What is it about ?
Everything we see projects an image onto our retina. The retina is located at the back of the eye, inside the eyeball. In the center of the retina is the macula, which means ‘spot’ in Latin, a small area of yellow color, responsible for central vision and the perception of details (visual acuity).
Damage to the macula results in deterioration of eyesight. The main risk factor is age. Other risk factors include smoking, a previous intervention for cataracts and the onset of the disease in the family.
There are 2 forms of macular degeneration:
- The dry form: the cells of the eye die very slowly, over several years or several decades.
- The wet form: abnormal vessels are responsible for bleeding in the eye. This usually happens quickly, over a few weeks or months. Sometimes the dry form can exist for years and then suddenly turn into the wet form.
Where and how often?
Macular degeneration is the most common cause of visual impairment in people over 65 years of age.
Eye exams show changes in 1 in 50 to about 1 in 4 people in the population aged 43 to 64 and in about 1 in 4 to about 1 in 3 in the population aged 75 and over .
Some degree of macular degeneration is seen in 1 in 10 people over 60 years old, and severe form in 1 in 100 people over 60 years old.
In 2 out of 3 cases, the disease affects both eyes.
1 in 10 people suffer from the wet form, 9 out of 10 people from the dry form.
How to recognize it?
The disease usually starts in one eye and is therefore often not noticed at first. The vision is in fact compensated by the eye which is not affected. Often times, the person only notices the first symptoms when the other eye is affected as well.
Typical symptoms are distortion of straight lines and enlarging or reducing the size of the image. As you read, the letters can change size and sometimes even disappear. The person can see a gray spot in the center of their field of vision. Part of the central image may also be missing. This sometimes makes it difficult to read and recognize faces. Changes can also occur in color vision, especially yellow and blue.
Eventually, vision can deteriorate to such an extent that only finger counting is still possible. However, it does not go so far as to be blind (complete blindness). The outer area of the field of vision (peripheral field of vision) is preserved. Daily activities therefore remain more or less possible. The person then has a very poor view of the center of the image, and a fairly good view of the periphery of the image.
How is the diagnosis made?
The diagnosis is made by the ophthalmologist. Using an ophthalmoscope, he examines the inside of the eye and the retina.
The central distortions of the image can be detected using the Amsler grid, a grid of horizontal and vertical lines. If there is a problem, the lines are not straight.
What can you do ?
Use assistive devices to compensate for the visual impairment, and give useful indications to help you. You will be able to read and watch TV better up close. Provide sufficient lighting inside the house and observe the necessary safety rules: wear protective gloves in the kitchen when handling hot dishes and when using the oven. Also agree with those around you about cleaning and shopping.
What can the doctor do?
There is no treatment for the dry form. The doctor will regularly check the retina to detect in time a worsening and possible evolution to the wet form.
The progression of the wet form can be slowed with certain injections and, in some cases, with photodynamic treatment, which uses visible light. It is the ophthalmologist who provides treatment and follow-up.
Want to know more?
Are you looking for more specialized help?
- Smoking Assistance Center (CAF®) – FARES – Respiratory Affections Fund
- Tobacco specialists – FARES – Respiratory Affections Fund
- The LUSS – A federation of associations of patients and relatives
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