Alamo Optometry Blog

April 27, 2014

Macula

Filed under: Uncategorized — gkblog @ 1:49 pm

(As appeared in Alamo Today, February 2014)

               The macula is probably the most talked about and questioned structure in the eye.  Patients are constantly asking about the macula and macular degeneration because they either have someone in their family or a friend that is battling this disease.  I will discuss the macula, some new treatments for the disease, and what you can do to help decrease your chances of getting macular degeneration.

                The macula is located in the central part of the retina (the back surface of the eye).  As light enters the eye, it is focused directly onto the macula, which is centrally located and is 5-6 millimeters in diameter.  It is comprised of cones, which are the photoreceptors that allow sharp vision and color vision; there are no cones elsewhere in the retina.  These cells then transmit the image through ganglion cells that form the fibers of the optic nerve.  The images travel via the optic nerve to the brain.  The macula has a yellowish color which is different from the normal red color of the retina.  The retina is red from all of the blood traveling through it.  The macula has certain pigmented materials such as lutein and zeaxanthin; which are derived from diet alone as these are not made by the body.  These components are vital to the health and maintenance of the macula and they act as an ultraviolet filter for the macula and are also believed to help protect the macula from macular degeneration.

                Even though the treatments for macular degeneration are getting better, there is still no cure.  Injections into the eye of either Lucentis or Avastin have shown the ability to slow down, and in a lot of cases, halt the progression of macular degeneration.  Getting a direct injection into the eye is not necessarily fun; however the likelihood of having vision preservation far outweighs the injections.   Older treatments including laser are not current options because the side-effects are sometimes worse and the possibility of vision improvement is minimal.

                Unfortunately, as previously mentioned, there is no cure for macular degeneration.  There are no drops, pills, etc. that can prevent it.  Your likelihood for the disease does increase as you age; therefore it is very important to maintain your overall health.  It has been shown that smokers, diabetics, and those with poor diets are more likely to suffer from the disease.  That being said, there is a genetic component to the disease that cannot be altered at this point.  For the most part, if it genetically programmed, there is very little that can be done.  The things that can be done are lifestyle modification and maintaining your overall health; this includes smoking cessation, properly managing your diabetes and high blood pressure, and having a well-balanced diet.  If your intake of green vegetables, which is the main way to maintain lutein and zeaxanthin levels in the macula, then vitamin supplementation is a wise thing to do.  There have been several studies that have conclusively shown that adding these along with other minerals have slowed down the progression of macular degeneration. 

                As with most conditions of the eye, annual comprehensive eye exams are the best for early detection.  In the early stages of the disease, your vision might not be affected, but there are some macular clinical signs that are evident.  Early diagnosis and treatment is still one of the best ways to stretch out the course of the disease which will allow for good vision for a longer period of time.

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