American Medical Association Family Medical Guide - American Medical Association [741]
Symptoms
The most common early symptom of dry macular degeneration is blurred vision. Distortion or a small blind spot may appear in the center of your field of vision, and you may be gradually less able to distinguish fine details on, for example, faces or printed pages. Over time, the blind spot may become larger and darker. The disease may affect only one eye at first but, in most cases, the other eye is affected eventually.
Location of the macula
The macula is the part of the retina that provides sharp focus at the center of the visual field. The macula enables you to see fine details, which are essential for activities such as reading and driving and for recognizing colors and faces.
In wet macular degeneration, fluid from the leaking blood vessels collects beneath the macula and lifts it, causing shapes to appear distorted and objects in straight lines (such as sentences on a page) to look crooked or wavy. Colors may appear faded. A blind spot in the center of the field of vision may develop quickly.
Neither dry nor wet age-related macular degeneration affects peripheral (side) vision or causes pain. A person may have difficulty seeing in bright light and may have problems adjusting from darkness to light. In people with dry macular degeneration, the disease progresses so slowly that they are not aware of any changes in their vision. In people with wet macular degeneration, the disease progresses rapidly and leads to the loss of sharp central vision in one or both eyes.
Diagnosis
To diagnose macular degeneration, an ophthalmologist (eye MD) will take a health history and ask you questions about your lifestyle—such as your diet and exercise habits and whether you smoke—to help determine your risk of developing the disease. He or she will evaluate your central and peripheral vision, measure how well you can see at various distances, and may assess your ability to see color. The doctor will perform tests to determine how your eyes function, both separately and together. He or she will dilate (widen) your pupils with eyedrops and look inside your eyes with an ophthalmoscope (a viewing instrument that projects a bright light onto the back of the eye) to examine the retina. He or she also may take a series of photographs of the retina to establish a baseline that will allow him or her to track the progression of the disease.
A common early sign of dry macular degeneration is the appearance of tiny yellow deposits in the retina called drusen, which the ophthalmologist can easily see during an eye examination. The doctor may ask you to look at a pattern called an Amsler grid; if the lines of the grid look wavy or distorted, or if some sections of the grid appear blank, you may have macular degeneration. The ophthalmologist may perform tests called fluorescein angiography and indocyanine green angiography. In these procedures, a dye is injected into a vein in your arm, and a rapid series of photographs is taken as the dye moves through the blood vessels in the retina. This allows the doctor to evaluate the condition of the blood vessels in the choroid and in the retina.
Treatment
There is no cure for either form of age-related macular degeneration. Although there is currently no proven treatment for dry macular degeneration, this does not mean that you will lose your sight, because the disease progresses very slowly. The doctor may prescribe a supplement containing antioxidants and zinc and recommend changes in your diet that may help protect your eyes from additional damage and help slow the progression of the disease. Eat lots of fruits and vegetables, which are rich in antioxidants. Two antioxidants, lutein and zeaxanthin (which make up the pigment in the