David Austen Optometrists
45-46 Church Gate, Loughborough, Leicestershire LE11 1UE
Tel: 01509 263881

 

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Macular Degeneration and the Digital Retinal Camera

Age-related Macular Degeneration (AMD) is the most common cause of loss of sight in persons over the age of 60 years. Persons under the age of 60 can also suffer from AMD, but this is less common. In either case, it is a debilitating disease, as it causes a loss of central vision, which is the type of vision we use for reading, writing, and detailed vision work.

Below is a photo illustrating what the view of the previous practice front might look like to a person suffering from macular degeneration. The surrounding vision, the peripheral vision, is retained but the central vision, so important in recognition of faces and details within a scene, is lost. This is a distressing form of vision loss, because it can result in a tremendous visual handicap, which can lead to a loss of confidence and independence. At its worse, it can result in profound visual loss, and these patients are then registered partially-sighted. To see an animation of macular degeneration risk factors, click on the link below:

Macular Degeneration Risk Factors


The view of a person suffering from macular degeneration. Note the central area cannot be seen while the peripheral detail remains.

The digital retinal camera, while useful in photographing all eyes, healthy or otherwise, is particularly useful in monitoring the progression of macular degeneration. The retinal camera, which captures pictures of the retina and instantly produces a ‘photograph’ on a computer screen, is useful in documenting and dating degenerative changes in the retina. See also Ocular Abnormalities.

Digital photography offers many advantages to the patient. For example, the optometrist can explain to the patient a problem with the eyes by referring to the screen picture. This can be done at the time of the appointment, so the patient leaves the consulting room fully aware of the health of the eyes, and knowing the next course of action, if any is required. Also, if a hospital referral is necessary, a photograph can be included in the hospital referral letter, which identifies the problem to the hospital consultant. But even if there is no need for a referral and all looks well within the eye, a photograph documents this. This is important for all patients, especially those whose ocular health is slightly at risk, for example persons with diabetes.

We feel that the camera represents a step forward in patient care, as inter/intra- practitioner monitoring of ocular changes is improved, as well as inter-practice communication. For instance, inter/intra-practitioner monitoring no longer relies on interpretation of hand drawings but instead can be done by close examination of photographs taken at previous visits. And inter-practice communication improves as hospital referrals include a photograph with the letter, which highlights the problem seen by the optometrist. This helps the GP and the eye specialist at the hospital to immediately see why the patient has been referred.


Digital Imaging Retinal Camera

What does Macular Degeneration look like to the Optometrist?

Macular degeneration is damage to the central retinal tissue. First symptoms are a fuzziness of vision, which usually brings the patient in for a new pair of spectacles. Examination by the optometrist reveals minor degenerative changes in the macula, as small degeneration changes result in significant reduction in visual acuity, which is the ability to read down the letter chart.

There are two main types of macular degeneration: the dry type and the wet type. Dry macular degeneration is the most common type, affecting 90% of those who suffer macular degeneration. Vision loss results from retinal deposits and tissue atrophy. To see an animation of this type of macular degeneration, click on the link below:

Dry Macular Degeneration

The second type of macular degeneration is the wet type, also called exudative macular degeneration because loss of vision results from the leakage of blood and fluid. Recently there has been tremendous advances in treating this form of vision loss, namely in the form of anti VEGF medicine. This medicine is injected into the eye to reverse the formation of new tissue growth, which is the cause of leaked blood and fluid. To see an animation of this type of macular degeneration, click on the link below:

Wet Macular Degeneration

 

Wet Macular Degeneration

The patient in the photo above has wet macular degeneration and has significantly reduced visual acuity due to the leakage of blood and fluid into the retina. If left untreated, the chronic nature of this condition causes irreversible and extensive vision loss due to scarring of the macula.

 


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