Signs Vs. Symptoms of Macular Degeneration

Signs of a disease are actually “findings upon an examination.”  Signs are what a doctor sees.  Symptoms are what ails the patient.  Both signs and symptoms should match up to make a diagnosis.  Sometimes there is a disconnect, that is, signs are present, but no symptoms, etc.

Signs of macular degeneration include drusen, pigment changes, serous fluid and blood;

• Drusen – either “hard” or “soft”
  • Hard Drusen – fine well defined white spots in the retina
  • Soft Drusen – larger, lacier edged white spots

• Pigment Changes – either increased or decreased pigment

• Fluid – actual clear accumulation of fluid in the retina

• Blood – er, blood

Symptoms of Macular Degeneration include;  blurry vision, distortion and scotomas (dark/blind spots in the vision).

What Does This Mean? If you have symptoms of macular degeneration, and the symptoms are persistent, then I’d recommend your eye doctor examine you.  If your doctor examines you and see “signs” of macular degeneration, then a fluorescein angiogram might be ordered to help confirm the diagnosis.  Not everyone will insist on a fluorescein angiogram.

A fluorescein angiogram will demonstrate areas of degeneration (defects in the RPE layer of the retina) and can also confirm suspicious area of neovascularization; leading to the diagnosis of “wet” macular degeneration.

Sometimes, patients have no complaints, but a doctor notices drusen in the retina.  Not all drusen are associated with macular degeneration.  Some drusen are normal for patients.  Taking into account the patient’s age, vision and lack of symptoms, it is likely that these “drusen” are normal and not associated with disease.  The fluorescein should be normal.

“Randy”

Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist
Fairfax, Virginia