Signs Of Macular Degeneration

What are some of the signs of age related macular degeneration?

Age related macular degeneration is a degenerative vision condition.  It exists in a slower moving form called dry (non-neovascular) macular degeneration in which an accumulation of drusen (small bits of extracellular material) occurs.  It also exists in a faster moving form called wet (neovascular) macular degeneration in which abnormal blood vessel growth occurs in the eye.  Leakage of blood and fluids from these new vessels contributes to scarring in the retina.  Both forms of macular degeneration cause a loss of central vision; the detailed vision that allows for reading, facial recognition, and driving.  An overview of the symptoms follows below.

Macular degeneration usually follows a predictable course of symptoms.  The primary difference, other than rate of degeneration, is the presence of drusen.  In dry macular degeneration, the first symptom is the accumulation of drusen.  This is not a symptom that can be identified at home.  It can be detected by an ophthalmologist when they perform a retinal examination.  Drusen accumulation can begin during middle age and early detection can help to slow the process.  As such, it is advisable to begin receiving eye examinations approximately every other year at the onset of middle age, unless otherwise indicated by a doctor. 

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The first personally detectable sign of macular degeneration is typically persistent blurred vision that vanishes in brighter light.  This is an early sign that cells in the macula are no longer functioning properly.  Another early symptom can be distorted vision.  Distorted vision tends to manifest as objects appearing to be an inappropriate size or shape.  Wet macular degeneration will often manifest as distortion of straight lines. In the event that there appears to be distortion of central vision, an exam using an Amsler grid (a graph patterned chart) to test for line distortion.  Distortion of contrast or color that grows worse over the course of time is common in both wet and dry macular degeneration. 

In the event of persistent, lasting more than a few days, blurriness or distortion of vision, an eye exam should be scheduled.  Many eye conditions can cause blurriness or distortion and only a trained physician can accurately diagnose them.  This may also include a fluorescein angiography.  This is test in which dye is injected into your bloodstream that will travel to the eye.  A camera with filters specially designed to detect the dye is used to evaluate blood flow in the eye. 

In the long term, it is common for scotomas to develop.  Scotomas are areas of vision that look shadowed or are entirely dark.  In macular degeneration, these scotomas are located in the central area of vision due to the location of the macula.  At times, due to contrast issues, the scotoma are may appear as a white out rather than a blacked out area.

While the loss of vision can be a deeply distressing emotional event, both wet and dry macular degeneration are pain free conditions.  In the event that symptoms of macular degeneration begin to develop and are accompanied by pain, seek immediate medical attention as it could indicate other serious conditions.


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