Receiving a macular degeneration diagnosis can be scary. If the condition runs in your family and you haven’t been diagnosed yet, then you could be at an increased risk. As the leading cause of vision loss, macular degeneration is best treated by preventing the condition or catching it early to stop further progression. Currently, the disease is considered incurable once you have been diagnosed. Because of this, it helps to educate yourself about the disease and take the steps needed to ensure that your vision remains healthy for as long as possible.
This article discusses the signs of macular degeneration. We’ll talk about the difference between wet vs. dry macular degeneration and how to prevent the condition from worsening if you have already been diagnosed. There are many natural practices you can do at home to prevent macular degeneration, such as taking vitamins, doing acupuncture, and following a healthy diet. We’ll also discuss the stages for macular degeneration and whether or not a diagnosis is in your future.
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What is Macular Degeneration?
Macular degeneration is a serious condition. Research shows that it affects nearly ten million Americans, which is more than glaucoma and cataracts combined. As the leading cause of vision loss in adults, macular degeneration is a disease that attracts and destroys your central vision. This is the part of your vision that is needed to see clearly so that you can perform simple tasks such as read or drive. The disease affects a part of the eye known as the macula that allows you to see fine details. Although macular degeneration does not hurt, it kills the cells in your macula and causes them to die. This is what causes you to lose your vision.
The condition starts in your retina, which is the back inside layer of the eye that scans the images we see and sends them from the eye to the brain through the optic nerve. The center part of the retina is known as the macula, and this is the part of the eye that macular degeneration affects. The macula is the most sensitive area of the part of the eye that films the images you see. A healthy macula scans highly detailed images in the center of its vision and sends them to the optic nerve. These images are then sent to the brain and that’s how you see. Macular degeneration causes the macula to deteriorate. As a result, the images you see are not perceived correctly. Early onset macular degeneration may not affect vision, but later stages do. A person with advanced macular degeneration (AMD) is considered to be legally blind. Because of the remaining part of their retina still works, a person with AMD may still keep their side vision but this is not as clear as your central vision.
Macular degeneration is different from cataracts and glaucoma. For example, glaucoma refers to a group of optic nerve disorders that occur when there is too much fluid pressure in the eyes and it slowly builds up. This pressure causes damage to the optic nerve and may result in vision loss. Cataracts are clouded lenses that lead to blurry vision. Surgery can usually correct cataracts in most people.
There are three basic stages of macular degeneration, which are listed below. These stages are defined by the number and size of drusen in the retina. Drusen is a yellow spot that occurs underneath the retina. Although some people develop drusen as a normal part of the aging process, having medium to large sized drusen can be one of the signs of macular degeneration.
- Early AMD - this type of macular degeneration is detected by the presence of medium-sized drusen in the retina. This is approximately the width of a human hair. At this stage, a person with AMD does not usually experience vision loss.
- Intermediate AMD - this type of macular degeneration is characterized by large drusen or pigment changes in the retina. In some cases, both symptoms will occur. These changes are detected by taking an eye exam. At this stage, most people with intermediate AMD do not experience any symptoms; however, some may start to lose their vision.
- Late AMD - by this stage, vision loss is usually a common characteristic. People with late AMD tend to have a large amount of drusen. Late AMD can further be broken down into the following: geographic atrophy and neovascular AMD. These are also known as wet and dry AMD.
What Is The Difference Between Wet And Dry Macular Degeneration?
Wet macular degeneration occurs when your vision gets blurry or there is a blind spot in your central vision. It is usually caused when damaged blood vessels leak blood or fluid into the macula. As we mentioned above, this is the part of your eye responsible for central vision. Wet macular degeneration always begins as dry macular degeneration.
