What is Macular Degeneration? The macula is a small area of the retina located directly at the back of the eye. While the entire retina receives light rays, the macula is responsible for central vision, including fine detail and colors. When degenerative processes affect this region, the vision can be decreased. Sometimes abnormal new blood vessels grow through these thin degenerative areas, causing leakage of fluid, bleeding and scar tissue formation (wet AMD). Sometimes the retina simply becomes thinner and sees less well (dry AMD). Symptoms include decreased vision, blind spots in vision, and distortion (straight lines appearing curved or wavy). AMD is diagnosed by an examination, and by photography. The ophthalmologist examines the eye for signs of degeneration, leaking fluid, bleeding or scar tissue formation. A series of photographs, called a fluorescein angiogram, is taken to identify any leaking blood vessels. Other tests such as measuring the retinal thickness with OCT, can help to monitor AMD. Is AMD treatable? There is no cure for the degenerative aspect of AMD. However the Age Related Macular Degeneration Study has indicated that supplements with antioxidants may help prevent progression of dry AMD. Medicines to stop the abnormal blood vessels from leaking have been shown to be effective when injected to treat wet AMD. Standard laser and photodynamic therapy (PDT) are options that are less frequently used. What should be done after the initial visit or treatment? The goal is to save as much vision as possible. Sometimes, after treatment, the vision is improved, but usually we are happy to prevent further vision loss. Periodic visits are recommended, at least twice a year, and whenever a change is noted in the Amsler grid. If the vision is decreased in both eyes, low vision devices may be tried. Magnifying glasses, telescopes, and closed-circuit televisions are often the most useful. Although the vision loss with AMD can be frustrating, it is not expected that a total loss of vision will occur. Peripheral vision can be used even in most of the advanced cases. How do I use the Amsler Grid? The grid should be used with reading glasses, in good light and held at a comfortable reading distance. Both eyes are tested, one at a time. Covering one eye, the other eye is focused on the center dot, noting the location and size of any irregularities in vision - including wavy, fuzzy or gray areas, or blind spots. It is important to stay focused on the center dot and analyze the remainder of the grid using the peripheral vision. If changes occur and they persist for several days, the patient should be examined promptly.
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