Dry macular degeneration symptoms usually develop gradually and without pain. They may include:

• Visual distortions, such as straight lines seeming bent
• Reduced central vision in one or both eyes
• The need for brighter light when reading or doing close-up work
• Increased difficulty adapting to low light levels, such as when entering a dimly lit space
• Increased blurriness of printed words
• Decreased intensity or brightness of colors
• Difficulty recognizing faces
• A well-defined blurry spot or blind spot in your field of vision

Wet macular degeneration symptoms are essentially the same, but their onset can be much more sudden and severe.

It’s important to have routine eye exams to identify early signs of macular degeneration. The following measures may help reduce your risk of developing dry macular degeneration:

• Manage your other medical conditions. For example, if you have cardiovascular disease or high blood pressure, take your medication and follow your doctor’s instructions for controlling the condition.
• Don’t smoke.
• Maintain a healthy weight and exercise regularly. If you need to lose weight, reduce the number of calories you eat and increase the amount of exercise you get each day.
• Choose a diet rich in fruits and vegetables. Choose a healthy diet that’s full of a variety of fruits and vegetables. These foods contain antioxidant vitamins that reduce your risk of developing macular degeneration.
• Include fish in your diet. Omega-3 fatty acids, which are found in fish, may reduce the risk of macular degeneration. Nuts, such as walnuts, also contain omega-3 fatty acids.
• Take AREDS II Vitamins.  The Age Related Eye Disease Study (AREDS) found that the formulation in AREDS II vitamins can slow or prevent the progression of dry macular degeneration.

Amsler Grid Testing:  The  Amsler grid is a very simple test that can be done at home to detect worsening of macular degeneration.  Using your reading glasses, you simply cover an eye and look at the center of the grid square, looking for any areas of distortion.  You then repeat the test for the other eye.  

This is very important – you MUST do the test with one eye at a time or you may miss distortion occuring in your non-dominant eye.

If you see a sudden change in your Amsler grid, you should notify Dr. Thayer within 48 hours.

Ocular Coherence Tomography (OCT): Augmenting the dilated examination of your retina Dr. Thayer will perform, you may be imaged with our OCT.  This is painless, quick, and covered by insurance.  It is a truly invaluable test in the detection and management of macular degeneration.  It is particularly helpful in diagnosing wet AMD in its early stages, when the prognosis with treatment is better.

Treatment for Dry AMD is limited to the preventative measures listed above, frequent Amsler grid monitoring (at least weekly), and regular, dilated eye examinations.

If Dr. Thayer detects the Wet form of AMD, you will be referred to a Retina specialist for further treatment.  Treatment of wet AMD involves periodic injections of medication, called anti-VEGF medicine, into the eye.  This has the potential to reduce the fluid leakage near your focus area that is the hallmark of wet AMD.

Over time, too much sugar in your blood can lead to the blockage of the tiny blood vessels that nourish the retina, cutting off its blood supply.  The eye responds by growing new blood vessels, but these new blood vessels don’t develop properly and can leak easily.

There are two types of diabetic retinopathy:

• Early diabetic retinopathy. In this more common form — called nonproliferative diabetic retinopathy (NPDR) — new blood vessels aren’t growing (proliferating).
• When you have NPDR, the walls of the blood vessels in your retina weaken. Tiny bulges protrude from the walls of the smaller vessels, sometimes leaking fluid and blood into the retina. Larger retinal vessels can begin to dilate and become irregular in diameter as well. NPDR can progress from mild to severe as more blood vessels become blocked.
• Sometimes retinal blood vessel damage leads to a buildup of fluid (edema) in the center portion (macula) of the retina. If macular edema decreases vision, treatment is required to prevent permanent vision loss.  This condition is the most common way in which diabetic retinopathy causes vision loss.
• Proliferative diabetic retinopathy (PDR). This is the most severe form of diabetic retinopathy. In this type, damaged blood vessels close off, causing the growth of new, abnormal blood vessels in the retina. These new blood vessels are fragile and can leak into the gel that fills the center of the eye (vitreous).
• Eventually, scar tissue from the growth of new blood vessels can detach the retina from the back of the eye. If the new blood vessels interfere with the normal flow of fluid out of the eye, pressure can build in the eyeball, giving rise to a particularly aggressive type of glaucoma known as Neovascular Glaucoma.

