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 Edwin Y. Endo, OD Optometrists, Associates & Interns

We are the leading Provider in Eye Care and highly regarded professional Optometry establishment in honolulu for the entire family where Quality eye exams are Affordable with Excellence. Diplomate,  Board Certified Optometrists, Eye Doctor near you

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Dry macular degeneration is a common eye disorder among people over 50. It causes blurred or reduced central vision, due to thinning of the macula. The macula is the part of the retina responsible for clear vision in your direct line of sight.

Dry macular degeneration may first develop in one eye and then affect both. Over time your vision may worsen and affect your ability to do things such as read, drive and recognize faces. Early detection and self-care measures may delay vision loss due to dry macular degeneration.

Symptoms

Dry macular degeneration symptoms usually develop gradually. They may include:

  • Visual distortions
  • Reduced central vision
  • The need for brighter light when reading or doing close work
  • Increased difficulty adapting to low light levels, such as when entering a dimly lit environment
  • Increased blurriness of printed words or images
  • Decreased intensity or brightness of colors
  • Difficulty recognizing faces

Dry macular degeneration usually affects both eyes. If only one eye is affected, you may not notice any changes in your vision because your good eye may compensate for the weak eye. And the condition doesn't affect side (peripheral) vision, so it rarely causes total blindness.

Dry macular degeneration is one of two types of age-related macular degeneration. It can progress to wet (neovascular) macular degeneration, which is characterized by blood vessels that grow under the retina and leak. The dry type is more common, but it usually progresses slowly (over years).

Your Treatment Options

The following dietary or lifestyle choices can reduce the supply of oxygen and vital nutrients to the retina and eventually lead to the death of cells in the retina and macula:

  • Smoking can decrease blood supply by causing a narrowing of the blood vessels and a thickening of the blood, much the same as in a heart attack or stroke.
  • High saturated-fat diets can cause plaque buildup along blood vessel walls, including the macular vessels, which impedes blood flow.
  • A lack of antioxidants, such as vitamin C, vitamin E and lutein may increase the ability of plaque to stick to the blood vessel walls and promote the damage of the tissue.

With macular degeneration there is typically a loss of vision in both eyes. The initial symptom may be a distortion of vision in one eye, causing straight lines to appear wavy. Eventually, loss of central vision worsens, making it difficult to see at long distances, read up close, see faces clearly or distinguish colors. Peripheral vision (what you see out of the corners of your eyes) is not affected.

Recommended Lifestyle Changes

  • Don’t smoke and avoid exposure to second-hand smoke.
  • Protect your eyes. Be sure to wear sunglasses that contain UV protection.
  • Follow a diet that is very low in saturated fat and rich in antioxidants, focusing on vegetables, fruit, and legumes including soy, whole grains and fish.
  • Eat antioxidant-rich berries, especially blueberries, frequently.
  • Increase your intake of antioxidants such as vitamins C and E, lutein and zinc.

Nutrition and Supplements

Try to choose foods or take supplements that contain vitamin C, vitamin E and lutein, as well as zinc. Vitamin C-rich foods include citrus fruits, melons, tomatoes, potatoes and broccoli. You can get vitamin E from soybeans, greens, fish, wheat germ, nuts and seeds. Dietary sources of zinc are legumes (peas, dried beans, garbanzos/chickpeasblack-eyed peas, lentils and soy products) and whole grains. The carotenoid pigment lutein is found naturally in spinach, kale, collard greens, romaine lettuce and peas. Other protective compounds are the red and purple pigments found in berries and other fruit. Eat berries, especially blueberries, often. You can also get these pigments into your diet with supplements of bilberry, grape seed extract or pine bark extract. My recommendations for daily vitamin E are to take 400-800 IU of natural mixed tocopherols, or at least 80 mg of natural mixed tocopherols and tocotrienols. People under 40 should take 400 IUs a day; people over 40, 800 IUs. 

 Dr. Weil on Healthy Aging.

Anti-angiogenic drugs. Your doctor injects these medications into your eye. They stop new blood vessels from forming and block the leaking from the abnormal vessels that cause wet macular degeneration.

Some people who take these drugs have been able to regain vision that they lost from AMD. You will likely need to get the treatment repeated on follow-up visits.

Laser therapy. Your doctor may suggest a treatment with high-energy laser light that can sometimes destroy actively growing abnormal blood vessels from AMD.

Photodynamic laser therapy. It's a two-step treatment that uses a light-sensitive drug to damage your abnormal blood vessels.

Your doctor injects a medication into your bloodstream, which gets absorbed by the abnormal blood vessels in your eye. Next, he shines a laser into the eye to activate the drug, which damages the abnormal blood vessels.

Vitamins. A large study by the National Eye Institute of the National Institutes of Health, called AREDS (Age-Related Eye Disease Study), shows benefits if you take a supplement formula that has vitamins C and E, beta-carotene, zinc, and copper. According to the research, the risk for vision loss goes down for some people with intermediate to advanced dry AMD.

An updated AREDS2 formula, which might be safer for smokers, added lutein, zeaxanthin, and omega-3 fatty acids and removed beta-carotene.  

Low vision aids. You can get devices that have special lenses or electronic systems that enlarge images of nearby objects.

Next Steps for Macular Degeneration

Some people with the dry form of AMD can develop the wet form. If you've got the dry form now, it's important to keep a check on your vision. Perform a vision check one a week, testing each eye separately. Follow the directions for using an Amsler Grid Chart, which you can place on your refrigerator, or you can view it on a tablet or computer. Let your doctor know if you have any changes. 

If you have the wet form of macular degeneration, even if it's been treated, you should test your vision to see if any blind spots grow bigger or if any new blind spots appear. New blood vessels can emerge months or years after you had injections or laser treatment.

If you only have AMD in one eye, your doctor will do regular eye exams on your other eye to check for signs of new problems.

What's the Outlook?

People rarely lose all of their sight from age-related macular degeneration. You may have poor central vision, but even with advanced AMD you'll still be able to see things to the side, outside your direct line of sight. And you'll still be able to do many of your regular daily activities.

With the severe form of either wet or dry AMD, your central vision may decrease to less than 20/200 in both eyes. Even though you'll have peripheral vision, your vision problems meet the definition of legal blindness.

The dry form of AMD, which is much more common, tends to get worse more slowly, allowing you to keep most of your vision.

Sometimes, even after you get treatment for wet AMD, the condition can come back. Test your vision regularly and follow the recommendations of your doctor. The right treatment not only slows your vision loss, but it can improve your vision.

Prevention

The earlier you get a diagnosis of AMD, the greater the chance that treatment will help.

See your eye doctor if you have any symptoms of AMD, and make sure you keep a regular schedule of eye exams.

Try these prevention tips:

  • Check your sight every day by looking at an Amsler grid -- a pattern of straight lines that's like a checkerboard. It can help you spot changes in your vision.
  • Stop smoking, eat a balanced diet that includes leafy green vegetables, and protect your eyes with sunglasses that block harmful ultraviolet (UV) rays.
  • Supplements with antioxidants plus zinc may lower your odds of getting AMD, according to the Age-Related Eye Disease Study.
  • If you're over 65, your vision exams should include testing for AMD.