What exactly is the macula?
- A condition that usually occurs in people over 60 years of age. With age, the macula is undergoing anatomical and functional changes, resulting in significant loss of vision. This type called “age-related macular degeneration”. The occurrence of the disease in younger people is usually hereditary and called “macular dystrophy”.
- Limits slowly and gradually
- (dry form) central vision (80% of cases) or produces a sudden, usually irreversible, loss of functional vision (liquid form). In the first case, a cloudy and dark spot appears in the center of the field of vision, while in the second one pathological vessels, which are brittle and may bleed, develop under the macula.
- Smokers are about 2.5 times more likely to develop some kind of macular condition. This high-risk group includes hypertensive, obese, diabetic, light-colored eyes; people exposed to sunlight without sunglasses, and those taking anti-coagulant, suppressant, erectile or osteoporosis drugs.
Causes / Symptoms
- The patient perceives a distortion of the image of the objects and his straight lines appear wavy and distorted.
- There is difficulty in various activities (sewing, reading, writing, etc.), while the inability to recognize the characteristics of individuals from a distance is intense.
- Colors may look dull.
- The increased need for more artificial lighting in enclosed spaces is common.
- Altitude and distance estimation can be extremely difficult.
- Degeneration usually starts from one eye, but in the next 5 to 6 years, it manifests in the other one too. Unfortunately, the bilateral manifestation of the condition is the rule and not the exception.
- A simple test anyone can do is to control their vision by closing their eyes one by one and focusing on a doorframe or a straight line. If it deforms or becomes zigzag, it means that there is a problem (Amsler test). Because macular degeneration affects only central vision, the peripheral remains normal and the patient can handle things by himself during the course of the disease. You should know that there is never total blindness.
Diet
The diet of those suffering from macular conditions should include fruits and vegetables rich in lutein and lycopene, such as pomegranate, strawberries, cherries, berries, beets, red peppers, tomatoes, spinach, broccoli, carrot and avocado.
Diagnosis
- Simple macular examination: the examiner looks at a square mesh, such as millimeter paper, in a reading distance. The patient may see this net distorted (metamorphosis) or perceive discounts (Amsler table).
- Retinal biomicroscopy: Done with the Goldman’s trihedral lens, where we have the most direct and clear visual access to the bottom of the eye.
- Fluorescein angiography: Infusion of fluorescein solution is injected and with a special camera and special color filters, the distribution of the pigment in the affected area can be seen. It is an irreplaceable method to determine the form of paleness if it is wet or dry.
- Lastly, the OCT (Optical Coherence Tomography) has been developed to accurately record the existing lesion in the affected area.
Treatment
- For the dry type of age-related ocular degeneration, our healing capabilities are limited. We simply administer vasodilators or various other formulations (e.g. vitamins) for a long time.
- Liquid form is treated by thermal laser, photodynamic therapy and by administration of anti-angiogenic agents.
- Restoring the visual difficulty of a patient with a macular condition is based on low vision aids including telescopic glasses, special magnifying glasses or other more complex electronic devices. The patient takes advantage of the peripheral vision of the eye and “trains” to behave like the macula. Vision progressively improves, visual acuity increases, and patients can re-work, read and move more easily and safely than in the past.
