Monday, February 27, 2017

The eyes have it.

That is not a typo. I don't mean ayes, that the ayes have it as opposed to the nays. I meant just what I said, that the eyes have it as opposed to, say, the feet.

Houston, we have a problem.

Recently I learned that I have Age-related Macular Degeneration (AMF). If you don't know where the macula is, here's a helpful chart:


When my ophthalmologist told me that I have macular degeneration, I thought immediately about a friend of mine who was told the same thing about 25 years ago who has become legally blind. I immediately thought this will be happening to me also, but the good doctor told me it probably will not. For one thing, mine was found fairly early. For another, the medical community has learned a few things in the past 25 years.

Most of the information in the remainder of this post is from a handout provided by the American Academy of Ophthalmologists.

Age-Related Macular Degeneration (AMD) is a problem with your retina. It happens when the part of the retina called the macula is damaged. With AMD you lose your central vision. You cannot see fine details, whether you are looking at something close or far, but your peripheral vision will still be normal. This is akin to looking at a clock with hands and being able to see the clock's numbers but not the hands.
















I would say that the illustration above is very accurate. In very dim light I experience something quite similar, except that in my own case the smudge is only about the size of a quarter instead of the size of a silver dollar.

AMD is very common. It is a leading cause of vision loss in people 50 years or older. Unfortunately there is no cure for AMD. But it can be treated, if that is the right word, slowed down significantly, or even arrested at its current level in some cases.

I have learned that there are two types of AMD, "dry" and "wet." Lucky me, I have both types (one type in my left eye and the other type in my right eye).

Sometimes drusen (tiny white or yellow particles that form under the retina) develop. They seldom cause vision loss, but many (or very large) drusen can be a sign of AMD.

Dry AMD is quite common. About 90% of people who have AMD have the dry form. Dry AMD occurs when parts of the macula get thinner with age and drusen grow. You slowly lose central vision. There is no way to treat dry AMD yet. However, a major study that lasted several years (called AREDS and AREDS2) revealed that people with serious vision loss may be able to slow their dry AMD by taking these vitamins and minerals on a daily basis:

Vitamin C (500 mg)
Vitamin E (400 IU)
Lutein (10 mg)
Zeaxanthin (2 mg)
Zinc (80 mg)
Copper (2 mg)

...so I have begun doing that. They can be purchased over the counter without a prescription. The important thing is that the brand you buy says "AREDS2" on the package. I'm taking PreserVision by Bausch & Lomb.

Wet AMD is less common but much more serious. Wet AMD occurs when new, abnormal blood vessels grow under the retina. These vessels may leak blood or other fluids, causing scarring of the macula. A person loses vision faster with wet AMD than with dry AMD. To help treat wet AMD, medications called anti-VEGF (Vascular endothelial growth factor) drugs can help reduce the number of abnormal blood vessels in the retina and also slows any leaking from blood vessels. This medication is given through injections (shots) in your eye. As I was saying, lucky me.

I am grateful that treatment exists and that complete blindness will probably not occur. Still, who wants to get shots in the eye?

Nobody, that's who, unless you discover that you need them to retain what vision you have.

So I received my first shot a couple of weeks ago and will be getting one per month for a while. The doctor said that if there is noticeable improvement he may lengthen the interval between the shots.

Laser surgery may also be used to treat some types of wet AMD. The doctor and I may be talking more about this down the road.

You now know as much about Age-Related Macular Degeneration as I do.

Lucky you.

6 comments:

Shooting Parrots said...

I'm sorry to hear your news. Blindness is one of my great fears. As it happens, I do know something about the macula as I had to take my dad to see the ophthalmologist a couple of weeks ago. He has minor cataracts that are to be treated, but while it might make his world seem brighter, it is unlikely to help him read the small print of his tv because of irreparable damage to the macula.

Emma Springfield said...

A SHOT IN THE EYE????!!!! I can't deal with the thought. Oh my God!

rhymeswithplague said...

Ian, as it happens I also have some cataracts in my left eye, but apparently surgery is not called for yet. Mrs. RWP had cataracts removed from both eyes several years ago without any complications afterward.

Perhaps I didn't understand what you were saying about your dad's eyes -- I read it to mean that his cataracts had caused the damage to his macula, but that can't be right because cataracts affect the lens at the front of the eye and the macula is a next to or a part of the retina at the back of the eye. I'm thinking you mean that your dad has both cataracts and macular damage but not that the one caused the other.

rhymeswithplague said...

Emma, I know. It is sort of scary to think about, but the reality is nowhere near as bad as the prospect. They thoroughly numb everything first, so you don't really feel anything when they do it. And the shot actually goes into the white of the eye, not the iris or the pupil. I hope that helps a little.

Yorkshire Pudding said...

Oh dear. Thanks for sharing this with your blogging friends Bob. This post has taught me a lot about macular degeneration. To be frank, I knew nothing about it beforehand but now I know that I do not want it to happen to me!

rhymeswithplague said...

YP, neither did I, but nonetheless it happened to me. I don't think anyone has figured out how to prevent it, though, since it is "age-related" -- and we all age. Not everyone who ages gets macular degeneration, of course, but everyone who gets macular degeneration has aged. I hope you stay free of it, but I have no advice to offer on how to keep that particular wolf from your door.