Macular Degeneration
Care & Advice

What is the macula?

The macula is part of the light sensitive layer at the back of the eye called the retina.

The macula is the name given to the central part of the retina. It is very important as it is here that the light sensitive cells are most densely packed. If you think of a camera it is the macula that has the most pixels and the best resolution, therefore it is responsible for our precise, detailed central vision.

If the macula was damaged you would find it hard to read or recognise faces but walking around would be manageable as we mostly use our peripheral vision for this.


What is macular degeneration?

Macular degeneration is damage to the light sensitive cells at the macula, there are two main types:

Dry macular degeneration

Dry macular degeneration develops when the cells of the macula become damaged as a result of a build-up of waste products called drusen.

It is the most common type of macular degeneration. The loss of vision is gradual, occurring over many years.

Wet macular degeneration

Wet macular degeneration develops when abnormal blood vessels form underneath the macula and damage its cells. With wet macular degeneration vision can deteriorate rapidly within days.


Symptoms

In the early stages of macular degeneration fluid or blood leakage can build up under the macula, which can distort its layer of light sensitive cells.

If the macula is distorted the vision also appears distorted. Often people report that a lamp post looks like it has bend or bulge in it. Others may notice a blob in the central vision.

If this is left untreated it can cause permanent damage to the light sensitive cells at the retina, leading to permanent central vision loss.

Causes

The exact causes of macular degeneration are not fully known. However we are all more at risk of macular degeneration as we get older and if you have a family history of the condition.

Macular degeneration is also more common in women than men and because of the protective effect of pigment it is more common in Caucasians than other ethnicities.

There are also lifestyle factors that increase your risk of macular degeneration, reducing your exposure to these risk factors will reduce your chances of developing macular degeneration.


Lifestyle risks of macular degeneration

• Smoking increase you risk of macular degeneration by 4 times.

• Unprotected UV exposure to the eyes can damage the sensitive light cells at the macula.

• Poor diet reduces the quality of the macular pigment which has a protective role

Treatment

Wet macular degeneration is mainly treated with an injection, this reduces the formation of blood vessels at the macula. There is currently no treatment for dry macular degeneration.


Diet & macular degeneration

The macula has a natural defence against degeneration in the form of macular pigment.

The macular pigment protects the delicate light sensitive cells at the back of the eyes by absorbing short wave-lengths of light and scavenging free radicals. People with reduced macular pigment are at a high risk of macular degeneration.

The macular pigment is made from pigments found in plants called carotenoids. Leafy greens (like broccoli, spinach, brussel sprouts and kale) are rich in carotenoids. Making these vegetables a regular part of your diet is shown to significantly reduce your risk of macular degeneration.

Protecting your eyes from harmful UV rays

Good quality sunglass lenses will protect your eyes from damaging UV light in bright sunlight. Always make sure they have protection up to 400nm.

Harmful ‘blue’ light is also emitted from devices and energy saving bulbs, you can limit your exposure to this by wearing lenses that have a blue absorption coating.

Macular Degeneration

MONITORING

Monitoring your eyes for macular degeneration – The Amsler Chart

The early stages of wet macular degeneration can be treated and in many cases if the treatment is given promptly the progression of the condition can be stopped. If the condition becomes established then it can lead to permanent vision loss and any future treatment will become ineffective. Therefore it is essential that if you notice any distortion in your vision that you inform your optometrist immediately

An Amsler Chart is a quick and simple method of monitoring your vision for distortion. The simple grid pattern makes it easy to pick up distortion before you would normally become aware of it. Keep the chart where you can notice it, for example on a noticeboard, fridge or the inside of a wardrobe (don’t put it in a drawer!).


Follow these 4 steps on each eye individually

1. Wear your reading glasses and hold the grid at about 35cm.

2. Cover one eye completely with the heel of you hand (it’s really important you only check one eye at a time!).

3. Focus on the central dot of the grid but be aware of the rest of grid without looking around.

4. Looking at the central dot, are any of the lines of the grid missing or distorted?

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Aim to check your Amsler Chart at least once a week.

Repeat these steps on the other eye and contact Eyeworks London immediately if you notice any distortion.

For more information on how to use an Amsler Chart see our video below.

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