Category: Low Vision Tips

The two “best friends” for those with macular degeneration are magnifiers and lights. But when we think of a magnifier, we usually think of the traditional large round magnifying glass with a handle that can be used to enlarge the words of what we are reading or perhaps to see a photograph or picture more clearly. This is called “near vision.” But really we only use our near vision a small portion of the time.

Seeing things in the distance, like recognizing a friend’s face at church or enjoying the spring
time blossoms on a Yoshino cherry tree are just as important as seeing things close up.  Magnifying one’s distance vision keeps us more connected to the world around us.   So does that mean you have to carry around a pair of binoculars all the time, constantly bringing them up to your eyes and focusing them to see things a couple of feet or several yards away?

Not at all.  Thanks to the work of Dr. Henry Greene, optometrist, founder of Academy Eye Associates, and co-founder of Ocutech, Inc., distance magnifiers can be mounted on a pair of
glasses so that they can be used any time.  These glasses, also called bioptic telescopes, make it possible to enjoy activities you thought only belonged to your past.  Golfing, gardening, or enjoying a football game or a local play not only keeps you active, it keeps you connected to friends and family.  Poor central vision or the inability to see the winning football touchdown or the beautiful costumes of a musical separates people from those who can see. It can be isolating and lonely and leads to feeling disconnected from those around you.  It is not just being together that bonds family and friends, but it’s the shared enjoyment of seeing your grandchild play soccer or admiring the paintings of your favorite artist that builds relationships and special memories.

Those who have loss of central vision due to macular degeneration, diabetic retinopathy, Albinism, Stargardt’s Disease, optic atrophy, myopic degeneration, nystagmus, or macular holes can benefit from these special glasses.  Bioptic telescopes can be used for other activities as well like watching television, seeing faces, traveling, shopping, seeing blackboards in school, computer screens, board games, or playing cards.

Dr. Henry Greene explains how these glasses work, what kinds of bioptic telescopes are available, who is a candidate for them and what makes Ocutech glasses different from other brands in a recent interview:

Macular Degeneration Glasses – Bioptic Telescopes for Distance Vision

Leslie Degner, RN, BSN
www.WebRN-MacularDegeneration.com

Why are antioxidants so important in the world of macular degeneration? Whether you have been diagnosed with the early stages of this retinal disease, trying to prevent it or have advanced AMD, antioxidants play an important role in the macula  - a very tiny spot in the center of our retina that gives us that sharp, distinct detailed vision, our color vision, and our straight ahead vision.

The macular pigment (MP) is just that – yellow pigment found in the macula and especially in the area of the fovea – an even tinier spot in the center of the macula.  The fovea plays an even more important role in our color vision and detailed, sharp vision.  The two antioxidants that make up the macular pigment are lutein and zeaxanthin. Many people have heard of lutein, but are less familiar with its twin, zeaxanthin.  The fovea actually maintains a natural  ratio of 2:1 Zeaxanthin to lutein.  So to have a healthy macula it is important that both antioxidants are part of a macular degeneration diet or an eye vitamin program.

How doe these antioxidants help the macula? The MP protects the retina in two ways – one is from oxidation which is the process that causes rusting and the other is from light.   Thinning of this pigment leads to macular diseases, while thickening protects the macula. It has been found that those with higher MP density are at less risk for developing age related macular degeneration. .

“This pigment is thought to protect the retina from damage by light and excess oxidation, which over a lifetime can accumulate and contribute to the process of macular degeneration,” says Dr. Max Snodderly, Medical College of Georgia vision scientist.

The good news is that research shows that MP density can be increased through eating foods high in lutein like spinach or kale and  foods high in zeaxanthin like goji berries or orange peppers. Supplementing with vitamins for eyes that include these antioxidants also help to build the MP.

How do you know if your MP is thick enough to protect your eyes or too thin putting you at risk for macular degeneration?  If it is too thin because of genetics, smoking, diet or other causes can one increase their macular pigment density?

