08 Feb How to Diagnose Macular Degeneration
Prevent Blindness America has declared February as “Age-Related Macular Degeneration Awareness Month.” Making the diagnosis of macular degeneration is usually very straightforward and is based upon your age, your vision and the appearance of your retina.
The “Age-Related” in Macular Degeneration
Age related macular degeneration, or ARMD, certainly increases in prevalence as we get older, that is, the number individuals affected increases as we age. BUT, this does not mean we are all destined to get the disease.
Overall, I hesitate to diagnose the disease in patients less than 55 years old. Can a 50 year old have the disease? Certainly, but not a 20 year old (they must have something different).
So, there is an age requirement: age > 55.
Your Vision Must be Affected
By definition, the disease is a bilateral (affects both eyes) and causes degeneration of the macula and, thus, decreased central sight.
Remember, the macula is the center of the retina. It gives us central vision, ability to read fine print and our color vision.
When your vision is tested with the “Snellen” chart (that’s the chart that starts with the big “E” at the top), we are testing only how well your macula functions (as opposed to peripheral sight).
If you your vision is 20/20, it’s hard to say you have any loss of vision caused by a disease.
The examination of your retina is a key to diagnosing macular degeneration. There are characteristic changes in the appearance of your retina that identify certain patients with macular degeneration.
To diagnose ARMD, I look for pigmentary changes, drusen, loss of pigment, fluid, blood, etc., to make the diagnosis. Often, I perform a fluorescein angiogram to aid in the diagnosis.
What Does This Mean?
Well, in a nutshell, this means that it is usually pretty easy to diagnose patients with macular degeneration. Sometimes the diagnosis is difficult, say when the retina appears to have the disease, but the vision is normal.
I get comments all the time about patients who have drusen and wondering if they have, or will have, macular degeneration.