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Macular Degeneration

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Macular degeneration
Macular degeneration is an eye disease that disrupts the central, specialized part of the retina called the macula. The macula is responsible for giving us clear, sharp central vision and enables us to see things in great detail. We use our macula when we are reading printed material or looking at street signs. Macular degeneration may affect only one eye, although it commonly affects both. Some types of macular degeneration can occur in young people; however, the main type, age-related macular degeneration (ARMD), mainly affects people 55 years of age and older. The autonomy of a normal eye is Cornea - The transparent "front window" of the eye. It is a thick, nearly circular structure covering the lens. The cornea is an important part of the focusing system of the eye. Pupil - The round black hole in the center of the iris. The size of the pupil changes automatically to control the amount of light entering the eye. Iris - The pigmented (colored) membrane of the eye, the iris is located between the cornea and the lens. Its color varies from pale blue to dark brown. Lens - A transparent biconvex structure located behind the iris. It focuses light rays entering through the pupil in order to form an image on the retina. Retina - A thin multi-layered membrane which lines the inside back two-thirds of the eye. It is composed of millions of visual cells and it is connected by the optic nerve to the brain. The retina receives light and sends electrical impulses to the brain that result in sight. Macula - An area of the eye near the center of the retina where visual perception is most acute. The macula is responsible for the sharp, straight-ahead vision that is used for seeing fine detail, reading, driving, and recognizing faces. It is one hundred times more sensitive to detail than the peripheral retina. The macula is sometimes referred to as "the bull's eye center of the retina." Optic Nerve - Cable-like structure composed of thousands of nerve fibers that connect the macula and retina with the brain. The optic nerve carries electrical impulses from the macula and retina to the processing center of the brain where they are interpreted into clear, colorful sight.
Macular degeneration symptoms usually develop gradually. You may notice these vision Blurred or decreased central close-up and distance vision, which is often delayed because patients subconsciously ignore the eye with worst vision prior to development of the condition in the previously good eye. Blind spots, or scotomas, are a direct result of lost macular function. Straight lines look irregular or bent, called metamorphopsia, and objects appear a different color or shape in each of the eyes. Objects appearing smaller in one eye than the other, called micropsia may also indicate a swelling and bulging of the macula, leading to a greater distance between the individual photoreceptors, which in turn cause the brain to interpret the object as smaller than seen by the good eye. The wet form of age-related macular degeneration is more likely than the dry form to cause significant vision loss. Different treatments of the wet form are available and may help decrease the amount of vision that is lost. Laser treatment may stop or lessen vision loss in early stages of the disease. It is performed with a specific wavelength designed to cauterize the abnormal blood vessels. Argon and krypton lasers are most commonly used for treating macular degeneration. A laser beam destroys existing blood vessels and may stop the growth of new ones. Nutritional supplementation with vitamin C, vitamin E, and beta carotene with zinc decrease the likelihood of developing advanced age-related macular degeneration in some people. The AREDS researchers recommended that patients at risk of developing advanced age-related macular degeneration and those without contraindications, such as smoking, should consider taking antioxidant and zinc supplements. Anecortave acetate (Retaane) is an investigational drug aimed at inhibiting the abnormal growth of blood vessels (neovascularization) in macular degeneration. The drug has the advantage of being injected behind the eye rather than into the eye and requires less frequent administration (every six months). Alcon discontinued investigations of this medication when statistical endpoints were not met in preliminary studies. One major difficulty was determining the exact dosage to the interior of the eye since variable concentrations occur with behind-the-eye injection techniques. Reformulations with better predictability promise improved results.

References

1. http://vision.about.com/od/eyediseasesandconditions/g/Mac_Degeneration.htm

2. http://www.macular.org/humaneye.html 3. http://www.mayoclinic.com/health/macular-degeneration/DS00284/DSECTION=symptoms 4. http://www.emedicinehealth.com/macular_degeneration/page3_em.htm 5. http://www.emedicinehealth.com/macular_degeneration/page8_em.htm 6. http://www.emedicinehealth.com/macular_degeneration/page9_em.htm

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