Find out how you can have your macular pigment measured, what the numbers mean and how to increase your MP density along with supporting research here:

Lutein and Zeaxanthin and Macular Pigment Density

Leslie Degner, RN, BSN

www.WebRN-MacularDegeneration.com

Wet macular degeneration (AMD) treatment often involves intro-ocular or eye injections using anti-VEGF medications. VEGF stands for vascular endothelial growth factor. VEGF is a protein that the body makes that promotes blood vessel growth. Another term for new blood vessel growth is angiogenesis.  Wet AMD is aptly named because the macula – a very small spot in the center of the retina – gets “wet” as a result of these new, but abnormal vessels that leak blood and fluid. The goal of wet macular degeneration treatment is to “dry up” this area in the retina that is responsible for our detailed  and straight ahead vision. Another goal of wet AMD treatment is to prevent the new growth of these abnormal and fragile vessels.

This fairly new class of drugs, called anti-VEGF medications, is given as injections directly into the eye to help shrink existing abnormal blood vessels and to prevent the growth of new leaky blood vessels. There are four different medications that are used to treat wet macular degeneration. They are Macugen, Lucentis, Avastin and the most recent one is Eylea.

Macugen

The first anti-angiogenic or anti-VEGF medication used to treat wet AMD was Macugen (pegaptanid). It was FDA approved in 2004. This eye injection was normally given every 6 weeks for up to two years.  New anti-VEGF drugs have come on the market since 2004 that have shown to be more effective, so Macugen is not used as frequently for wet AMD. However, there are several clinical trials looking at the effectiveness of Macugen in the treatment of macular edema.

Lucentis

In 2006 Lucentis (ranibizumab) was FDA approved after several clinical trials. It is manufactured by Genentech, Inc. in California.  These monthly eye injections were shown to help maintain vision at 12 months in almost 95% of the participants in the three multicentered, randomized studies.  Sixty percent of patients who received the control treatment maintained their vision in the same time frame.

Avastin

Avastin is also an anti-VEGF therapy that was originally approved for use – not in patients with wet macular degeneration – but for patients who had colon cancer. Cancer tumors also develop new blood vessels that feed the tumor and cause it to grow. Anti-VEGF treatment prevents the growth of these blood vessels causing the cancer to “starve.”  What made this medication so appealing compared to Lucentis is the dramatic difference in cost.  Avastin is molecularely very similar to Lucentis, so physicians were administering Avastin to patients with wet macular degeneration in what is called off-label use. In other words this medication is FDA approved – but FDA approved for the treatment of cancer – not macular degeneration.  As a result there are clinical trials comparing Lucentis to Avastin in the treatment of wet macular degeneration.

Eylea

Eylea is the most recent anti-VEGF therapy on the market at the time of this writing. Recently FDA approved in November of 2011, the benefit to this eye medication is that it can be given less frequently. Less visits to the eye doctor and less eye injections are very appealing to most patients.

Knowing about the different medications used for wet macular degeneration treatment helps you to be an informed patient. Learn more about these injections, how they are given, possible side effects and current studies:

Anti-VEGF Therapy for Wet Macular Degeneration Treatment

Leslie Degner, RN, BSN

www.WebRN-MacularDegeneration.com

Wet macular degeneration treatment is very different from dry macular degeneration treatment.  Even though both eye conditions cause central vision loss, how and why that vision loss occurs is because of very different processes going on in the body.  Dry macular degeneration is a slow, gradual degrading or dying of the photoreceptor cells located in the macula, the center of the retina that is responsible for our straight ahead vision.

Wet Macular Degeneration
Wet macular degeneration causes a more sudden and severe vision loss. This is the result of abnormal and fragile tiny blood vessels developing under the macula which then start leaking blood and fluid. This fluid build up causes the macula to raise up which then distorts one’s vision. That’s why straight lines – like a telephone pole look bent or wavy. The blood and fluid also damages existing photoreceptor cells – rods and cones. When there are less photoreceptor cells there is diminished vision – vision is somewhat blurred and not sharp, more light is needed, and colors are not as vibrant.

