|
|
|
|
Macular degeneration (ARMD)Macular degeneration is the major cause of loss of vision in people over the age of 50 in the United States. It is often called age-related macular degeneration (ARMD) because it is associated with aging. (There are also some unusual types of macular degeneration that start very early in life). Macular degeneration is also associated with genetics and is more common in some families. Macular degeneration usually begins with the appearance of spots in the central region of the retina, called the macula. These spots are called drusen. Drusen usually do not affect the vision and may disappear, remain stable, or increase over time. They may herald the development of the "dry" form of macular degeneration. Occasionally, they may also herald development of the "wet" form of macular degeneration, which is more severe and characterized by leaking or bleeding blood vessels in the retina.
Loss of vision from macular degeneration usually begins in one eye and only later may affect the other eye. In some people, vision in the second eye is never affected. When a person loses their central vision from macular degeneration in one eye, the loss of vision may not even be noticed because the healthy eye maintains detailed (or central) vision. The healthy macula compensates for the loss of vision in the affected eye. It is only when macular degeneration severely affects both eyes that it becomes difficult, or perhaps impossible, to do the kind of work that requires detailed vision. A person with severe macular degeneration, who has lost the ability to see detail with each eye, will usually retain their peripheral vision. It is very rare for someone with macular degeneration to lose both macular (detailed central) and peripheral (side) vision. Almost all people with severe macular degeneration in each eye can see well enough to take care of themselves and continue activities that do not require detailed vision. The FDA has approved pharmaceutical treatments for the wet form of macular degeneration, for which additional information is available here.
Nutritional recommendations for avoiding or treating
macular degeneration are controversial and are the subject of ongoing scientific studies. Most studies suggest that a diet containing lutein and zeaxanthin, omega 3s (fish oil or flaxseed oil), and possibly zinc may be helpful.
Diabetes mellitus is a systemic disease that causes problems with the use and storage
of sugar. High blood-sugar levels can result in damage to many
systems of the body, including the kidneys, the nervous system, and the eyes.
Diabetic retinopathy occurs because of changes to the blood vessels of the eye.
Normal blood vessels in the eye do not leak or bleed. Blood vessels in the
eye affected by diabetes may leak fluid or blood, resulting in blurred vision.
This type of retinopathy is called background retinopathy, and the swelling is
called macular edema. Advanced diabetic retinopathy (proliferative retinopathy)
is characterized by the growth of new blood vessels on the retinal surface
(called neovascularization). These vessels are fragile, and traction on them may
cause bleeding or even retinal detachment.
Visual loss in diabetic patients is a late complication of the disease, and
complications may in fact be occurring prior to the onset of symptoms. Diabetic
patients should schedule eye examinations at least once a year. Examinations may
be more frequent based upon the degree of retinopathy.
Treatments range from close observation with tight control of blood sugar
levels, to laser for macular edema and neovascularization, to surgery for
hemorrhages and retinal detachments. |
|
|
