ARMD is a disorder characterized by the accumulation of tiny deposits, known as drusen, under the retina’s central part, the macula. Initially, these deposits might not result in any noticeable vision issues. However, as they increase in size and number, they can lead to a blurry or warped central vision. If the retina suffers significant damage due to these deposits, it could start to bleed, resulting in a swift decline in vision.

What is the difference between “Dry” and “Wet” ARMD?

All ARMD begins as the Dry variant, meaning that the drusen deposits are present but the retina is not bleeding. If a specific layer within the retina becomes sufficiently damaged by these drusen, the retina may bleed, a condition we call Wet ARMD. Approximately 10% of dry ARMD cases progress to wet ARMD.

How is ARMD diagnosed?

ARMD is formerly diagnosed when your eye doctor examines your retina and identifies the presence of drusen. Early changes the macula may be more easily detected by an instrument called Optical Coherence Tomography (OCT), which we utilize in our practice.

How is ARMD treated?

Regardless of the type of ARMD, there are a few things we recommend to help lower your risk of vision loss: Lower your blood pressure, wear UV protected sunglasses outside, eat leaf green vegetables daily, and cease smoking. Additionally, a small piece of grid paper calld an Amsler Grid is used to help you identify subtle changes in your central vision at home.

If you have dry ARMD, the most important thing we can do is monitor you closely, watching for signs that wet ARMD has developed. Two large studies called AREDS 1 and 2 have confirmed that taking a specific mixture of vitamins helps to slow down the progression from Dry to Wet AMD. This formulation is available over the counter and should denote that it follows the AREDS-2 Formulation. 

If you develop wet ARMD, a medicine in the Anti-VegF family (there are several brand names) is injected into your eye to help clear the blood from the retina. These injections are relatively painless and are often performed several times over the course of months or years to make the bleeding subside. A retina specialist may also use a laser to help stop the bleeding in certain circumstances.

Will I lose my vision if I have ARMD?

Dry AMD often has very little impact on central vision in the early stages of the disease. However, in later stages, central vision is impacted more significantly, causing distorted central vision or a “blind spot” centrally, called a scotoma.

Wet AMD is more likely to have a noticeable impact on central vision, at least prior to treatment. If treatment is administered early on and is successful, vision typically will improve, although not always back to as clear as before it began bleeding.

While it is frightening to consider losing the clarity of your central vision, many take some comfort in knowing that ARMD will never affect their peripheral vision. In other words, although ARMD can affect central vision significantly, it will never cause “black out” blindness where the eye perceives no light.

Why does ARMD occur?

We understand that there are genetic factors that cause ARMD in some but not others. Research into these genetic markers continues. In addition to inherited genes, we know that environmental factors and systemic health plays a role. For example, UV exposure over the course of a lifetime plays a role. We also know that diabetes, hypertension, smoking, and poor diet are risk factors for developing ARMD. Finally, we see ARMD more often in Caucasians, females (although still common in males), and those over 60, hence the name “Age-Related”.

Cataracts occur when the crystalline lens inside the eye turns from clear to a yellow-brown color or develops other opacities that makes it difficult to see through.

What are the symptoms of cataracts?

As cataracts begin to develop, the most common first symptom involves decreased night vision, including halos and starbursts around lights. As cataracts continue to progress, vision changes include blurred vision, needing additional light to read, and desaturation of colors.

Who gets cataracts?

Cataracts are most commonly age-related, often occuring in the mid to late 60’s and beyond. Other factors, such as diabetes, trauma, or prolonged steroid use can cause premature cataracts to form.

When do I need cataract surgery?

When cataracts begin to interfere with normal tasks that you perform daily, it’s time to have cataract surgery. Each medical insurance has different qualifications that patients must meet before they will pay for the surgery, but these often coincide with the onset of moderate symptoms.

Will I need glasses after cataract surgery?

Cataract surgery is a quick outpatient surgery that often takes around 10 minutes per eye. Surgery is typically performed on one eye with the fellow eye scheduled a few weeks later. Eye drops are used for around a month following surgery to prevent infection and promote healing. While complications can occur, they are not common in routine cataract surgery and are often managed with eye drops alone.

During cataract surgery, the surgeon will remove the natural crystalline lens and replace it with a permanent intraocular lens implant. The benefit of this exchange is that the lens implant can correct your glasses prescription, making most people glasses-free following cataract surgery (many people still need reading glasses after cataract surgery, but may not if the choose a multifocal lens implant).