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Wearing sunglasses that block ultraviolet rays and sun visors may help prevent damage to the macula. Try vision aids such as magnifying glasses, bright lights, large-print reading materials, special lenses, and computer monitors with large print.

The effects of dry macular degeneration

Dry macular degeneration damages the macula, the part of the retina that provides sharp focus in the center of the visual field. An early symptom of dry macular degeneration is blurred vision, which makes it difficult to distinguish fine details on faces or printed pages.

Some people who have wet macular degeneration can be treated with laser photocoagulation, a type of surgery in which a highly concentrated beam of light is used to destroy abnormal blood vessels under the retina and stop vision loss. Laser photocoagulation is effective in about half of cases, but the results may last only for about a year. The procedure is usually performed using a local anesthetic in a doctor’s office or in an outpatient facility; you return home the same day.

An outpatient procedure called photodynamic therapy sometimes is used for treating wet macular degeneration. In this procedure, the doctor injects a light-activated drug called verteporfin into the person’s arm, and the drug collects in the abnormal blood vessels behind the macula. A special laser beam is aimed at the targeted area of the retina to activate the drug, which seals the leaking blood vessels and stops progression of the disease. If leaking recurs, the procedure needs to be repeated.

If you have dry macular degeneration, be sure to have your eyes examined by an ophthalmologist at least twice a year or as often as your doctor recommends. Ask your doctor about using an Amsler grid at home to monitor your vision daily to determine if your vision is getting worse. Your doctor will tell you how to use the Amsler grid.

If you have wet macular degeneration, frequent eye examinations will enable your doctor to detect any recurrence of leaking blood vessels. If you smoke, quit now. Smokers who have wet macular degeneration may have a greater risk of recurrence than nonsmokers because free radicals in cigarette smoke may damage the cells in the macula. If you notice any changes in your vision, see your doctor as soon as possible. Treatment of wet macular degeneration is most effective in the early stages.

Diabetic Retinopathy

Diabetic retinopathy is an eye disorder in which changes in the blood vessels of the retina (the light-sensitive membrane that lines the back of the eye) can lead to vision loss or blindness. The disorder occurs in people who have diabetes (see page 889), which can damage blood vessels, including those in the eye. Diabetic retinopathy is the leading cause of blindness in adults in the United States.

In some people who develop diabetic retinopathy, the blood vessels in the retina leak fluid. In others, abnormal new blood vessels grow on the surface of the retina and bleed and leak into the vitreous fluid (the substance that makes up the mass of the inside of the eyeball), preventing light from reaching the retina. The abnormal blood vessels also can produce scar tissue that pulls the retina away from the back of the eye, causing retinal detachment (see page 1050).

Anyone who has diabetes can develop diabetic retinopathy, and the longer you have diabetes, the more likely you are to develop this eye disorder. Nearly half of all people who have diabetes develop diabetic retinopathy. Good control of both blood sugar (glucose) levels and blood pressure and early detection and treatment of diabetic retinopathy can help slow progression of the disease and can help prevent vision loss and blindness.

Symptoms

Diabetic retinopathy often does not produce obvious symptoms in the early stages. As the disease progresses, symptoms may include blurred vision, seeing spots, vision that alternates between being normal and being diminished, pain in the eyes, or sudden loss of vision. If you experience any of these symptoms, contact