Macular Degeneration
The macula is the part of the retina responsible for straight-ahead central vision. The macula is used for reading, recognizing faces, and watching television.
Risk factors
- Increasing age
- Smoking history Hypertension
- Overweight
- Hyperopia
- Familial incidence
- Wet AMD (more common in Caucasians than African Americans)
- Use of thyroid hormones & hydrochlorothiazides
- Arthritis
Types -Dry and Wet
l . Dry or non exudative type
- Between 85% and 90% of people
- The outer layers of the retina slowly break down. With this breakdown comes the appearance of drusen.
- When the drusen occur outside of the macular area, patients generally have no symptoms.
- When the drusen occur within the macula, there is a gradual blurring of vision that patients may notice when they try to read.
- There is no known treatment that can slow or curc this type
2. The wet or exudative type,
- May have an abrupt onset.
- Patients complain that straight lines appear crooked and distorted or that letters in words appear broken up.
- This effect results from proliferation of abnormal blood vessels growing under the retina, within the choroid layer of the eye, a condition known as choroidal neovascularization (CNV).
- The affected vessels can leak fluid and blood, elevating the retina.
- Some patients can be treated with the laser to stop the leakage from these vessels. This treatment is not ideal because vision may be affected by the laser treatment and abnormal vessels often grow back after treatment
Management
- Support patient and family.
- Be realistic about prognosis there is no treatment, and condition is progressive.
- Refer patient to local chapter of NGOs or other agency to help with adaptive devices for low vision.
COMMENTS