An Ophthalmologist's
Candid Viewpoint About ARMD
(As you can see from the
comments below, ARMD is a very serious problem. I like
these comments as they are TO THE POINT and are VERY CANDID.
Bold print and underlining are added by Dr. Kenneth J.
Wozny, Optometrist and Webmaster. Without ANY attempt at
"nutritional intervention", the prognosis for ARMD is very bad.)
For all the diseases and conditions of
the eye, none is more frustrating than macular degeneration.
It is one of the most devastating conditions, and we
are essentially powerless to prevent or treat its effects.
Macular degeneration, for the most part, is age related to
people over the age of fifty. It can occur in
younger people, but the more severe cases occur later in life.
The disease is not well understood as to its risk factors and
etiology. But, it is associated with a family history and
exposure to smoking and probably to sunlight.
The macular is the central part of the retina, and contains the
area responsible for all our central and fine vision. For
reasons unknown, yellowish deposits (drusen) form in the macula
which tend to damage the
retina and affect the vision. In the class of macular
degeneration, there are classified as to two types.
Dry macular degeneration is by far the most common, and
specifies that no fluid or blood has formed in the retina.
It usually implies a very slow progression to the disease, and
generally with a better prognosis.
Wet macular degeneration is normally more severe, with
most patients left legally blind. The 'wet'
refers to the presence of either fluid or blood in the retina.
The condition develops from dry macular degeneration, and
usually with a rapid onset. It is usually noticed by a
rapid decrease in vision or a noted distortion to objects.
The blood or fluid will distort the surface of the retina which
in turn affects your perception of images. The
result will leave a blind spot in your central vision, with the
peripheral vision unaffected.
Unfortunately, in both cases, our treatment of the
disease is very lacking. The
only proven treatment of the disease is laser treatment for the
wet form of the disease. The dry form can only be
observed, with the warning to the patient that if a sudden
change in vision or distortion is noted to call us as soon as
possible. If the wet form is picked up quickly, laser
treatment may be an option to prevent further deterioration of
the vision. However, in many cases in which laser is
performed, the vision can continue to deteriorate but perhaps
not to the same level as without laser. Surgery can be
performed in some instances to remove the blood, but the results
are unpredictable.
Patients with early forms of macular degeneration should be
given an amsler grid. It is a large square with horizontal
and vertical crossed lines. It can be used to monitor
daily visual changes, with anything new brought to the attention
of the ophthalmologist. It should be noted that vitamins,
particularly with zinc included, are touted as a treatment for
macular degeneration. It has been through some reports
that they have slowed the progression of the disease, but they
are far from a proven and reliable treatment.
I wish we had more to offer patients with the disease,
either with prevention or treatment. It is frustrating to
both doctors and patients when there are no answers and no
solutions or alternatives. Research is very busy
in this area, developing a better understand of the disease so
that hopefully macular degeneration will not be such a
devastating disease in the future.
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