Age-related macular degeneration 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) 744-2566 today to schedule an eye exam and evaluation for AMO 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 AMO: 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 AMO: 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.
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
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 AMO is to use injected medicines, such as Avastin, Lucentis and Eylea. Occasionally laser treatments are useful, and a few cases of wet AMO can be observed without treatment.
What Exactly Is a Macular Hole?
The macula, which is a specialized area of the retina, is responsible for clear, detailed vision. A macular hole is an abnormal opening that forms in the center of the macula over weeks to months.
What Causes a Macular Hole?
Macular holes in most cases are caused by one of the following problems:
- The vitreous jelly within the eye pulls on the macula until it tears.
- Sometimes scar tissue on top of the retina can cause a macular hole.
What Are the Symptoms of a Macular Hole?
Symptoms vary from patient to patient, but the most common symptoms are blurred and distorted vision. Sometimes patients notice a blind spot in the central part of the vision. Typically the side vision remains normal.
A macular hole can be diagnosed by a thorough ophthalmologic examination along with the use of photographs. For the photographic test, a fluorescent angiogram may be performed. This dye test can sometimes determine the amount of damage in the macula, or the central part of the vision.
What Is the Treatment for a Macular Hole?
Medication such as drops, or laser treatment is not effective for macular holes. The only known effective treatment to close the hole and improve the vision is vitrectomy surgery.
During the vitrectomy surgery the vitreous jelly that pulls on the retina is removed and in most cases the eye is filled with a gas bubble. This gas bubble will slowly dissolve after surgery. In order for the hole to close, the patient must maintain a facedown position for one to two weeks following surgery to keep the gas bubble in contact with the macula. A successful result is often dependent upon how will this positioning is maintained.
Once the macular hole closes, the eye slowly regains some sight. The amount of sight recovered depends on how long the hole was present before surgery and other factors that are unique to each case. If it is difficult for the patient to maintain a facedown position because of arthritis or another medical condition, in some cases a substance called silicone oil can also be used to close the hole. The substance typically stays in the eye for six to 12 weeks following surgery and then is removed once the hole is closed after six to 12 weeks. Using silicone oil eliminates the need for facedown position which is necessary when a gas bubble is used. If silicone oil is used, you will require a second surgery to remove the oil, unlike the gas bubble that goes away on its own.
Do I Need Surgery for a Macular Hole?
Surgery is not necessary for everyone who has a macular hole. In some patients who have normal vision in the other eye, they may not be troubled enough to want surgery. This surgery is an elective procedure and can be done if one so desires. In about 5% to 7% of patients, macular holes can develop in both eyes.
What Is a Macular Pucker (or Epiretinal Membrane)?
A macular pucker or epiretinal membrane is wrinkling over the macula or over the central part of the vision.
Symptoms of a Macular Pucker?
The most common symptom of a macular pucker is distorted vision where straight lines like doorways or stop signs often appear wavy. This distortion can be mild, moderate or severe.
What Causes a Macular Pucker?
There are many conditions that cause a macular pucker:
- A torn or detached retina.
- Inflammation within the eye.
- Injury to the eye.
- Problems with the retinal blood vessels.
- Vitreous detachment or aging of the gel inside the eye.
Prevention and Diagnosis of a Macular Pucker
There is nothing you can do to prevent a macular pucker. A complete ophthalmologic examination along with a photographic test called a fluorescent angiogram may be necessary to determine the extent of the damage to the macula from the macular pucker.
What Is the Treatment of a Macular Pucker?
If the symptoms of distortion and decreased vision are mild, no treatment is necessary. Eye drops, medications and laser surgery will not improve the vision. Sometimes changing glasses by improving the magnification can help.
The only treatment for worsening vision is vitrectomy surgery where tiny instruments are used to remove the wrinkling in the retina. Vision does not usually return all the way to normal, but it does improve in most cases. Surgery is not necessary for everyone who has a macular pucker.
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) 744-2566 today to schedule an eye exam and evaluation for AMO. We serve patients from Loveland, Fort Collins, Windsor and throughout Northern Colorado.