The eyes have it: macular degeneration

Photo credit: photodune.

By Fasiha Hasham

Eyes are the most precious gift from the Almighty. They are a gift that we usually take for granted, but if something happens to our sight we are unable to perform our daily activities and face difficulties even in performing the simplest of tasks.

Macular degeneration can be defined as the degeneration of the central portion of the retina. The retina is the inner layer of the eye, which conveys images to the brain. The Macula is the region in the retina which contains dense amount of light receptors. If the macula is damaged or diseased then the person is unable to see small print and distant objects appear blurred. Macular degeneration causes legal blindness, and occurs in people over 50 years of age.

Macular degeneration occurs because of decreased blood flow. The decreased blood flow forms small cysts and causes separation of the macular area from the eye ball. Sometimes abnormal shaped blood vessels may from in the macula. These blood vessels may rupture and bleed and also result in macular degeneration.

The condition is diagnosed by the ophthalmologist in regular eye examination and is confirmed by special tests. The doctor uses an ophthalmoscope, an instrument with a bright light to look through the eye into the retina, examining the blood vessels for any damage and also to check the retina if it is intact. Changes in the in eye pigment and hemorrhages where the blood vessels might have burst, can be seen during the examination.

A test known as the fluorescein retinal angiography may be performed if macular degeneration is suspected. In this procedure the pupils are dilated with eye drops and fluorescein dye is injected through a vein in the arms. This dye helps to see the blood flow in the retina when x-rays are taken. The patient sits still with their head resting in a frame to prevent movement and then some x-rays are taken.

The most recent and affective treatment is with the krypton laser. The laser seals off the abnormal blood vessels in the macula. Laser surgery not only closes the blood vessels but it may also reattaches the retina to the back of the eye ball, thus reducing or slowing the loss of vision.  Good prognosis is seen in cases in which laser treatment is given in early stages of the disease.

The onset of the disease is gradual and without obvious symptoms. If the condition is not detected early then the central field of vision is lost permanently but peripheral vision is still intact and the person is able to take care of himself. With macular degeneration the person is considered legally blind and is unable to drive and sometimes unable to read.

Regular eye examination should be done at least once every two years. Also, avoid smoking as it damages the blood vessels.

Editor’s Note: Dr. Fasiha Hasham obtained her medical degree from Sindh Medical College and completed a residency at Jinnah Post Graduate Medical Centre in Pakistan before moving to the United States. Her specialties include Internal Medicine and Gynecology and Obstetrics. She is married with four children and lives in Farmington Hills, Michigan. The views expressed here are her own.