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Senior Citizen's Guide to Connecticut

The Battle Against Blindness
Macular Degeneration in the U.S.

Connecticut Eye Care practioners are now able to better predict, detect, diagnose and treat this devastating disease thanks to important breakthroughs in recent years. There has always been a great deal of publicity for other ocular diseases and conditions such as glaucoma and cataracts. However, macular degeneration has been in the background because there was little doctors could offer for treatment, until now.

Macular degeneration alters life in a profound way. There is a loss of central visual acuity, a loss of color vision and a loss of depth perception. There is also a huge emotional toll that this type of vision loss extracts from patients as they lose their independence. Feelings of isolation and helplessness emerge as simple tasks of pouring yourself a glass of water suddenly become challenging.

The leading cause of blindness in developed countries is macular degeneration. It is expected as the Baby Boomer population ages there will be an epidemic over the next 10 to 15 years. Eye care practioners now can take a proactive role in screening their patients to determine risk and begin intervening earlier to reduce that risk.

Previously Macular Degeneration was described as AGE Related Macular Degeneration. In recent years, our understanding of this disease has changed and we know that although the cumulative effects of this disease may manifest itself later in life there may be ocular changes present much earlier. It is up to the eye care professions to educate both the public and themselves to better detect this condition.

There are two main types of Macular Degeneration.

The early “Dry” form and the more severe “Wet” form. Up until recently there was no effective treatment for either form. Typically most people develop the dry form first with some people converting to the wet form as time goes on.

How Macular Degeneration occurs is not totally understood. We do know, however that cumulative exposure to blue light resulting in what is called oxidative stress is a large factor. Smoking is also a major contributing risk factor.

It is helpful to understand that the macula is the structure that contains our cones. This small area in the back of the eye provides our color vision and our sharp central vision. It is an area that is one of the most active metabolic areas in our body constantly working throughout the day to enable us to see. The effects of damage are cumulative to this area. Therefore, early detection is critical.

Risk Factors

Risk factors are broken down into two categories: Nonmodifiable and Modifiable.

Nonmodifiable Risk factors include:
Age, family history (genetics), gender (females have higher risk), light colored eyes, farsightedness (hyperopia) and diabetes.

Modifiable risk factors include:
Smoking, sun exposure, obesity, alcohol consumption, poor diet, cardiovascular disease and a sedentary lifestyle.

Patients can modify their risk to some extent but cannot remove all of the factors that could cause this disease. In recent years the role of a protective pigment layer in the macula has come to light. The importance of elements known as carotenoids has been established. Lutein is an example of a carotenoid that many people are familiar with. Recent studies show that the carotenoids are protective of the sensitive macular tissue. Carotenoids act like thousands of little sunglasses right in the macular tissue. Unfortunately humans do not possess the ability to manufacture these carotenoids and we must take them as a supplement or obtain them from our diet.

Detection of macular degeneration has improved in recent years. Today we have instruments that detect and monitor changes in the protective pigment layers that aid the assessment and treatment protocols.

They include:

Once identified as “person at risk” modifying the diet, wearing proper sunglasses to protect the eye, and starting a regimen of nutritional supplements are all highly recommended to slow the progression of the degeneration. The goal is to do all you can to prevent the degeneration from progressing to the more devastating wet form. If progression does occur to the wet form treatment includes injections of medication along with nutritional supplements.

The saying “you are what you eat” rings true and a good diet with nutritional supplementation appears to be the best combination for preserving good vision. Eye care practioners need to educate their patients about the dangers of poor nutrition and try to influence lifestyle changes in the areas of smoking, obesity and diet. The message is have your eyes examined regularly. Your doctor has the tools to help and protect you and your family from this disabling disease.

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