Eye Disease

Macular degeneration, commonly referred to as age-related macular degeneration (AMD), is the single largest cause of sight loss in the developed world and affects more than 10 million Americans. It usually affects people over the age of 60, but has been known to affect those who are younger. It is a painless condition that usually affects both eyes with the loss being experienced in the central vision. It does not affect the peripheral vision, meaning that it does not cause total blindness.

What is the macula?

The macula is the most sensitive part of the retina and is responsible for our central vision and what allows us to see fine details with clarity.

Varieties of AMD

Wet AMD

Wet AMD is one variety of the condition in which abnormal blood vessels grow into the macula, leaking blood or fluid which then causes scarring and a rapid loss of central vision. Wet AMD can develop suddenly and rapid referral to a specialist is essential as it can be treated if caught quickly.

Dry AMD

Dry AMD is the most common variety of age-related macular degeneration and is a gradual deterioration of the retina as the cells die off over time and are not regenerated. Up to 15% of people with dry AMD go on to develop wet AMD, and so any sudden changes in your vision should be followed up with your optometrist as soon as possible.

Symptoms of macular degeneration

Macular degeneration affects each person differently, which means that it can sometimes be difficult to diagnose, particularly as you may not notice any change in your vision early on in the condition. However, as the cells deteriorate, you will start to see an increasing range of symptoms, including:

• Distortion or bends in what should be straight lines (such as lampposts or door frames)

• Dark spots in your central vision

• Fading colors

• Difficulty adapting from dark to light environments

• Blurred vision

• Objects may appear to change shape, size or color, or may move or disappear

• Bright lights may be difficult to tolerate

• Words may disappear while you are reading

Is there any way I can reduce my risk of developing AMD?

Unfortunately, there is no clear reason as to what triggers the process that causes macular degeneration. However, you are at an increased risk if you have a family history of the condition, or if you are over 60.

Experts suggest that the best thing you can do to minimize any potential risk is to ensure that you live a healthy, active lifestyle. You can do this by:

• Stopping smoking

• Eating a healthy, balanced diet with plenty of fruit and vegetables

• Moderating your alcohol consumption

• Maintaining a healthy weight

• Getting regular exercise

There is also some limited research that suggests that eating leafy, green vegetables can slow the deterioration of vision in cases of dry AMD.

Treatment for AMD

Sadly, there is currently no cure for either variety of AMD. In the case of dry AMD, the treatments suggested are done so with the aim of aiding the patient to make the most of their remaining vision. This can include things such as using magnifying glasses to help with reading.

Wet AMD can be treated with anti-vascular endothelial growth factor medication. This should stop additional blood vessels from developing and stop your vision from deteriorating further.

Occasionally, laser therapy is suggested as a possible treatment for destroying abnormal blood cells, but this is only suitable for cases of wet AMD and usually only around 1 in 7 sufferers may be potential candidates for this procedure.

If you have any questions or concerns regarding macular degeneration, we highly recommend that you speak with your optometrist who will be happy to assist you.

If you’ve been diagnosed with cataracts, you may wonder if cataract surgery is right around the corner. Not to worry. There are many preventive steps you can take to slow the progression of cataracts and preserve your vision. That doesn’t mean you won’t eventually need surgery, but you can at least delay the need for quite a while.

Protect Your Eyes from the Sun

The National Eye Institute recommends protecting your eyes from the sun's harmful ultraviolet (UV) and high-energy visible (HEV) rays by always wearing good quality sunglasses while outdoors. Look for sunglasses that block 100 percent of UV rays and absorb most HEV rays with large lenses or a close-fitting wraparound style. Remember that the peak hours for sun exposure are between 10 am and 3 pm or 11 am and 4 pm during daylight savings time and that the sun’s rays are strong enough to pass through clouds, so you need your sunglasses every day.

Avoid Steroid Eye Drops

Steroid eye drops are routinely prescribed to treat dry eyes or an arthritic flare-up in the eyes. Unfortunately, they can also speed up the progression of cataracts. Talk to your Optometrist about how you can manage both conditions without inadvertently making your cataracts worse – and hastening the need for surgery.

Check Your Medications

There are over 300 commonly prescribed medications with side effects that may impact cataract progression. Since your primary care physician may not have access to your eye doctor’s medical records, be sure to ask your doctor if your current medications will affect your cataracts. If you must stay on the medication, it’s even more important to avoid sunlight during peak hours and to wear sunglasses.

Quit Smoking

If you haven’t quit already, here’s another good reason to do it: over time, the damage from smoking can double or triple an individual's risk of developing cataracts. If you’ve been a smoker, your habit was probably a big contributor to the diagnosis. The good news is – by quitting smoking now, you can slow the progression of cataracts.