Anyone who has diabetes can develop diabetic retinopathy. The risk of developing the eye condition can increase as a result of:

• Having diabetes for a long time
• Poor control of blood sugar level
• High blood pressure
• High cholesterol
• Pregnancy
• Tobacco use
• Being Black, Hispanic or Native American

You can’t always prevent diabetic retinopathy. However, regular eye exams, good control of your blood sugar and blood pressure, and early intervention for vision problems can help prevent severe vision loss.

Things you can do:

• Manage your diabetes. Make healthy eating and physical activity part of your daily routine. Try to get at least 150 minutes of moderate aerobic activity, such as walking, each week. Take oral diabetes medications or insulin as directed.
• Monitor your blood sugar level. You might need to check and record your blood sugar level several times a day — or more frequently if you’re ill or under stress. Ask your doctor how often you need to test your blood sugar.
• Ask your doctor about a glycosylated hemoglobin test. The glycosylated hemoglobin test, or hemoglobin A1C test, reflects your average blood sugar level for the two- to three-month period before the test. For most people with diabetes, the A1C goal is to be under 7%.
• Keep your blood pressure and cholesterol under control. Eating healthy foods, exercising regularly and losing excess weight can help. Sometimes medication is needed, too.
• Stop smoking.
• Pay attention to vision changes. Contact your eye doctor right away if your vision suddenly changes or becomes blurry, spotty or hazy.
• DO NOT BURY YOUR HEAD IN THE SAND!  Ignoring your diabetes, especially in youth, is always a mistake.

Dilated Eye Examination:  Dilated eye exams are recommended for all diabetics on an annual basis.  Once any degree of diabetes is detected in the eye, these exams should be done more frequently.  Dr. Thayer will recommend the frequency of dilated examinations you should have based on the severity of your disease.

Ocular Coherence Tomography (OCT):  If Dr. Thayer detects diabetic signs in your eyes, you may be imaged with our OCT.  This is painless, quick, and covered by insurance.  It is a very helpful tool in the detection and management of macular edema (swelling).     

In all stages of diabetes, good control of blood pressure and sugar are essential.  The early stages of diabetic retinopathy usually do not need any treatment beyond these measures.  There are five main complications that require treatment:

1. Macular Edema:  This swelling in the focus area of the eye is treated with either drops, laser, or injections of medication into the eye.  If injections are required, Dr. Thayer will refer you to a local Retina specialty group.
2. Vitreous Hemorrhage:  This is bleeding within the eye that causes vision filminess or downright vision loss.  If Dr. Thayer detects this complication, you will be referred to the Retina group for special imaging to detect the source of the bleeding and to determine the best treatments to avoid further complications.
3. Proliferative Diabetic Retinopathy:  In this case of abnormal new blood vessel growth in the eye, management options include laser and injections into the eye of a compound that slows new blood vessel growth.  These compounds are known as anti-VEGF, or anti Vascular Endothelial Growth Factor.  This complication must be dealt with urgently as it can lead to vitreous hemorrhage, retinal detachment, and eye pressure problems.
4. Neovascular Glaucoma:  This is a particularly aggressive type of glaucoma resulting from abnormal blood vessel formation on the iris and in the drainage angle of the eye.  If the drainage angle is blocked by this process, eye pressure can be very difficult to control, leading to blindness.  Management includes drops, laser, and intraocular injections of anti-VEGF compounds.
5. Traction Retinal Detachment:  This is a late stage complication in which abnormal blood vessels or blood within the eye trigger the formation of traction bands that pull the retinal off of its bed.  Prognosis is poor here, and management is performed by a Retina surgeon.