Wet macular degeneration symptoms include:
- A general haziness in your central vision
- Visual distortions, such as seeing bent lines when they are really straight
- Reduced or impaired central vision in one or both eyes (macular degeneration does not usually affect side vision)
- A blurry spot or blind spot in your central vision
- Decreased perception of colors (colors don’t appear as bright)
On the other hand, dry macular degeneration does not involve any leaking of fluids into the retina. As stated above, wet macular degeneration starts out as dry macular degeneration and then progresses into wet macular degeneration. According to the American Macular Degeneration Foundation, people with dry macular degeneration may still have good central vision but they have severe limitations, such as vision that fluctuates, difficulty reading, or problems driving at night. They may also notice reduced lamination.
Dry macular degeneration symptoms include:
- Problems with recognizing faces
- Blurriness of words when trying to read
- Reduced light intensity (again, colors don’t seem as bright)
- The need to brighten up your work area to see better
- Impaired or blurry central vision in one or both eyes
- A blurry or blind spot in your central vision
- Visual distortions, such as seeing bent lines on straight objects
- Difficulty adapting to areas that are dimly lit, such as restaurants
15 Early Signs and Symptoms of Macular Degeneration
Early signs of macular degeneration may be completely nonexistent. In other words, you might not experience any symptoms at all when the disease is in its early stages. This is because the disease tends to be painless and can only be detected by undergoing an eye test to check for drusen. However, in middle to later stages of the disease, you may notice that your vision is not as good as it once was. By this time, the disease may have already formed, but you can take measure to prevent it from progressing.
Here are 15 common signs and symptoms of macular degeneration:
- Slightly blurred vision
- The need for more lighting
- Difficulty reading or recognizing faces even when they are close to you
- Straight lines seem wavy or bent
- A blurry spot in your central vision but no changes in your side vision
- The presence of drusen under your retina (can only be detected during an eye test)
- The illusion that some objects are smaller than they really are
- A dark or empty area that occurs in the middle of your vision
- Seeing paler colors than normal
- Partial loss of central vision with side vision being normal
- Seeing spots or “floaters”
- Difficulty determining the color of things, even if they are placed side by side
- Worsening of visual symptoms when there is a glare
- Inability to judge distances ahead of you
- “Blacking out” of vision due to sun in your eyes or a glare
Macular Degeneration Causes and Risk Factors
Research shows that the primary causes for macular degeneration are unknown. However, some sources state that the causes can be linked to family members who also have the disease as well as environment factors, such as diet and lifestyle habits. The primary cause of macular degeneration is the deterioration of the macula; however, scientists aren’t sure what causes it. Back in the 1800’s, doctors started to look at the eyes with an ophthalmoscope, and they believed that drusen was an indication of an eye inflammation or an infection. Research shows that even today, drusen might occur as a result of an immune system reaction, especially during cases of neovascularization, which occurs when new blood vessels are formed. But doctors today know that sometimes people develop drusen and it doesn’t always mean they have macular degeneration. It could be a sign of the natural aging process.
Dietary factors seem to play a large role in the development of macular degeneration. Several studies have shown that eating a high glycemic diet is linked to AMD. High glycemic foods are carbohydrates that spike blood sugar levels easily. Eating too many of these foods is linked to other diseases as well, including metabolic disease (obesity, heart disease and type 2 diabetes). Animal studies have found that when mice are switched from a high glycemic diet to a low glycemic diet, the accumulation of harmful factors in the eye tissues stopped, were delayed or became reversed. One of the reasons why high glycemic diets are harmful is because they induce inflammation, which can stimulate the progression or onset of many diseases. On the other hand, a diet high in anti-inflammatory foods such as fruits and vegetables appears to protect the body against disease. Other lifestyle habits that may cause macular degeneration include a sedentary lifestyle, overexposure to light, and taking drugs or being exposed to toxins.
Genetics also play a role in macular degeneration. Research shows that if you have a family history of AMD, then you are more likely to get it, especially if your family member is first degree such as your parents or a sibling. Interestingly, there are at least 52 different genes linked to macular degeneration, which is promising because it means that maybe one day people will be able to determine their risk by taking a genetic test. However, being a carrier of the genes that increase your risk does not mean you will get the disease. Lifestyle habits and diet play a major role in determining whether these genes will be turned “on” or “off” over the course of your lifetime.
