Eye Examination for ARMD: Macular Degeneration

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Eye Examination for ARMD: Macular Degeneration

When You Need Eye Exam for Macular Degeneration.  Randall Wong, M.D., Retina specialist, Fairfax, Virginia.Routine eye examinations for macular degeneration in patients without symptoms are probably not necessary.

Unlike conditions such as diabetic retinopathy, where the disease is likely to occur  yet still be asymptomatic, macular degeneration is not “silent” and does have associated symptoms.

Once diagnosed with macular degeneration; however,  routine examinations are important.

Family History Does Not Matter

While it is true that patients of northern European descent have a greater chance of developing the eye degeneration, brothers and sisters and children of patients with the disease are not necessarily at any higher risk.

For example, if I contract the disease, my twin brother is not necessarily going to get the disease.

Vision Must “Degenerate”

The most common symptoms of macular degeneration are decreased vision (e.g. blurry vision) and/or the development of distortion.  Both signify a change in vision.

Without a change in vision, that is, if your vision remains 20/20 it is unlikely you have ARMD.

Signs vs. Symptoms of ARMD

Signs of a disease are those things we, as doctors, see or find during an examination. If you have no  signs of macular degeneration, you do not have it.

For instance, drusen and pigment changes in the retina are common signs, or findings, of dry macular degeneration.  Fluid, edema and blood are common findings of wet ARMD.

Pigment changes, fluid and blood may cause blurry and distorted vision….symptoms (subjective, what the patient experiences) of macular degeneration.

Often, patients are diagnosed with drusen.  Drusen alone, especially without loss of vision, do not make the diagnosis of macular degeneration.

Advancing Age and Macular Degeneration

The National Eye Institute has a nice review of macular degeneration.  The incidence of developing macular degeneration does increase with age.  This means the chance of getting the disease does increase with age, but not without signs and symptoms.

What Does This Mean?

In short, unlike diabetic retinopathy, a disease that may develop without symptoms,  you can safely monitor yourself for any symptoms of the ARMD, regardless of ethnicity, age or family history.

If you develop symptoms of decreased vision or if you develop decreased vision you should get an eye exam.  Often, patients are directed to test themselves with an Amsler Grid.  This is a simple way to monitor changes in your vision.

If you have signs of the disease, for example, drusen and changes in the retina, you might ask your doctor about getting examinations on a routine basis.  This will be more important in the future if/when we discover changes in our diet or behavior (i.e. quitting smoking) alter the course of developing the disease.

If you have neither symptoms nor findings, you most likely require exams periodically as directed by your doc.

 

Comments
  • cheri March 23, 2012 at 6:24 pm

    Should silicone oil be used if a patient has a silicone lens implant. I know the oil will attatch to the lens.

    • Randall V. Wong, M.D. April 4, 2012 at 7:18 am

      Dear Cheri,

      In my opinion, not an issue. The fact that the oil may attach to the lens does not impact the fact that the retina must be attached. In other words, if your retina is detached….who cares if silicone oil attaches to the implant. Worse case scenario…remove the implant later. If needed, that means your retina is attached!

      Randy

  • Michelle Kuse March 27, 2012 at 2:33 pm

    Hi Dr. I was wondering if you have any information about Ushers Syndrome – my daughter is 26 and was diagnosed when she was 19. She was born profoundly deaf and they found something “different” in her retina when she was 19 – this turned out to be a progressive retinal disease associated with deafness. Dr. Miyamoto has given her a bilateral cochlear implant – she has no night vision, no perpherial vision, and cannot see the floor when looking straight ahead. She has been in a study at NIH for the past 4 – 5 years -gathering data for Ushers. Do you have any new research, trials, studies that you could share with us? Thank yo for your time. Michelle Kuse

    • Randall V. Wong, M.D. March 30, 2012 at 8:36 am

      Dear Michelle,

      I am sorry, but I am of no help. I’ve seen Usher’s many times, but have no knowledge of any ongoing research or studies.

      All the best,

      Randy

  • Avery March 30, 2012 at 10:04 am

    Hi Dr. Wong…is it true that central serous retinopathy and macular degeneration share the same symptoms? Can central serous retinopathy lead to macular degneration?

    Thanks,
    Avery

  • Rebecca MacKenzie May 16, 2012 at 9:03 pm

    I was very suprised to read that Family History does not matter with ARMD. My mother, my grandmother and all my mother’s 3 sisters have ARMD. Also I am only 54 y.o. and was recently diagnosed with ARMD. Are you sure that family history does not matter?

    • Randall V. Wong, M.D. May 22, 2012 at 2:05 pm

      Dear Rebecca,

      In a handful of cases, macular degeneration, or something very, very similar runs in families.

      In most cases, macular degeneration does see to run in families. Keep in mind, that for now, without genetic testing, the term “macular degeneration” is probably a collection of retinal problems.

      r

  • great blog and information, i work on computers all day and notice more and more issues slowly developing with my eyes. Just out doing some research.

    thanks, Will

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