Macular degeneration

Macular degeneration is a condition in which there is age-related deterioration of the macula. It is a leading cause of vision loss in people over 60 years of age.  The macula is the area in the centre of the retina which is responsible for central vision.  The two main types of macular degeneration are “dry macular degeneration” and “wet macular degeneration”.

See “About the Eye” for more information about eye anatomy.

Macular degeneration tends to cause problems of central vision.  People often complain of difficulty reading and distortion of central vision.  As the disease progresses it can become difficult to see faces.

This is the most common form of macular degeneration and can lead to a gradual deterioration of central vision. It is called “dry” because there is no leakage of fluid or bleeding at the macula (in contrast to “wet” – see below).  Many people with dry macular degeneration have good vision but central vision can be affected as the disease progresses. People with dry macular degeneration are at increased risk of developing wet macular degeneration.

Wet macular degeneration is the less common but often more serious form of macular degeneration. The term “wet” refers to abnormal blood vessels that grow under the retina and can leak or bleed at the macula, thereby causing vision loss.

It is important to eat a diet rich in green leafy vegetables and to avoid smoking. A vitamin supplement may be appropriate.  An Amsler grid should be used regularly.  The Amsler is a self-monitoring tool to detect changes in your vision that might represent “wet macular degeneration”.  An Amsler grid can be downloaded here.

Previously, there were no particularly effective treatments for wet macular degeneration and many people ended up with very poor central vision.  In recent years injections into the eye have been introduced (called intravitreal injections).  These injections of an anti-VEGF medicine have been shown to be highly beneficial and have transformed the treatment of wet macular degeneration. The commonly used anti-VEGF injections in Australia are Lucentis and Eylea.

An intravitreal injection is an injection of an anti-VEGF medicine into the eye.  A very small dose of either Lucentis (Ranibizumab) or Eylea (Aflibercept) is injected into the eye under sterile conditions by an eye surgeon.

The injections need to be performed regularly. The frequency depends on the patient.  Most patients start getting injections every 4 weeks and the eye surgeon will try to reduce the frequency.  Some patients may continue to need the injections every 4 weeks, whereas others may require injections much less frequently.

As with any procedure, there are some risks associated with getting an injection into the eye.  Fortunately these are rare but include infection in the eye which can lead to loss of vision. You should contact your surgeon immediately if you develop pain, reduced vision, a red eye or other concerns after an injection.