Macular Degeneration Symptoms, Risk Factors & Treatment

What Is Macular Degeneration? 

Macular Degeneration, also known as Age-related macular degeneration, is a visual impairment that occurs with age. This disease often affects people over the age of 50. This visual impairment occurs because there is damage to the macula, which is a small spot near the center of the retina.

The macula is needed for sharp central vision, allowing a person to see objects straight ahead. The bad news is, this condition often develops very slowly and does not show symptoms at first.

As a result, macular degeneration is only detected when it has triggered complications, including loss of vision in one or both eyes. One symptom that often appears as a sign of this disease is the appearance of a blurry area near the center of vision.

This disease can affect vision and the ability to perform daily activities, such as the ability to see faces, drive, read, write, or do close work, such as cooking or repairing items around the house.

Symptoms of Macular Degeneration

Not everyone experiences the same symptoms. Some people experience symptoms of vision loss later than others.

Macular degeneration is an eye disease considered progressive and usually gets worse over time.

Doctors can detect macular degeneration before a person experiences obvious symptoms of the disease.

1. Early Symptoms

The loss of vision in early macular degeneration is so gradual that most people don’t even notice it. As the disease progresses, there is a significant loss of central vision, while peripheral vision remains unchanged.

At first, images that normally appear clear and sharp become blurred. As the disease progresses they can become distorted, enlarged, cloudy, dark, or invisible.

Some vision problems in the early stages of macular degeneration:

• Straight lines appear crooked.
• Reduction of central vision in one or both eyes.
• The need for brighter light when reading or doing close work.
• Difficulty adapting to low light levels, such as when entering a dimly lit room.
• Blurred vision when reading.
• Vision of color brightness decreases.
• Difficulty recognizing faces.

2. Advanced Symptoms

As symptoms progress, vision becomes worse, affecting the ability to perform daily activities such as reading, driving, recognizing faces, and writing.

In some cases of advanced macular degeneration, vision can be completely lost over time and permanent blindness can occur.

Causes of Macular Degeneration

In general, this disease is divided into two types, namely dry and wet macular degeneration. In dry macular degeneration, there are yellow deposits on the macula that can increase in number, causing blurred vision.

Meanwhile, the wet type is characterized by the growth of abnormal blood vessels in the choroid layer.

These abnormal blood vessels will leak blood and fluid into the retina causing straight-line vision to become wavy and loss of central vision.

These abnormal blood vessels eventually form scar tissue and cause permanent central vision loss. Both types of macular degeneration are caused by the aging process.

Risk Factors for Macular Degeneration

One factor that can increase the risk of this disease is increasing age. People over the age of 50 are said to be more susceptible to developing macular degeneration.

However, this disease can also attack younger people, especially if they have risk factors, such as: 

• Active smoking.
• Genetic factors or family health history.
• Hypertension.
• Obesity.
• Frequent exposure to sunlight.

Macular Degeneration Diagnosis 

The early stages of macular degeneration usually begin without symptoms. Only a comprehensive eye exam can detect macular degeneration. An eye exam may include:

• Visual acuity test. This test aims to measure how well your vision is at a distance.
• Funduscopic examination. The examination begins with the instillation of mydriatic eye drops to widen or dilate the pupil. This allows the examination of the back of the eye, such as the retina, macula, and optic nerve, and also signs of macular degeneration.
• Amsler test. In this test, the sufferer is asked to look at vertical and horizontal lines. Changes in central vision can cause the lines to disappear or appear wavy, a sign of macular degeneration.
• Fluorescein angiogram. In this test, performed by an ophthalmologist, a fluorescent dye is injected into a vein in the arm. Pictures are taken as the dye passes through the blood vessels in the eye. This allows leaky blood vessels, which occur in the more progressive wet type of macular degeneration, to be seen.
• Optical coherence tomography (OCT). OCT uses light waves and can achieve very high-resolution images of any tissue that light can penetrate, and with this exam, the macula can be seen in detail.

Macular Degeneration Treatment

There is currently no cure for macular degeneration. Treatment aims to improve vision but cannot eliminate the cause, as it is an age-related disease.

Treatment of macular degeneration in the early stages there is no specific treatment. Treatment is aimed at slowing down macular damage, such as giving some vitamins and minerals that are antioxidants, for example:

• Vitamin C (500 mg);
• Vitamin E (400 IU);
• Lutein (10 mg); and
• Zinc (80 mg).

To slow down damage to the macula, sufferers are also advised to adopt a healthy lifestyle, such as:

• Quit smoking.
• Regular exercise.
• Lose weight until you reach your ideal body weight.

For the treatment of advanced macular degeneration, it is based on the type of macular degeneration, namely dry or wet. Some treatment options that can be done:

Anti-VEGF (anti-vascular endothelial growth factor) drug injection. This drug is injected directly into the eyeball to stop the growth of abnormal blood vessels in wet macular degeneration so that macular damage can be slowed or stopped.

Laser eye surgery. This treatment method is also performed for wet macular degeneration by lasering or killing abnormal blood vessels, thus preventing worsening of vision problems.

Macular Degeneration Complications

Blindness is the most feared complication of macular degeneration. A person who cannot see is at risk of being isolated from the social environment which can lead to depression.

Blindness due to macular degeneration can also cause sufferers to experience visual hallucinations (Charles-Bonnet syndrome).

Although macular degeneration can cause vision loss, sufferers do not actually lose their vision completely, because macular degeneration does not affect peripheral vision.

Macular Degeneration Prevention

Macular degeneration is a disease caused by aging, so there is no specific prevention effort so that someone does not experience macular degeneration. The following steps can reduce a person’s risk or slow the worsening of macular degeneration, namely:

• Maintain ideal body weight

Eat a nutritious diet that includes green leafy vegetables, yellow and orange fruits, fish, and whole grains that are high in vitamins, minerals, and antioxidants;

• Quit smoking.
• Maintain normal blood pressure.
• Exercise regularly.
• Wear sunglasses or a hat when exposed to direct sunlight for long periods of time.
• Have regular eye exams at age 50 and over, and consult a doctor if you experience changes in your vision.