Anti-VEGF Medications
Angiogenesis is a term that you may hear from your doctor. It simply means the growth of new blood vessels.  A protein called VEGF – Vascular Endothelial Growth Factor is responsible for the body creating these harmful and abnormal blood vessels under the retina.  So the goal of wet macular degeneration treatment is to  prevent or inhibit this growth or angiogenesis.  Researchers have developed medications that help block the VEGF protein – hence the name anti-VEGF treatment.  The four names of the anti-VEGF drugs that are used to treat wet macular degeneration as eye injections are  Lucentis, Avastin, Macugen and Eyelea.

Macular Degeneration Eye Injections
These medications are given as intraocular injections or injections that are given right into your eye.  There may be some improvement in vision when the blood vessels shrink or when the fluid under the macula is absorbed. Unfortunately,  the treatment is not a one time visit to the doctor. The frequency of the injections depends on many factors such as which anti-VEGF medication the doctor uses, the amount of abnormal bleeding one has and how well one responds to it.  A person may have to see the doctor as frequently as every month.

Questions to Ask Your Retina Doctor
Ask your retina specialist these questions if you have wet macular degeneration:

1.  What medication are you giving me?
2.  What is the goal of the treatment? What kind of improvement in my vision should I expect?
3.  What are the possible short term or long term side effects?
4.  How often do I need to come in for injections?
5.  What visual changes or eye symptoms require immediate attention?

Finding a retina specialist that you feel comfortable with and that addresses your concerns and questions is an important part of your treatment decision. Learn more about wet macular degeneration treatment here:

Wet Macular Degeneration Treatment

Leslie Degner, RN, BSN
www.WebRN-MacularDegeneration.com

If you have macular degeneration or know someone with macular degeneration, you may be wondering what is a good gift to give them for Christmas.  We are wondering ourselves what to give my 85 year old father-in-law who has wet macular degeneration. You may find just the right gift for that person by rephrasing your question from “What do you want for Christmas?” to “What do you want to do?”  What I mean by this is ask the person what activity or task they struggle with because of poor vision?.

Large Number or Talking Watches

Is it telling time? Then give the gift of a large number or  a talking watch. These watches have large bold black numbers on them with a large face while the talking watches will say the time by simply pressing a button.   A wall clock with large numbers hanging on the wall is an easy way to tell time while at home. Maybe it’s the alarm clock that has become too difficult to set or to read. Again there are talking alarm clocks with easy to see large numbers.

Low Vision Games

Maybe your loved one enjoys playing cards or games. Did you know that you can get large print playing cards for $5.00?  Other favorite games that are available in large print are Sequence, Rummikub, and Scrabble. Don’t let poor vision keep you from engaging in these fun, social activities. Keeping your social live active is good for your emotional health while mentally challenging games helps to keep the mind sharp.

Large Button Phone

Perhaps seeing the numbers on the home phone or cell phone is becoming a challenge. There are many large button phones with lighted key pads for those with macular degeneration. One touch speed dialing to frequently used numbers makes a low vision phone especially easy to use. There are also large button cell phones that have a voice activation feature. Just say, “Call Linda” and the phone will automatically dial Linda’s number.

Lighted Magnifying Mirrors

It is amazing the difference there is in the bathroom mirror that hangs on the wall versus a lighted magnifying mirror.  The combination of the light and magnification makes grooming a much more pleasant experience. From styling one’s hair, to shaving or putting on make-up this vision aid for someone with macular degeneration will be much appreciated.

Of course the best gift of all is the gift of time. Offer to take your loved one or friend out shopping or to a concert. Everyone enjoys a special meal at a restaurant or a ride in the countryside. Perhaps you could offer to help with some household chore or yard work that needs to be done. Maybe a ride to the hairdresser or the dentist would appreciated. There is no better gift than the gift of friendship.