Here are some other risk factors that may determine your likelihood of developing macular degeneration:
- Smoking- research shows that smokers are twice as likely to develop AMD than non-smokers
- Eating a diet high in inflammatory foods, such as processed carbohydrates and refined sugar
- Race- research shows that Caucasians are more likely to develop AMD than other races such as African Americans and Latinos
- Being far-sighted
- Being female- research shows that females are more likely than males to develop the disease because they are genetically prone and tend to live longer
- Having high levels of c-reactive proteins in the body (a marker of inflammation)
- Overexposure to harmful UV rays, such as bluelight
- Certain medications
Macular Degeneration Progression Timeline
During the early stages of macular degeneration, vision is not usually affected, which makes the condition hard to detect unless you get regular eye exams. Macular degeneration begins with early stages of the disease and ends with central vision loss. The disease always starts with dry macular degeneration and then sometimes moves to wet macular degeneration. However, the timeline progression of the disease is different for everyone. There is no way to determine how long a person will move from early AMD to late AMD. Nor is it possible to tell how much time a person will spend in each stage.
Research shows that the disease tends to move slowly and can take years before vision loss occurs. It’s a good idea to have your eyes checked regularly, especially during your older years, to catch the disease before it progresses. Dry AMD tends to be more common than wet AMD. It also takes longer to advance and doesn’t cause as much vision loss as wet AMD. Although it can be hard to detect, the progress of macular degeneration can be slowed down by eating fruits and vegetables that are high in vitamins, especially vitamins A and C. Reducing inflammation in the body and quitting smoking are also helpful ways to slow down the progression of the disease.
How Is Macular Degeneration Diagnosed?
A macular degeneration test is the only way to diagnose the disease. These can be done by getting regular checks by your optometrist. Most eye exams involve the following procedures:
- Dilation: your eye doctor may perform a dilated eye exam, which occurs when he or she puts drops in your eyes to dilate or widen the pupils to provide a better view of your eye. Your doctor may use a magnifying glass to look at your retina and look for signs and symptoms of macular degeneration or other diseases.
- Visual acuity test: a visual acuity test determines how well you see from long distances.
- Optical coherence tomography: this type of test is similar to an ultrasound for your eyes, which uses sound waves to capture images of the tissues inside your eyes. However, with an optical coherence tomography, your doctor uses light waves to take high resolution pictures of your eye tissues. He or she will start by dilating your eyes and then you’ll hold still while the images are taken. This procedure is painless.
- Fluorescein angiogram: this type of test is performed by injecting fluorescent dye into your arm. Then, an ophthalmologist takes pictures of your blood vessels as the dye runs through your veins to your eyes. This allows your doctor to determine if you have any blood vessels that leak, which could lead to macular degeneration, especially the wet kind. Not everyone reacts well to this form of test, so be sure to talk to your doctor about options if this concerns you.
- Amsler grid: this test involves looking at an Amsler grid to determine if the lines in the grid appear wavy or disappear altogether, which is a sign of macular degeneration.
Your doctor may also check you for drusen during your eye exam. Keep in mind that the formation of drusen does not always mean that you have macular degeneration. This can be a part of the normal aging process. Another thing your doctor might check for is the appearance of your pigment under the retina. There are pigmented cells located in your iris, which is the colored part of your eye, but there are also some located under the retina. When these cells break down, they release their pigment and your doctor may check to see if any dark clumps are being released into your eye. Keep in mind that these pigment changes will not affect the color of your eye.
If you don’t get regular eye exams, you’ll want to pay extra close attention to your eye health. At the first sign of blurry vision, make an appointment to have your eyes checked. This can help stop the disease from progressing into full-blown vision loss. Keep in mind that there is no other way to diagnose AMD other than to take an eye test, so make sure to get screened regularly, especially if you have a family history of the condition, have had previous eye problems, or are over the age of 40.
Is Macular Degeneration Hereditary?
