What is the Macula?
The macula is located roughly in the center of the retina, temporal to the optic nerve. It is a small and highly sensitive part of the retina responsible for detailed central vision. The fovea is the very center of the macula.The macula allows us to appreciate detail and perform tasks that require central vision such reading.
Common Macular Conditions
Macular Degeneration (Age-Related Macular Degeneration-AMD) is the breakdown or damage of the macular, the area of the eye that allows you to see fine details clearly and perform activities such as reading and driving. AMD usually does not affect side or peripheral vision. There are two forms of AMD:
- “Dry” macular degeneration involves degeneration of the pigment cells under the macular, these cells are vital to the retina so when the cells are lost the overlying retina stops functioning and blind spots may occur. Sometimes abnormal substances called drusen can accumulate under the macular in the dry form of macular degeneration and can cause distortion and blind spots.
- “Wet” macular degeneration has abnormal blood vessel growth under the macular which can cause swelling and/or bleeding. The vision loss with the wet form of macular degeneration is usually more rapid and severe than the dry form.
- Symptoms: Words on a page look blurred, a dark or empty area appears in the center of vision or straight lines look distorted
- Acuity test to measure the accuracy of your central vision at specific distances
- Amsler Grid test checks for blind spots, loss of sight and distortion
- Color Testing determines the status of your cone cells which are the cells located in the macular and are the retinal cells that interpret color
- Fluorescein Angiogram test identifies new blood vessel growth and leakage from blood vessels
- Treatment options:
- A Thermal laser was the first treatment used to treat wet macular degeneration and is still occasionally used today. Photodynamic Therapy (PDT) uses a low intensity laser to stimulate a light sensitive drug that is injected intravenously to cause shrinking of abnormal blood vessels of the macular.
- Anti-VEGF Injections are the newest treatment involving a series of injections of a small quantity of drugs into the eye. These drugs block chemicals that allow the abnormal blood vessels to grow. Treatment for wet macular degeneration can involve combining these types of treatments and the treatments may take several months to complete.
Macular Pucker is when wrinkles, creases or bulges form in the macular.
- Symptoms: blurred central vision, distorted or “wavy” vision, difficulty reading or performing tasks that require detail vision, gray and/or cloudy area in the central vision.
- Causes: as the vitreous begins to pull away from the retina, scar tissue may develop on the macular. The scar tissue may warp and contract, causing the retina to wrinkle or bulge.
- Treatment: for mild symptoms, no treatment may be necessary but if there is significant vision loss, vitrectomy surgery is recommended to remove scar tissue.
Macular Hole occurs when the shrinking vitreous gel adheres to the macular. This causes the macular tissue to stretch and after several weeks or months the macular tears forming a hole.
- Symptoms: in the early stages, your central vision becomes blurred and distorted. As the hole progresses, a blind spot develops in your central vision and impairs the ability to see at both distant and close ranges.
- Treatment: vitrectomy surgery is the most effective treatment to repair a macular hole and possibly improve vision. Surgery causes the macular hole to close, allowing the eye to slowly regain part of the lost sight.