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Macular Degeneration

Normal Vision

Vision with Macular Degeneration

Macular degeneration is the number-one cause of blindness in the United States. It occurs when the macula - a part of the retina in the back of the eye that ensures that our vision is clear and sharp - degrades or "degenerates," causing a progressive loss of vision.

The "dry" form of macular degeneration has no treatment, but the "wet" form may be helped by laser procedures if it is detected early. Because of this, and because vision lost to the disease is irrecoverable, regular eye exams are highly recommended. Certain vitamins and minerals may also aid in slowing or preventing vision loss.

Symptoms often associated with macular degeneration include:

A gradual loss of ability to see objects clearly
A gradual loss of color vision
Distorted vision
A dark or empty area appearing in the center of vision

Treatments for macular degeneration include Avastin and Lucentis injections, PDT/Visudyne laser therapy, laser photocoagulation, and intravitreal implants.

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Macular Hole

Macular Hole | Manhattan | New York City A macular hole is exactly what it sounds like: a hole in the macula, the center of the retina responsible for central and reading vision. Specifically, the hole or defect occurs in the fovea, the center of the macula and the most delicate part of the entire retina.

Macular holes almost always develop during the natural aging process, when the vitreous (the gel that fills most of the eye) thins and separates from the macula. This can pull on the macula and cause a hole to form. Less commonly, macular holes are caused by eye injury, intraocular inflammation, retinal detachment and other diseases. Most cases occur in people over the age of 50.

At first, a macular hole may only cause a small blurry or distorted area in the center of vision. As the hole grows over several weeks or months, central vision progressively worsens. Peripheral vision is not affected, and there is no risk of blindness.

Surgery is over 95% effective for the treatment of macular holes. The procedure is outpatient with local anesthesia. A vitrectomy is performed to remove the vitreous gel, and then a gas bubble is injected into the eye to help the hole close. As the eye heals, the fluid is naturally replaced. There is no non-surgical alternative.

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Macular Pucker

Macular Pucker | Manhattan | New York City An epiretinal membrane, also called a macular pucker, is a thin layer of tissue that forms over the macula, the area of the retina that gives us clear central and reading vision.

Epiretinal membranes often develop on their own as a part of the natural aging process. Particles that have drifted into the vitreous (the gel that fills the eye) settle onto the macula and begin to obscure vision. Membranes may also result from eye conditions or diseases such as retinal detachment, inflammation, injury or vascular conditions. These are called secondary epiretinal membranes, whereas spontaneously formed membranes are called idiopathic.

Many epiretinal membranes do not disrupt vision. Thicker membranes, however, can create wrinkles or puckers in the macula, and small blurry or distorted areas in the center of vision may appear. Vision loss increases as the membrane thickens. Peripheral vision is not affected, and there is no risk of blindness.

Some epiretinal membranes heal on their own. For those that do not, surgery is recommended. The procedure is outpatient with local anesthesia. A vitrectomy is performed to remove the vitreous gel, a saline solution fills the eye and then the membrane is lifted from the macula. There is no non-surgical alternative.

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