Age-related macular degeneration (AMD) is a condition that results in the loss of central vision, and it is the leading cause of vision loss among individuals over the age of 65. It causes deterioration of the center of the retina, the area that is responsible for detailed central vision. It does not affect peripheral (side) vision.
At Kirk Eye Center we have extensive experience in treating age-related macular degeneration. Dr. John Kirk can recommend treatment with dietary supplements and provide injections of medicines and laser treatment to slow the progression of this disease and help preserve your vision. Drs. Kirk and Colvin check for this condition during all complete eye exams in order to catch treatable problems as early as possible. Please call 970-669-1107 today to schedule an eye exam and evaluation for AMD at our Loveland ophthalmology office.
Find out more about Macular Degeneration:
- Types of Age-Related Macular Degeneration
- Symptoms of AMD
- AMD Treatment
- What is a Macular Hole
- What Causes a Macular Hole
- Symptoms of a Macular Hole
- Macular Hole Treatment
- Do I Need Surgery for a Macular Hole?
- What is a Macular Pucker
- Symptoms of a Macular Pucker
- Macular Pucker Causes
- Prevention and Diagnosis of a Macular Pucker
- Macular Pucker Treatment
- Contact Us Today
Types of AMD
There are two kinds of AMD, and the terminology is confusing. In a given eye, you may have either the first kind of AMD ("dry"), or both the first and second kind of AMD (both "dry" and "wet" at the same time).
- Dry Age-Related Macular Degeneration: This first kind of AMD is more common. It begins with a slight change in the appearance of the macula. Yellow deposits called drusen begin to accumulate, and this eventually leads to dimmed or distorted vision. You may notice it most when reading. As the condition becomes more advanced, you may gradually develop blind spots near the center of your vision. Over a long period of time, dry AMD can cause loss of central vision.
- Wet Age-Related Macular Degeneration: After dry AMD is present, a second kind of AMD may also appear (you may have either dry AMD, or BOTH dry and wet AMD at the same time). Wet AMD involves the growth of an abnormal blood vessel just beneath the retina and leads to fluid leakage, bleeding and scarring there. Wet AMD progresses rapidly over the course of weeks or months and usually causes complete loss of the center of your vision. This kind of AMD can be treated, and in many cases central vision can be preserved to a great degree.
Symptoms of Macular Degeneration
During the earliest stages of AMD you may not notice any symptoms, or perhaps you'll have symptoms in only one of your eyes. Over time, you will likely experience a gradual worsening of your central vision. Common symptoms are:
- Shadowy areas in your central vision
- Fuzzy or distorted vision (straight edges look "warped")
- The need to use very bright light for reading and other close activities
- Blurred appearance of fine print
- Difficulty recognizing faces
- Difficulty seeing in dim light, especially after being outdoors
- Difficulty distinguishing between colors
Macular Degeneration Treatment
Dr. Kirk will evaluate your macular degeneration and decide on a treatment plan that will be of most help for you. For many people certain vitamin supplements (AREDS2 vitamins) are recommended. We may recommend that you check your vision daily, one eye at a time, using a card that has a grid printed on it.
The most common treatment for wet AMD is to use injected medicines, such as Avastin, Lucentis and Eylea. Occasionally laser treatments are useful, and a few cases of wet AMD can be observed without treatment.
What Is a Macular Hole?
Your macula is responsible for providing crisp and clear central vision, which you use for everyday tasks such as driving and reading. The macula is located in your retina, which is the light-sensitive tissue near the center of your eye. The formation of an abnormal opening in this area of your eye, typically within weeks or months, is called a macular hole.
What Causes a Macular Hole?
Your eye is filled with vitreous jelly, which makes sure your eye keeps a round shape. A macular hole occurs when this gel-like substance pulls on your macula, creating a tear. Scar tissue on the surface of your retina can also lead to a macular hole.
What Are the Symptoms of a Macular Hole?
Macular holes develop gradually, and symptoms may start with blurred or distorted vision when you look straight ahead. Objects and lines may appear slanted or bent. Your ability to read and perform other everyday tasks could become difficult over time as well. However, symptoms vary per person. A blind spot in your central vision is another sign of a macular hole, and your side vision should remain the same.
How is a Macular Hole Diagnosed?
Diagnosis of a macular hole involves an extensive ophthalmologic examination and photographs. The photographic test typically includes a fluorescent angiogram, and a dye test can help identify the extent of the damage in your macula and to your central vision.
What Is the Treatment for a Macular Hole?
The only mode of treatment that is effective for macular holes is vitrectomy surgery, which seals the hole and improves central vision. Eye drops and other medications are unsuccessful in treating macular holes, as is laser surgery. Vitrectomy surgery involves removing the vitreous jelly pulling on the retina and replacing it with a gas bubble. The gas bubble gradually dissolves after surgery.
The recovery from vitrectomy surgery is the most important aspect of treating a macular hole. For one to two weeks, you will need to stay in a face down position, so the gas bubble remains in contact with your macula. The final result relies on how well you maintain the face down position. After the macular hole has been sealed, your vision will slowly improve. How much of your central vision comes back depends on how long you had the macular hole before seeking treatment, among other factors.
Some patients have difficulty remaining face down due to other medical conditions such as arthritis. In this instance, a silicone oil could be used to seal the macular hole. The silicone oil will stay in your eye for approximately six to 12 weeks after your surgery. After that period, the substance is removed, and the hole is closed. By using the silicone oil, you can avoid the discomfort of staying face down. However, using this substance instead of a gas bubble will require you to have a subsequent surgery to remove the oil.
Do I Need Surgery for a Macular Hole?
Not every patient with a macular hole will require vitrectomy surgery. If you have normal vision in your other eye, the macular hole may not bother you enough to want surgery. Vitrectomy surgery is an elective procedure and is performed based on your needs and the recommendations of our eye doctors. Macular holes can develop in both eyes, which occurs in approximately five to seven percent of patients.
What Is a Macular Pucker (or Epiretinal Membrane)?
Epiretinal membrane, or a macular pucker, occurs when the area over your macula becomes wrinkled and interferes with vision.
What are the Symptoms of a Macular Pucker?
Macular pucker typically presents with distorted vision that causes doorways, stop signs and other straight lines to appear wavy. Visual distortion from a macular pucker can vary from mild to moderate to severe.
What Causes a Macular Pucker?
A macular pucker can be caused by many factors such as:
- Inflammation in your eye
- Eye trauma
- Issues with retinal blood vessels
- A detached or torn retina
- Detachment or aging of the vitreous gel inside the eye
Prevention and Diagnosis of a Macular Pucker
There is nothing you can do to prevent a macular pucker. A thorough ophthalmologic examination is performed with a fluorescent angiogram (photographic test) to determine how much damage has occurred to your macula.
What Is the Treatment of a Macular Pucker?
The symptoms of a macular pucker are often mild, which means no treatment is necessary, but if the distortion and decreased vision are severe, vitrectomy surgery may be a viable option. Similar to a macular hole, eye drops, medications and laser surgery are not effective treatments for a macular pucker. However, increasing the magnification of glasses could help improve vision. Vitrectomy surgery uses tiny instruments to smooth the wrinkled area in your retina. You may not have full visual recovery, but vitrectomy surgery improves vision in most cases. As with a macular hole, vitrectomy surgery is elective and is not necessary for everyone.
Contact Kirk Eye Care Today
For help with any form of macular degeneration, including a macular hole or macular pucker, please contact Kirk Eye Center using the form on this page, or call 970-669-1107 today to schedule an eye exam and evaluation for AMD. We serve patients from Loveland, Fort Collins, Windsor and throughout Northern Colorado.