventive measures are;
  •    Smoking cessation
  •   Reduction in weight- body mass index
  •   Proper management of hypertension etc
If not combated early it could lead to blindness but it definitely leads to loss of efficiency. Visit your eye doctor today for comprehensive check up. If detected early it can be properly managed. 

Dr. Evbu