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MACULAR DEGENERATION
Macular degeneration is a related deterioration of the central area of the retina called the macula. The macula is very small, accounting for only 5% of the surface area of the retina. Because it had a very special architecture, it makes fine, detailed vision possible, such as seeing features on faces, reading fine print or seeing street signs while driving. The remainder of the retina provides us with our less detailed peripheral, or side vision.
In macular degeneration, damage or breakdown of the macula occurs. The symptoms are distortion or blurriness of central, detailed vision. The most common type of macular degeneration is the "dry" or atrophic form. In this form, there is damage to the pigment layer under the retina. Because the pigment layer provides nutrition and protection to the retina, when it is damaged, the retina doesn't function properly. The dry form of the disease tends to progress slowly, and cause less severe vision loss.
All macular degeneration starts out as the dry type. In 10-15% of cases it progresses to the more aggressive "wet" or exudative type. Abnormal blood vessels form under the macula, which leak fluid or blood. Vision loss from the "wet" type tends to be more rapid and severe than the "dry" type.
Macular degeneration almost always involves both eyes, but one eye is often many years ahead of the other in the deterioration process. It is possible to have one eye with the dry type and one eye with the wet type.
Despite the fact that age related macular degeneration (AMD) is one the major causes of decreased vision, scientists are not able to determine what causes this change in the macular. In most cases of AMD, people are affected at the age of 60 - 65; however there have been cases where people have been diagnosed at age range from 40's to 50's. AMD has also been found to be a hereditary disease, which may provide an increased risk to people whom are related to someone with AMD. It is not known what else causes it.
Most people who develop AMD have the "dry" type; this is a very slow working process. In this condition, yellowish deposits called drusen accumulate beneath a part of the eye known as the retina and cause it to lose some of its function. Because the central part of the retina, known as the macula, is most affected, this process is called "macular" degeneration. The layer of light sensitive cells also gets thinner.
This normally causes the vision to get distorted or blurred when reading. When the disease strikes one eye there is an increased risk that the other eye will also become affected. Persons with the "dry" AMD rarely become totally blind.
The real problem occurs when the "wet" type develops. When the wet type develops it is also called neovascular form. This form is caused by new blood vessels when they begin to grow under the macular. When these blood vessels leek, nearby cells weaken and die. This can make straight lines look curved and result in blank spots within the vision field. If the leaking continues it will destroy most of the nerve tissue within weeks to months. Today, this damage cannot be repaired by modern medicine.
The neovascular "wet" form only strikes a small percentage of AMD patients. When macular degeneration is found in juvenile individuals (age range from 7 years to early teens), the condition is called Stargardt's Disease and is similar to the "dry" form of macular degeneration.
Doctors perform a visual field scan on each patient to get a better understanding of the patient's vision limitations. The printed pattern identifies those areas that are affected by macular degeneration.
Dark colors represent seriously limited vision, black being no vision at all. Lighter colors, yellow being the highest, represent clear vision
The above photo represents Juvenile MD.
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