Overview
Dry macular degeneration is a common eye disorder, primarily affecting people over 50, that causes blurred or reduced central vision. It's caused by the breaking down of the inner layers of the macula, the part of the retina responsible for clear vision in the direct line of sight. Dry macular degeneration may progress slowly over years and can eventually result in vision loss, but not total blindness. It's one of two types of age-related macular degeneration, with the wet type being more likely to cause sudden vision loss. The exact cause of dry macular degeneration is unknown, but it's believed to be a combination of genetic and environmental factors, such as smoking, obesity, and diet. Early detection and self-care measures can help delay vision loss.
Understanding the disease
Symptoms
The symptoms of dry macular degeneration may include visual distortions, such as straight lines seeming bent, reduced central vision in one or both eyes, the need for brighter light when reading or doing close-up work, increased difficulty adapting to low light levels, increased blurriness of printed words, difficulty recognizing faces, and a well-defined blurry spot or blind spot in the field of vision. Dry macular degeneration typically develops gradually and without pain, and can affect one or both eyes. If only one eye is affected, you may not notice any changes in your vision, as your good eye may compensate for the affected eye. The condition doesn't affect the side vision, so it does not cause total blindness.
Risk Factors
The risk factors for developing dry macular degeneration include:
- Age: The disease is most common in people over 60.
- Family history and genetics: The disease has a hereditary component, and researchers have identified several genes linked to the condition.
- Race: Macular degeneration is more common in white people.
- Smoking: Smoking cigarettes or being regularly exposed to tobacco smoke greatly increases your risk of macular degeneration.
- Obesity: Research indicates that being obese may increase your chance that early or intermediate macular degeneration will progress to the more severe form of the disease.
- Cardiovascular disease: If you have heart or blood vessel disease, you may be at higher risk of macular degeneration. It is essential to take care of your eye health by following a healthy lifestyle, managing any medical conditions, not smoking, maintaining a healthy weight, and eating a diet rich in fruits and vegetables. Regular eye exams can also help identify early signs of macular degeneration and ensure timely treatment if necessary.
Development
Dry macular degeneration is one of two types of age-related macular degeneration. It typically progresses slowly over years and is the more common form. Dry macular degeneration causes the breaking down of the inner layers of the macula, which leads to blurred or reduced central vision. It can develop in one eye before affecting the other, or it can develop in both eyes simultaneously. Over time, vision may worsen, but people retain their peripheral vision. Dry macular degeneration may progress to wet macular degeneration, which is when blood vessels grow and leak under the retina. The wet type is more likely to cause a relatively sudden change in vision resulting in serious vision loss.
Assessment and Diagnosis
Triage
You should see a doctor if you notice any changes in your central vision, such as distortion or blind spots, or if you lose the ability to see fine detail. These changes may be the first sign of macular degeneration, particularly if you're over age 60.
Diagnosis
To diagnose dry macular degeneration, an eye doctor may review your medical and family history, conduct a complete eye exam, and perform tests such as:
- Examination of the back of your eye: Your eye doctor will dilate your eyes and examine the back of your eye for yellow deposits called drusen, which are characteristic of macular degeneration.
- Amsler grid test: This test checks for changes in the center of your vision. If you have macular degeneration, the lines in the grid may appear faded, broken, or distorted.
- Fluorescein angiography: An injected dye highlights blood vessels in your eye, and a special camera captures images to show if there are retinal or blood vessel changes, which indicate wet macular degeneration.
- Indocyanine green angiography: This test, like fluorescein angiography, uses an injected dye to identify specific types of macular degeneration.
- Optical coherence tomography: This noninvasive imaging test displays detailed cross-sectional images of the retina, helping to identify areas of retina thinning, thickening, or swelling caused by fluid buildup from leaking blood vessels. Please consult with an eye care specialist or healthcare professional for personalized advice and accurate information.
Management and Treatment
Prevention
Dry macular degeneration is often a progressive condition, and there is currently no cure. However, certain measures can be taken to potentially reduce the risk of developing dry macular degeneration or slow its progression. These measures include:
- Regular eye exams: Having routine eye exams can help detect early signs of macular degeneration, allowing for early intervention and management.
- Managing medical conditions: Controlling cardiovascular disease, high blood pressure, and other health conditions can help reduce the risk of macular degeneration.
- Quitting smoking: Smokers are more likely to develop macular degeneration, so quitting smoking can help lower the risk.
- Maintaining a healthy weight and exercising regularly: A healthy lifestyle can help reduce the risk of developing macular degeneration.
- Consuming a diet rich in fruits and vegetables: Fruits and vegetables containing antioxidant vitamins can help protect against macular degeneration.
- Including omega-3 fatty acids in your diet: Omega-3 fatty acids, found in fish and some nuts, may help reduce the risk of macular degeneration. While these measures may not prevent macular degeneration entirely, they can help delay its progression and potentially reduce the risk of developing the condition.
Home Remedies
There are no specific home remedies to cure or treat dry macular degeneration. However, following a healthy lifestyle and taking certain precautions may help reduce the risk of progression and potentially delay vision loss. These measures include:
- Maintaining a healthy weight and exercising regularly.
- Eating a diet rich in fruits and vegetables, which contain antioxidant vitamins that may reduce the risk of macular degeneration.
- Including fish in your diet, as it is a good source of omega-3 fatty acids, which may also reduce the risk of macular degeneration.
- Quitting smoking if you are a smoker, as smoking increases the risk of developing macular degeneration.
- Managing any underlying medical conditions, such as cardiovascular disease or high blood pressure, under the guidance of your healthcare provider. It is important to note that dry macular degeneration is a progressive condition, and there is no cure at present. Regular eye exams are essential for early detection and monitoring, and your healthcare provider can recommend appropriate treatment options to slow down the progression of the disease.
Treatment
There is currently no way to reverse the damage caused by dry macular degeneration. However, if your condition is diagnosed early, you can take steps to help slow its progression. These steps include eating a healthy diet, not smoking, and taking specific vitamin supplements. A high-dose formulation of antioxidant vitamins and minerals, as shown by the Age-Related Eye Disease Study 2 (AREDS2), may help reduce the risk of vision loss for people with intermediate or advanced disease. This formulation includes vitamin C, vitamin E, lutein, zeaxanthin, zinc, and copper. Surgery to implant a telescopic lens may also be an option for selected people with advanced dry macular degeneration in both eyes. It's important to consult with your eye doctor to determine the best course of treatment for your specific condition.
Preparing for medical consultation
To prepare for an appointment for dry macular degeneration, you should:
- Make an appointment with an eye doctor specializing in eye care, such as an optometrist or an ophthalmologist.
- Ask if there are any specific preparations needed before the appointment, such as not wearing contact lenses or fasting for certain tests.
- List any symptoms you're experiencing, including those unrelated to your vision.
- List all medications, vitamins, and supplements you take, including doses.
- Ask a family member or friend to accompany you to the appointment, as your vision may be affected after the dilated eye exam. Remember to discuss any concerns or questions you have with your eye doctor during the appointment.