Research shows that macular degeneration can be heredity, especially if you have an immediate family member with the disease, such as a parent or sibling. Age and family history are the two strongest factors for getting the disease. Keep in mind that having a relative with the disease does not mean you will get it, too. However, if you have a parent with the disease, then you are 12 to 27 times more likely to get it yourself.
According to one study, there are two major chromosomes that are linked to macular degeneration, which make this disease the most genetically defined disorder. Animal studies have shown that there are several retinal degeneration-related genes that may be linked to macular degeneration. More studies need to be done on the subject to determine if a blood test can one day determine your likelihood for developing macular degeneration. The good news is that there are many things you can do to reduce your risk of the disease or prevent it from worsening if you have already been diagnosed, which is discussed in the next section.
Macular Degeneration Treatment
Currently, there is no way to treat the dry form of macular degeneration. But according to the American Academy of Ophthalmology, people with vision loss or lots of drusen may benefit from taking a certain combination of nutritional supplements, such as vitamins C and E, lutein, copper, zinc, and zeaxanthin. We’ll discuss nutritional therapy later in this article. For people with wet macular degeneration, there are certain medications available to help treat the abnormal blood vessels in your retina. These include anti-VEGF drugs.
VEGF is an acronym that stands for vascular endothelial growth factor. This type of treatment is given as an injection in the eye by using a chemical known as anti-VEGF. VEGF is normally found in the human body to help support the growth of new blood vessels. But when you have macular degeneration, VEGF is not healthy. It causes blood vessels to become weak and leak into the layer behind the retina. These blood vessels leak blood, liquids, and lipids into the retina and cause the retina to scar. It also kills macular cells, such as the photoreceptor cones and rods. An eye injection of anti-VEGF prevents new blood vessels from forming behind the retina and helps to keep the retina dry.
Eye injections for macular degeneration may need to be performed more than once, and this procedure can take some time to get used to. Although it sounds painful, the injections are usually pain free because your doctor will apply anesthesia to the eye. Each procedure takes about 15 minutes and the appointment time requires you to be there for an hour. One injection lasts for at least a month and then needs to be repeated. Research shows that people with macular degeneration who get anti-VEGF shots reduce the amount of blood vessel leakage behind their eyes, which can help slow down the progression of the disease. Major concerns of anti-VEGF injections include stroke and hemorrhaging, but keep in mind that people with cardiovascular disease are already at an increased risk of macular degeneration. So it’s hard to say if stroke and hemorrhaging are due to the shots or if they are linked to heart disease.
Currently, anti-VEGF drugs are being created to prevent VEGF from binding to certain compounds. This will help stimulate growth of VEGF in the body to prevent macular degeneration. Research shows that there are some strands of RNA called aptamers that prevent VEGF from binding to a receptor.
Here are some examples of anti-VEGF drugs available:
All of these forms of eye injections work by preventing blood vessels in the eye from leaking.
Side effects may include the following:
- Increased pressure in the eye
- Detachment of the retina
- Eye infections
- Eye pain
- Light sensitivity
- Changes in vision
- Seeing “floaters”
Some forms of wet macular degeneration can be treated with laser surgery by shining a laser on the abnormal blood vessels and preventing them from leaking. Until recently, this was the only form of treatment for wet macular degeneration. The earliest laser treatment was called Laser Photocoagulation. It was shown to help reduce the risk of visual loss in one or both eyes with patients who had Choroidal Neovascularization (CNV). This type of laser treatment was followed up by Photodynamic Therapy (PDT), which was a two-step procedure that involved injecting the patient with a dye that helped the doctor laser the affected area of the eye. The procedure helped to seal off leaky blood vessels while leaving healthy ones along. One study found that using this type of laser therapy prevented vision loss for at least one year. However, the procedure cannot restore eye sight that has already been lost.
Research shows that there are three major problems with laser treatments:
- First, only about 10 percent of lesions are small enough to quality for fluorescent angiography.
- Next, even if the laser treatment is successful, there is a 50 percent chance that the blood vessels will begin leaking again within two years.
