MACULAR DEGENERATION LEADING CAUSE OF VISION LOSS

Age-related macular degeneration (AMD) affects the macula, an area inside the back of the eye in the center of the retina. This is where the eye focuses for recognizing faces and reading. The retina records images we see and sends them via the optic nerve from the eye to the brain. AMD occurs when the central portion of the retina begins to deteriorate, affecting a person’s ability to read, drive, recognize faces or colors and see objects in fine detail. AMD is the leading cause of vision loss in older adults.

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VISION IS LEARNED - AND IT CAN BE RELEARNED

Vision involves over 70% of the neural pathways of the brain. Vision is more than eye sight. Vision is the only body system that continues to develop after birth. Vision involves the way the eyes and brain interact. It takes approximately three years for the eyes to learn how to work together. When they do not, it can result in the eyes turning in (esotropia) or out (exotropia), crossed eyes (strabismus) or lazy eye (amblyopia).

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WHAT IS BEHAVIORAL OPTOMETRY?

Behavioral optometry starts with the concept that vision is learned. When we’re born, we don’t know how to use our arms, legs and hands. We also don’t know how to use our eyes. We have to learn how to integrate them with the rest of our body. The brain must process what the eyes are seeing, and then it has to integrate that information with the other senses. From a behav- ioral standpoint, seeing requires a more holistic approach, getting all the senses to work together.

….FULL ARTICLE

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MACULAR DEGENERATION LEADING CAUSE OF VISION LOSS

Age-related macular degeneration (AMD) affects the macula, an area inside the back of the eye in the center of the retina. This is where the eye focuses for recognizing faces and reading. The retina records images we see and sends them via the optic nerve from the eye to the brain. AMD occurs when the central portion of the retina begins to deteriorate, affecting a person’s ability to read, drive, recognize faces or colors and see objects in fine detail. AMD is the leading cause of vision loss in older adults. According to one source, the prevalence of AMD is estimated to reach epidemic proportions of 6.3 million Americans by the year 2030.


There are two types of AMD, wet and dry. Wet AMD is a progression of dry AMD, not a separate condition. Macular degeneration begins when waste products, called drusen, build up under the macula. This is called dry AMD; it causes blurring and distorts vision. As the condition progress, abnormal blood vessels grown beneath and into the retina, causing swelling, bleeding and changes in vision. This is called wet AMD because the abnormal blood vessels begin to leak. Most people have dry AMD.


Risk factors for AMD include age, genetics and environment, although research has not yet been able to show exactly why the cells in the macula begin to deteriorate. Smoking doubles the risk of developing AMD.


At present, AMD is incurable. In early stages, it does not affect vision, but as the disease progresses, patients may have wavy or blurred vision. For instance, the straight edge of a door or sentences on a page in a book seem wavy. You may also notice a gray or dark area in the center of your visual field. In its most severe form, the condition causes the patient to lose central vision completely. People with very advanced AMD are considered legally blind, although they may retain peripheral vision.


Treatment may include an option called laser photocoagulation or photodynamic therapy (PDT). Another treatment involves inject- ing the patient with a drug activated by a laser that selectively destroys and seals the leaking blood vessels. Although it is not a cure, the drug and laser treatment can probably slow the rate of vision loss. Some sight may be retained, but lost sight cannot be restored. The most com- mon and effective treatment for wet AMD is anti-VEGF therapy, which entails injecting a chemical called vascular endothelial growth factor directly into the eye. It inhibits the formation of new blood vessels behind the retina and may keep it from leaking.


As you grow older, it becomes more important to have regular eye exams. That is how most cases of AMD are detected. A specific test looks for drusen and pigment or color changes in the retina that may signal AMD. Your eye doctor may have you print out and use an Amsler grid with which you can discern visual changes that might indicate AMD.

DR. RICK GRAEBE

Dr. Graebe received both his B.S degree in Visual Science and Doctorate of Optometry from Indiana University. He is a Behavioral Optometrist and learning expert. He has been in private practice here in the Bluegrass area for the past 32 years.

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