For more ideas for gifts for those with macular degeneration or other vision problems visit:

Low Vision Gifts

Better Health for Better Vision

Leslie Degner, RN, BSN
www.WebRN-MacularDegeneration.com

Often the first question a person will ask when they’ve just been diagnosed with macular degeneration, is “How fast will my macular degeneration progress?”  The doctor usually gives a vague answer which usually instills even more anxiety in the patient. However, there’s a good reason why the doctor may be evasive. It’s because every person progresses differently and in fact, each eye may progress differently.

There are so many variables with this retinal condition. The main one being what kind of macular degeneration does the person have. Dry age related macular degeneration (AMD) is the most common.  Vision changes in the dry form are slower and more insidious – it may take months or years before one notices that colors are less vivid, one’s vision has become blurry or a grey or blank spot has developed in the middle of one’s vision. The wet form – wet age related macular degeneration produces a more sudden and severe vision loss – trees or fences look crooked and reading or recognizing faces is difficult because of this dark spot that sits right in one’s central vision. This sudden loss of vision is the result of tiny, fragile, and weak blood vessels leaking fluid which drowns or destroys photoreceptor cells – the cells that give us our sight.

A person can live with the dry form for many years with gradual changes in vision, and may never develop wet AMD.  Or he/she may have one eye with the dry form and the other eye may become wet. Or both eyes may progress to wet AMD.  These vision changes may come about tomorrow or years from now. Right now it’s not all that clear as to which eyes will remain stable and which eyes will become wet.  So  now you can better understand why it is not possible for the eye doctor to predict what will happen to your eyes.

This anxiety or unpredictability can be channeled in a way that can be productive and helpful. One can assess his lifestyle and diet to see what positive changes can be made to be a healthier person. A person can become more educated about this retinal disease and learn about the latest treatments, research and studies. Others become aware of the many different vision aids that are available and feel more prepared and confident about the future.

Find out what others have experienced who have AMD.  Readers from all over the world have shared their stories of living with macular degeneration – from being diagnosed to explaining their vision changes and the ways they are coping with AMD.  You will find their stories enlightening, encouraging and  uplifting:

Stories By Those With Macular Degeneration

Leslie Degner, RN, BSN

Better Health for Better Vision
www.WebRN-MacularDegeneration.com

The Macular Degeneration Foundation reports that two hundred thousand people are diagnosed every year with macular degeneration.  Although more people are becoming familiar with this retinal condition, many people are hearing about it for the first time. Perhaps it’s your mother,  your brother,  your spouse or yourself that has developed age related macular degeneration. (continue reading…)

Many people with macular degeneration or other types of vision loss, will alternate from reading their favorite books to listening to their favorite books. Sometimes, listening is a welcome change to the strain of trying to read. Simply find yourself a comfortable spot to sit, put up your feet, close your eyes, and listen. (continue reading…)

Antioxidants play a very important role in the health of our eyes, and especially the macula. Everybody produces free radicals every day. Free radicals are unstable molecules that are missing an electron. When there are more free radicals than antioxidants, these molecules cause damage to our bodies which can lead to many degenerative diseases including age-related macular degeneration (AMD). One place that produces a large amount of free radicals is the macula – the tiny spot in the middle of the retina that is responsible for our central vision and for seeing colors and details clearly.

(continue reading…)

It is possible that your eye doctor can detect early signs of macular degeneration before you notice any vision changes.   During your next eye exam ask your eye doctor if he/she sees any drusen. Macular drusen look like little round pebbles that are made up of  yellow matter that lie beneath the retinal pigment epithelium (RPE) in the macula. They are actually made up of “trash” or waste products that have built up beneath the RPE.  This “trash” prevents the efficient transportation of nutrients to the cone cells and likewise prevents the elimination of waste products. (continue reading…)