- Finally, more than half of the patients treated with lasers will still have some sort of leakage behind the center of their fovea.
Despite these limitations, laser treatments do a good job of delaying vision loss in people with macular degeneration.
Macular Degeneration Prevention
Prevention is always the best way to treat any disease. Because macular degeneration is incurable, it’s recommended that you take precautionary measures early in life to preserve your eye health for as long as you can. Macular degeneration vitamins are available to boost your eye health by delivering key nutrients to the area. Here is a list of some of the best vitamins you can take to prevent macular degeneration.
Astaxanthin is a carotenoid pigment that occurs naturally in foods such as microalgae, salmon, trout, krill, shrimp, crayfish, and crustaceans. It has antioxidant roles in the body that help prevent chronic disease by neutralizing free radical damage and preventing inflammation. According to one study, subjects with macular degeneration who took a supplement containing 4 mg of astaxanthin improved and stabilized their visual acuity and their contract sensitivity at 12 and 24 months. Another study found that taking 4 mg of astaxanthin also improved function in the general retina when measured on an electroretinogram. Supplementing with astaxanthin has also been shown to improve VEGF levels in the body to support blood vessel health and prevent leakage that leads to wet macular degeneration.
Vitamin A is best known for giving you healthy eyes. It’s found in orange colored fruits and vegetables such as cantaloupe, carrots, winter squash, sweet potatoes, and apricots. Beta-carotene is a carotenoid that converts to vitamin A in the body. Vitamin A and beta-carotene have antioxidant roles that fight inflammation and restore tissue health, which is an important part of preventing macular degeneration. According to the Age-Related Eye Disease Study (AREDS) that was conducted by the National Eye Institute in 2001, daily doses of vitamins C and E along with beta-carotene and the minerals zinc and copper can help slow down the progression of AMD. These supplements are recommended by the American Academy of Ophthalmology to reduce the risk of AMD.
Lycopene is a bright red carotenoid pigment that is found in tomatoes, watermelon, and papayas. Like other antioxidants, lycopene helps protect you against chronic disease by neutralizing free radical damage and reducing inflammation. Research shows that higher levels of carotenoids (especially lycopene) are linked to a lower risk of AMD. Another carotenoid that is helpful for preventing AMD is zeaxanthin, which is one of two primary carotenoids found in the retina (the other is lutein). Supplementing with zeaxanthin has been shown to reduce the risk of AMD, especially when taken long-term.
Vitamin C is a well-known vitamin with antioxidant properties in the body. It helps repair damaged tissue and keeps free radicals from accumulating. You can find it in all sorts of fruits and vegetables, such as broccoli, oranges, grapes, kale, and berries. As mentioned before in the Age-Related Eye Disease study, supplementing with 500 mg of vitamin C a day along with other important antioxidants helps reduce the risk of AMD.
Alpha lipoic acid or ALA is a type of chemical that has been shown to help protect the eyes, thanks to its anti-inflammatory and antioxidant abilities. ALA is naturally made in our bodies, but you can also find it in some foods, such as yeast and liver. Research shows that supplementing with ALA helps improve vision-related quality of life in patients with dry AMD by increasing antioxidant levels in the body.
Diet and Macular Degeneration
When it comes to diet, the bottom line is that a highly inflammatory diet will only make any condition you have worse. This is because foods that contain refined sugar and processed grains contribute to inflammation, which is often considered the starting point for most diseases. Inflammatory foods also disrupt your gut microbiome and make it harder to absorb nutrients that the body needs to fight off macular degeneration, such as the ones we listed above. Adopting an anti-inflammatory lifestyle includes eating lots of fresh fruits and vegetables and eliminating all processed foods that contain refined sugar, trans fats, food dyes and coloring, and antibiotics or hormones.
