Macular Degeneration: Diagnosis, Therapy & Prevention
In macular degeneration, the site of the retina is damaged, which is responsible for the central, sharp vision. The light-sensitive cells die at this site. As a result, the affected person can no longer be very sharp at this point. Reading or driving, for example, becomes impossible.
The age-related macular degeneration (AMD) is one of the most common causes of loss of visual acuity in old age – around 20 percent of 65- to 74-year-olds suffer from this, while the 75- to 85-year-olds account for 35 percent.
In Germany alone, about three million people suffer from visual impairment. The disease usually begins after the age of 55 and leads to blindness in the late stage. Seven million people suffer from this in Europe. This makes AMD the most frequent cause of blindness in industrialized countries.
Identifying in a timely manner is important!
The cause of the disease is not yet known. Scientists suggest that the pigment layer under the retina is destroyed over the years by deposited metabolic products. Patients with AMD often find that kitchens and bathroom tiles suddenly appear crooked or the curbs disappear.
This is due to changes in the retina. Because the healthy eye often compensates for the visual changes of the diseased eye, one should alternately occasionally cover the right and the left eye so as to perceive changes in the eyesight of the individual eyes even earlier.
Amsler grid Test
With the so-called Amsler lattice test, one can easily investigate whether symptoms are present for an AMD. The lattice is held in front of the eye at a distance of 30 to 40 centimetres in bright light. Eyeglasses or contact lenses should be put to the test. One eye covers the one eye, while the other eye fixes the point in the middle. If the lines around the fixed point are bent around and devastated, the person concerned should go to an ophthalmologist as soon as possible.
Even if there is no definite cure at present, the progress of the disease can be stopped.
Check the diagnosis at the ophthalmologist
If an AMD is suspected, the ophthalmologist can confirm the diagnosis with an ophthalmoscope (ophthalmoscopy). Changes in the centre of the retina, such as typical pigment compaction, can thus be recognized early on and before the onset of visual disturbances. In general, the ophthalmologists differ in two forms: the over 80 percent most frequent form is the dry macular degeneration and the 15 percent more rare form of the moist macular degeneration.
The dry macular degeneration often goes unnoticed for years and hardly affects the eyesight at first. However, the dry macular degeneration can always go into the moist macular degeneration, which has a markedly more severe disease pattern.
The moist macular degeneration is much more aggressive: it can lead to a serious loss of vision within a few weeks or months. There is currently no clear therapy for either of these forms, but many measures can improve vision.
Therapy approaches for macular degeneration
In moist macular degeneration, new vessels are formed in the retina, which can be destroyed by means of a laser treatment. However, the patient must accept the scarring of the retina, which in turn leads to visual disturbances. Therefore, this therapy is only possible if the vessels are not directly in the macula.
More promising is so-called photodynamic therapy (PDT), in which a light-sensitive dye is activated by means of a cold laser directed to the eye.
The dye itself enters the body as an infusion over the arm vein and accumulates in the new, leaking blood vessels in the eye. The ophthalmologist activates the dye by means of the laser beam so that the diseased vessels are closed. Since the photosensitive layer of the retina was permanently damaged before the operation, this outpatient treatment can stop the progress of the disease but cannot be fundamentally improved. In many cases, a multiple treatments is necessary.
After the treatment, the patient should wear a special protective goggle, which the ophthalmologist gives to the patient. Long-sleeved clothing for protection against the sun and light is necessary until the remaining inactivated dye has been completely separated after 48 hours.
Prevention helps: wear sunglasses!
Sunglasses and wide-brimmed hats are an effective weapon against too much sunlight – not only for the skin but also for the eyes. However, if you want to protect yourself against the sun, you should pay attention to the following when buying glasses: A pair of sunglasses should absorb at least 99 percent of the UV rays to 400-nanometer wavelength.
The filtering of the UV rays takes place in the glass or plastic material and is independent of the degree of tinting. Not the darkest lenses protect best, but sunglasses, whose glasses are made of high-quality material with a built-in UV filter.
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