DEAR DR. GOTT: First I will tell you I am 84 years old. I have my eyes checked one time a year. I have had cataracts removed from both eyes. My concern is that I will have macular degeneration and go blind. All of my family has had that. Please tell me what I could do to stop that from happening to me. I have yearly exams, floaters and sometimes I have seen light flashes and shadows over the center of the eye. This happens when I go to bed and close my eyes. The next thing that happens when I shut my eyes, I can see faces or other things such as pretty flowers. I don’t tell anybody because it sounds crazy but it has happened for a lot of years. My sister also had this.
DEAR READER: There are two forms of macular degeneration, wet and dry. The most common form is dry which causes loss of vision in the center of the retina, the layer of tissue at the back of the eyeball. Fortunately, the dry form does not usually cause total blindness, but a blind spot in a person’s central vision that results in things looking very blurry. Symptoms appear gradually and can additionally include colors becoming less vivid in intensity, problems reading a newspaper or recognizing faces, causing a need for brighter lights for doing household tasks and as you so aptly described without putting a name to your flower visions – hallucinations. The condition can affect one or both eyes. If only one eye is affected, symptoms may be less noticeable because the “good” eye will compensate for the “bad” one.
Unfortunately, you fall into a high risk category and many issues are simply out of your control. You are female. You are 84. You apparently have a very strong family history. We know these things cannot be modified at this stage of the game, so, let’s concentrate on some of the things over which you may have some degree of control. Review your diet. If it is lacking in nutritious choices, minor dietary changes may help lower any elevated cholesterol readings while allowing you to reduce your weight. Be sure to increase your consumption of fruits, vegetables and fish. The antioxidants in fruits and vegetables and the omega-3 fatty acids in fish and nuts can contribute to better eye health. Incorporate exercise into your daily routine. If you are a smoker, discontinue the habit. It may sound as if I may be taking all the pleasures from your life; however, these changes will make you healthier and will lower the risk for developing macular degeneration.
Diagnosis initially involves methods of looking for central vision defects. Your ophthalmologist may perform a test known as an Amsler grid. The grid that resembles screening for a person with healthy eyes may appear grossly distorted or broken for someone with macular degeneration. He or she will look for a collection of yellow deposits. You might have a colored dye injected into a vein in your arm that will ultimately travel to the blood vessels of your eye, or a non-invasive form of tomography that will show areas of thickening or thinning of the retina. If there are early stages of the disorder present, minimal yellow deposits will appear. Your eyesight may begin to blur but essentially, the change will be minimal. From there, if numerous yellow deposits are detected, your central vision may blur as the disorder progresses. Finally, a more advanced stage will reveal larger yellow deposits and a breakdown of macular light-sensitive cells that will cause pronounced central vision blurring.
There is no medication or treatment to reverse dry macular degeneration; however, individuals so diagnosed will not lose all their vision. And, your doctor might recommend you take several antioxidants and zinc to reduce the progression of the disorder. Those supplements known to help include vitamins A, C and E as well as zinc and copper. Since there is no scientific research to document progress in this regard, speak with him or her for an opinion regarding the efficacy of this regimen.
I must inform you that the dry form you have can progress to wet and rather rapid loss of vision. There really isn’t any means by which we can determine when this will happen or even if it will ever happen so we must concentrate on the positive. It would do no harm to have a plan in place, such as speaking with your physician to determine how long you will be able to continue to drive if you still do; asking if you indeed do have the disorder and how advanced it is if the answer is yes; and whether you can continue to live in your home or should make other arrangements. The visit may be difficult for you to make as the answers may not be what you want to hear so take a family member or friend with you who can express your concerns and help arrest your fears. Then leave the doctor’s office better informed and better able to cope once you know what you are dealing with.