When picking out meats, go for ones that are organic and raised without the use of antibiotics or hormones. Eggs should be pasture-raised as this means that the chickens have had access to roam and exposure to sunshine. Grass-fed beef tends to be higher in omega 3 fatty acids, which have anti-inflammatory effects on the body to promote overall health. Fruits and vegetables should also be organic because they contain higher nutrients compared to their conventionally raised counterparts. This means you’ll be getting more bang for your buck while increasing your resistance to diseases like macular degeneration.
Here are some foods to include in your diet:
- Organic, grass-fed beef
- Organic, antibiotic and hormone free poultry
- Organic, pasture-raised eggs
- Organic fruits and vegetables, especially pineapple, green, leafy vegetables such as kale and spinach, cruciferous vegetables such as broccoli and cabbage, and berries
- Organic nuts and seeds (including avocado)
- Spices and herbs, such as parsley, turmeric and ginger
- Healthy oils such as olive oil and coconut oil
- 100 percent whole grains, such as brown rice and oats (minimally processed)
- Probiotics or fermented foods
Avoid these foods to keep macular degeneration away:
- All refined sugars and sugar substitutes
- Processed carbohydrates, including cakes, candy, soda, and gum
- Snack foods, such as crackers, popcorn, and readymade mashed potatoes
- Bread made with enriched white flour (only bread made with 100 percent organic stone ground wheat should be allowed)
- Conventionally raised meats, including fish
- Trans fats such as vegetable oil
- Deli meat, such as bacon and lunch meat
According to one study, the Mediterranean diet was linked to a decreased risk of developing AMD. Many people find this diet easy to follow because it’s high in many tasty foods and is not restrictive. You are allowed to eat from all of the food groups with a few moderations. The Mediterranean diet is high in vegetables, seafood, whole grains, tomatoes, fruit and legumes. It is also characterized by a lower intake of red meat, processed meat, fried potatoes, refined grains, eggs and high-fat dairy products. People on the Mediterranean diet also tend to eat a lot of olive oil, which has anti-inflammatory properties that can help combat inflammation and keep your blood vessels healthy.
Keep in mind that while legumes, beans and lentils are a good source of fiber, vitamins and minerals, they are also known for being an anti-nutrient, which is a food that inhibits the absorption of nutrients in the digestive tract. This is because beans, grains and legumes contain chemicals such as saponins and phytic acid that are inflammatory in the gut. You can work around this by soaking your beans, grains, and legumes overnight and then rinsing and cooking them the next day. This allows you to retain all of the health benefits of these foods without the inflammatory effect on the body.
Acupuncture for Macular Degeneration
Acupuncture for macular degeneration might seem like a grueling thing, but many people turn to alternative practices to improve their condition because it’s natural and usually well-received by the body (unlike pharmaceutical procedures and drugs). Acupuncture treatment consists of putting needles on certain areas of the skin to pinpoint certain pressure points. According to one study, acupuncture can significantly improve the quality of life in people with dry macular degeneration. This study found that patients with AMD who took acupuncture had improvements in the following areas: distorted vision, visual acuity, visual fatigue, dry eyes, blurred vision, and central scotomas.
Another study found that acupuncture posses minimal risk if done by a professional acupuncturist and can have a significant impact on residual visual function in patients with retinitis pigmentosa or scoptic sensitivity. While acupuncture might not be your first pick for macular degeneration treatment, it’s worth looking into if you have tried everything else without success.
Macular degeneration is the leading cause of vision loss in the United States. It occurs when there is damage to the macula of your eye that results in cell death, which causes loss of your central vision. Once this area of your vision is lost, it cannot be regained. Because there is no cure for the disease, prevention is the best thing you can do to save your vision. Most pharmaceutical treatment options are only temporary and involve invasive procedures, such as eye injections or laser procedures.
In addition to adopting a healthier lifestyle, taking vitamins and antioxidant supplements is a great way to preserve your eye health. This is because inflammation plays a role in nearly every disease, and keeping your blood vessels healthy is a large part of maintaining your vision. Try supplementing with lutein, astaxanthin, vitamins A and C, lycopene, and ALA to improve your vision and prevent macular degeneration from occurring in the first place.