Follow Eye Health Diet Guidelines

Studies have shown that certain vitamins and nutrients may reduce age-related decline in eye health, particularly antioxidants. If you’ve already been diagnosed with cataracts, adding foods rich in antioxidants to your diet will help slow the progression. This list isn’t exhaustive, but here are some examples to get you started: dark chocolate, blueberries, strawberries, pecans, carrots, sweet potatoes, artichokes, kale, red cabbage, beans, beets, spinach, apples, and plums.

Doctors also recommend eating more fish high in omega-3 fatty acids. This has been linked to a potentially reduced risk of cataracts or their progression. You may also consider taking a multivitamin that contains Vitamin C and E. Talk to your doctor or nutritionist about how you might adopt a healthy eating plan that’s designed to prevent cataracts.

Fortunately, making these healthy modifications to your diet can prevent many other lifestyle diseases such as diabetes. Studies have shown that a diet rich in processed carbohydrates can increase your risk of both developing cataracts and speeding up its progression. It’s important to develop a plan that works for you and supports your holistic health.

Take control of your cataract diagnosis by getting regular eye exams, communicating with your doctor, and putting these tips into practice. You’ll have better vision and prevent the need for cataract surgery in the near future.

If you’ve been diagnosed with glaucoma, you’re probably already familiar with the typical options in glaucoma treatment – eye drops, laser treatment or traditional surgery. While these are certainly effective, especially when glaucoma is diagnosed early, researchers have been working hard to offer new glaucoma treatments. Their goal is not only to improve outcomes but also reduce the treatment’s side effects and frequency of use.

What is the Goal of Glaucoma Treatment?

Before we dive into the new options, it’s important to understand the goal of any glaucoma treatment. At present, glaucoma is not curable. However, treatment can significantly slow the progression of the disease. Glaucoma damages your eye's optic nerve. Extra fluid builds up in the front part of your eye (cornea), which increases the pressure in your eye. Reducing this pressure is the primary objective of any glaucoma treatment. This is often referred to as intraocular pressure or IOP.

What are the Limitations of Standard Glaucoma Treatments?

Eye drops for glaucoma treatment seem like an easy option but there are several challenges that can reduce its effectiveness. It can be difficult to get all the medicine in the eye, especially for older adults with less of a steady hand. In addition, since it must be applied daily, individuals may forget. Since the drops have no perceivable benefit because early stages of glaucoma have no symptoms, patients might make it a lower priority which is understandable since it may also have unpleasant side effects like burning, red eyes.

Beyond eye drops, laser surgery is a less invasive option. The laser opens clogged tubes and drains fluid. It can take a few weeks to see the full results. If laser surgery or drugs don’t relieve your eye pressure, you may need a more traditional operation. You would have to go into the hospital and will need a few weeks to heal and recover. Although usually effective, glaucoma surgery can make you more likely to get cataracts later on. It can also cause eye pain or redness, infection, inflammation, or bleeding in your eye.

What are Recent Advances in Glaucoma Treatment?

Alternatives or Improvements to Eye Drops
The Glaucoma Research Foundation reported several new developments on the horizon. These technologies focus on reducing patient error in applying eye drops which would make the medication more effective and improve the quality of life for the patient. Here are some of the products underway:

• A polymer, like a contact lens, would contain the drug; it would sit under the eyelid and release the medication over several months

• Microneedles would inject medication into a specific spot to be most effective

• Implantable extended-release devices using engineered highly precise microparticles and nanoparticles

• Polymer-based intraocular delivery technologies that would allow customizable sustained release

• Drops that allow the medication to get into the eye more easily

• Tear duct plugs that release medication

In addition, people with glaucoma who take more than one eye drop per day are beginning to see those medications available as a single, combined eye drop. New products include Cosopt (timolol and dorzolamide), Combigan (timolol and brimonidine) and Simbrinza (brinzolamide and brimonidine).

Minimally Invasive Glaucoma Surgery

Minimally Invasive Glaucoma Surgery (MIGS) procedures are small cuts or micro-incisions through the cornea that cause the least amount of trauma to the surrounding tissues. Doctors implant a tiny device to allow fluid to drain from the eye, reducing internal pressure. Some devices (iStent) are implanted during cataract surgery. Cataract surgery alone lowers pressure, but the combination of both is more effective and can lower the need for medication.

These new techniques minimize tissue scarring, allowing for the possibility of traditional glaucoma surgery in the future if needed. They also give doctors the opportunity to treat patients earlier and more safely than older surgeries.

Monitoring Eye Pressure

An easy, accurate way to measure eye pressure is critical to monitoring the progress of glaucoma and adjusting treatment as needed. For patients that require more frequent testing of their eye pressure, there’s now an at-home tonometer called iCare HOME. There’s no puff of air and no eye drops. The patient can easily share the information with their eye doctor.

If you have a glaucoma diagnosis, you can feel confident that your glaucoma treatment options are only going to improve in the years ahead. Although the disease is not curable, it is very manageable with the right treatment.