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Dr. Fowler discusses Macular Degeneration with South Oldham Lion’s Club

The final topic for tonight’s discussion is macular degeneration. A few of you mentioned to me earlier that you have a friend or family member that has been diagnosed with this condition. Macular degeneration is a progressive deterioration of the central retina that disrupts and distorts the vision. Currently, there is no cure for this condition, and it is often very devastating to those who get it.

The macula is a very small part of the retina, but it does about 80% of the work needed to navigate the world we live in. We use our macula to read, see color, perceive movement, and recognize faces. The rest of the retina just fills in the gaps. If the macula is not working properly it can cause a lot of problems.

Macular degeneration happens when the blood vessels under the central retina fail to remove dead cells and other trash from the back of the eye. As this trash accumulates, healthy cells and blood vessels get choked off from the nutrients they need to survive. Over time, the healthy cells die, the blood vessels leak, and vision is lost.

There are actually two types of macular degeneration: the dry (non-bleeding) form and the wet (bleeding) form. About 90% of people with macular degeneration have the dry form. Most of these individuals have vision distortion, but less than 10% of them have significant vision loss. On the other hand, 90% of people with wet macular degeneration have a significant loss of their central vision. You can’t see through blood, and the longer it stays there the more damage it does.

Several things can increase your risk of getting macular degeneration. Number one, of course, is age! The actual name of the condition is really age-related macular degeneration. There are currently 11 million Americans over the age of 50 with the condition, and 30% of Americans over 75 have it. Genetics also plays a factor - if it runs in your family, you are more likely to get it than not. Macular degeneration is almost exclusively found in Caucasians and affects twice as many women as men. Excessive exposure to the sun and smoking are also risk factors, as are other co-morbid conditions like high blood pressure, diabetes, and high cholesterol.

What are the symptoms of macular degeneration? Initially, you might have some difficulty recognizing familiar people or places until you get really close to them. You may also notice that certain objects seem distorted when you look at them – like a wall or a picture. They may appear to have a bump or a wavy area where they would normally be straight. Over time, macular degeneration also causes colors to fade – instead of being vibrant and bright they will appear dull and gray. Reading will also become problematic as words may seem to move, jumble, or otherwise not make sense.

Because there is no cure for macular degeneration, a lot of our treatments are aimed at trying to make an individual as functional as possible within their environment. This may include using brighter indoor lighting. Usually, the more light you have the better you are able to see, so that can be useful. Large print books and magnifiers are also helpful.

If the degeneration does progress to the wet form, treatment becomes much more invasive – and painful. The primary treatment is an ocular injection where medication is placed into the eye to dry up the blood. Lasers are also occasionally used, but once you laser the retina the tissue is scarred for life and is no longer useful.

So how do you avoid all of this? For starters, get regular eye exams - an ounce of prevention is worth a pound of cure. The earlier we catch it, the better the chance there is of slowing it down. Also, be sure to wear a hat and sunglasses anytime you are outdoors, and please don't smoke. Finally, eat a balanced diet with lots of lutein and zeaxanthin. These super vitamins are found in things like tomatoes, red peppers, green peppers, yellow peppers, and carrots. They help remove the trash from the retina, so they are very useful in delaying or preventing this condition.

So I guess we went a little bit long, but you guys had some really great questions. Thank you again for letting me speak tonight. I am happy to answer any questions afterward, or like I said earlier, feel free to stop by the Crestwood Walmart and talk to me there.