As nurses and caregivers, we want to provide any measure for a patient that we can in order to improve the quality of life. As patients and those that have loved ones with any disease, we want a simple understanding of what is going on with our health. Four years ago, my mother was diagnosed with macular degeneration. I studied things with her regarding the disease, and in particular, what visual aids we might get to help her function as best as she could. Her degeneration happened rather quickly (the wet kind) and time was of the essence to get to the doctor and save her vision. Even after multiple injections from hemorrhaging in both eyes, her vision deteriorated. In fact, she had to give up her driver’s license right away – a huge independence factor for the elderly.
Macular degeneration, or age-related macular degeneration (AMD), is a disease that causes blurring of your central vision. The blurring happens because of damage to the macula, a small area at the back of the eye. The macula helps you see the fine detail in things that your eyes are focusing on. Macular degeneration makes it harder to do things that require sharp central vision, like reading, driving and recognizing faces. It does not affect side vision, so it does not lead to complete blindness.
There are two types of macular degeneration – wet and dry. The dry form is by far the most common type. The wet form is much less common, but it happens more quickly and is more severe. You may have either type in just one eye, but over time you may get it in the other eye too. The dry form of macular degeneration accounts for about 9 out of 10 cases of macular degeneration. It develops slowly and causes central vision to become dimmer or more blurry over time. It usually does not cause severe vision loss unless it turns into the wet form. The wet form is only seen in about 1 out of 10 cases. However, it can cause serious vision loss within months or even weeks. People who have the wet form of this disease have the dry form first.
The most common symptom in dry AMD is blurred vision. This is limited to the center of the field of vision. Often objects in the central vision look distorted and dim, and colors look faded. A patient may have trouble reading print or seeing other details, but can generally see well enough to walk and perform most routine activities. As the disease becomes worse, you may need more light to read or perform everyday tasks. The blurred spot in the center of vision gradually gets larger and darker. In the later stages, you may not be able to recognize faces until people are close to you. AMD typically does not affect side (peripheral) vision. This is very important, because it means you will never have complete vision loss from this disease. The most common early symptom of wet macular degeneration is that straight lines appear distorted and wavy. You may also notice a small dark spot in the center of your vision that gradually gets larger. Central vision loss can occur very quickly. If this occurs, you urgently need evaluation by an ophthalmologist with experience in retina diseases.
At this time, there is no cure for macular degeneration. But experts are exploring many new treatments that hold hope for the future. Your doctor can keep you up to date on any changes in treatment that might help you. A diet rich in antioxidant vitamins and minerals may help slow down vision loss in some people with moderate to severe macular degeneration. Talk to your doctor about whether this diet might help you. If you have the wet form of macular degeneration, you may have one or more of the following treatments:
- Photodynamic therapy.
- Injections of medicine into your eye.
- Laser surgery.
These treatments can’t restore central vision, but they may slow down vision loss. If your doctor recommends photodynamic therapy, injections or laser surgery, it is important to have it done right away. Having a good support network is important too.
Scientists aren’t sure what causes AMD. The disease is most common in people over 60, which is why it is often referred to as age-related macular degeneration. Other than heredity, risk factors include being of Caucasian race, cigarette smoking, eating a high-fat diet, female gender and obesity. Obvious preventative measures, therefore, will include not smoking, eating a healthy diet that is high in fruits and vegetables and low in animal fat, exercising regularly and maintaining a healthy weight.
There are several visual aids that I have found to help patients with decreased vision. My mother uses some of these aids, and you can search on the Internet to purchase any of the following valuable items for macular degeneration:
The medical illustration is provided courtesy of Alzheimer’s Disease Research, a program of BrightFocus Foundation.