Questions & Answers

The fovea is the central part of the retina. It is actually a depression in the macula where only cones (not rods) are present. The cones are photoreceptor cells that facilitate the perception of sharp detail and color. Macular degeneration may or may not affect the fovea.

Several studies have been conducted to determine whether or not having cataract surgery causes or worsens macular degeneration. It is generally thought that underlying macular degeneration may sometimes go unnoticed until the cataract is removed and the eye doctor can more easily view the retina.

This is a difficult question. You are right to be concerned about your career. However, it is important to mention that there is no set time frame for which macular degeneration advances to the more sight-threatening stages. Some people notice a somewhat steady progression of the disease; while others have vision that remains relatively stable with no further progression for a number of years. Therefore, it is difficult to say how the disease will progress in your particular situation. I would advise that you seek counseling from a low vision specialist, and talk about these issues with the ophthalmologist who is familiar with your specific case. He or she can provide you with more precise information concerning the progression of the disease and what you can expect.

At present, I know of no injections available to treat dry macular degeneration. The wet form of the disease, however, is treated by the injection of compounds to stop or slow the growth of leaky new blood vessels. My advice is to ask your ophthalmologist about the specific name of the compound he/she plans to inject. You can then do some personal research and also obtain the opinion of another eye doctor concerning this injection.

There is no definite answer to this question. The progression of macular degeneration varies from patient to patient, so it is very difficult to make these predictions. My recommendation to you and your mother is to maintain frequent eye examinations to track her condition. Also, report any noticeable changes in her vision to the ophthalmologist as soon as they occur. She should also closely follow the advice of her ophthalmologist to slow or prevent the progression of the disease as much as possible.

Treatments currently available for macular degeneration vary depending on whether your husband has the wet or dry form of the disease. However, given the added fact that your husband also has diabetes, strict regulation of blood glucose levels is strongly encouraged. It is important to maintain blood glucose levels within acceptable ranges because it can help prevent or halt a number of diseases commonly associated with diabetes, including eye problems.

All wet AMD is considered advanced; however, the dry form of AMD has three stages:

• Early AMD - patients have several small drusen or a few medium-sized drusen. There is no vision loss or symptoms at this stage.
• Intermediate AMD - patients have many medium-sized drusen or one or more large drusen. Some people may need more light for tasks such as reading. A blurry spot may appear in the center of the visual field.
• Advanced AMD - patients exhibit a large number of drusen deposits and a breakdown of RPE and photoreceptor (light sensitive) cells and supporting tissue in the retina. A large blurry spot occurs in the center of the visual field and can become larger and darker, eventually causing a complete loss of central vision.

Myopic macular degeneration is not the same as age-related macular degeneration. Myopic macular degeneration, unlike age-related macular degeneration, is a type of macular degeneration that usually has its initial onset during the teenage years rather than in the elderly or aging population. Also, it is known that myopic macular degeneration is a form of macular degeneration that develops in persons who are extremely nearsighted. The extreme elongation of the eyeball in these individuals often leads to tears in the macula and bleeding beneath the retina similar to that seen in patients with age-related macular degeneration. The treatment options for myopic macular degeneration are very much similar to those for age-related macular degeneration. In addition, there are some promising studies involving the use of compounds like 7-methylxanthine in children ages 8-13 to minimize or stop the abnormal growth pattern of myopic eyes thereby preventing or reducing the risk of developing myopic macular degeneration.