A patient with macular degeneration should have regular eye exams by an ophthalmologist who has been trained to detect many vision-threatening conditions, even before symptoms develop. The earlier problems are detected, the better the chance of preventing vision loss.

Evaluation and diagnosis of macular degeneration

If an ophthalmologist suspects age-related macular degeneration, he or she may do the following:

• Perform a visual acuity test to measure vision at a distance.
• Perform a dilated pupil examination with an ophthalmoscope to check for drusen. The patient will be asked to look at an Amsler grid with a pattern of straight horizontal and vertical lines. To a person with macular degeneration, the lines appear wavy, distorted or missing, or a black spot may appear in the center of the grid.
• Perform a fluorescein angiography. During this test, dye is injected into the arm and quickly travels throughout the blood system. Once the dye reaches the blood vessels in the back of the eye, photographs are taken. The dye allows the ophthalmologist to detect abnormal blood vessels.

Treatment options for macular degeneration

Currently, there is no proven, effective treatment for dry form age-related macular degeneration; however, studies have found that high levels of zinc and antioxidants play a key role in slowing the progression of age-related macular degeneration in both new and advanced cases.

There are several treatments for wet age-related macular degeneration: drug therapy, laser surgery and photodynamic therapy. Low-vision rehabilitation usually is needed for advanced cases.

Drug therapy

Drugs injected into the arm or eye are used to inhibit the growth of new blood vessels. Your physician will go over potential side effects.

Laser photocoagulation

Laser photocoagulation is a surgical procedure involving the application of a hot laser to seal and halt or slow the progression of abnormal blood vessels. Through the use of a high-energy light that turns to heat when it hits the retina, laser photocoagulation seals the choroidal neovascularization and inhibits leaky blood vessel growth, preventing further vision deterioration. A scar forms as a result of the treatment, creating a permanent blind spot in the field of vision.

Vision usually does not improve after laser treatment and may be somewhat worse. However, loss of vision following laser treatment, though immediate, is generally less severe than the eventual loss of vision that usually occurs without laser treatment. In many cases, some visual distortion will disappear after laser treatment.

Early diagnosis of age-related macular degeneration is important because once vision is lost due to of the growth of abnormal blood vessels, it cannot be recovered.

Photodynamic therapy

Photodynamic therapy is one of the most promising new treatments for wet form macular degeneration. It involves the injection of a drug into the bloodstream followed by a brief laser treatment. The laser activates the drug, helping to destroy abnormal blood vessels in the eye that damage the macula. Several treatments may be necessary for the treatment to be effective. The procedure is painless, with few side effects.

Frequently asked questions

How do I know if I have age-related macular degeneration?

Your ophthalmologist or optometrist can give you a definitive diagnosis after a retinal examination. To a trained professional, the signs of macular degeneration are apparent when the eye is dilated and a special lens is used to see the retina. These may include the presence of drusen, leaking blood vessels, new growth of blood vessels or swelling of the retina.

To the patient, the first symptom of age-related macular degeneration is often a change in vision, which may be subtle or dramatic. You may notice that straight lines (telephone wires or door frames) look wavy. In wet age-related macular degeneration, there is more likely to be a sudden blurring or loss of central vision.

Will I go blind?

If your vision loss is only from age-related macular degeneration, you will never go completely blind. Age-related macular degeneration only affects the central vision. Your peripheral vision will remain intact.

I have had dry age-related macular degeneration for years. Will I get wet age-related macular degeneration, too?

The course of development for macular degeneration is different in each person. Some people only have the dry form for decades and never develop the wet form. However, if you have the dry form, or have age-related macular degeneration in one eye, your risk is higher for getting age-related macular degeneration in the other eye and for developing the wet form. This is why it is so important to use the Amsler Grid daily to check for any changes that may occur.

No one in my family has age-related macular degeneration. Why did I get it?

There is clearly a genetic component, meaning your risk for age-related macular degeneration is higher if there are other family members who have it. We don't fully understand how this works. Much of the research is focused on identifying the gene or genes of age-related macular degeneration and determining why some people get it and others don't. Other factors appear to contribute to the development of age-related macular degeneration, such as diet, smoking, high blood pressure or exposure to ultraviolet light.