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Rembalance-Can an optometrist diagnose macular degeneration?

by fiona basil (2021-06-08)

The macular degeneration is a disease of the eye which is impaired an area of the retina known as the macula. The retina is the structure in charge of converting the light beams from an image into electrical impulses, which are sent as nerve signals to areas of the brain for interpretation and recognition.

The macula is located in the posterior part of the retina with an extension of approximately 5 mm in diameter, with a central area known as the fovea, which has special histological characteristics that differentiate it from other areas of the retina.

Among these characteristics of the fovea, the following stand out: its lower thickness, the presence of cones in a high number and the absence of rods, which allows a finer and more detailed view of the images.

The macular degeneration, is a degeneration of the retina in the macular area, which as mentioned corresponds to the sector of visual acuity, so the central vision, but not the peripheral deteriorates.

The macular degeneration usually affects people over fifty years old, looking greatly increased in those with smoking habits consuming more than a pack a day.

Symptoms of macular degeneration

  • Blurred central vision, even with the use of glasses for those who require it.
  • Difficulty reading and recognizing faces.
  • Requirement for more lighting.
  • Reduced night vision.
  • Greater sensitivity to glare.
  • Poor sensitivity to color.

The macular degeneration does not cause painful symptoms. In some cases, macular degeneration progresses so slowly that people are unable to determine any change in their vision, but in other individuals, the disease progresses more quickly and can cause bilateral vision loss, and they can even be declared blind. legally, despite partially preserving peripheral vision.

Causes of macular degeneration

The macular degeneration is a multifactorial disease in which are involved genetics, diet, lifestyle and environment. Therefore, when evaluating these patients, a detailed personal and family medical history should be taken.

How to diagnose macular degeneration?

Early diagnosis is obviously essential for the measures to be taken to produce the best possible results. Therefore, primary care physicians who suspect macular degeneration should refer their patients directly to an ophthalmologist.

The macular degeneration is detected by physical examination and complete eye examination may require tests such as:

  • Visual acuity, to detect central vision impairment.
  • Exam with pupillary dilation, which allows the ophthalmologist to make direct vision of the retina and the optic disc, to see if there are signs of degeneration or some other ocular alteration, such as the presence in the macular area of drusen (yellow deposits of cellular debris), changes in the retinal pigment epithelium, hemorrhage, sub or intraretinal fluid, exudates, etc.
  • Amsler grid is a simple test used by ophthalmologists to assess vision and identify this pathology. It consists of an image composed of a lattice of identical and parallel straight lines that has a point in the middle. This test consists of looking at the grid approximately 40 centimeters away and fixing the gaze on the central point, alternately covering each eye without exerting pressure. The person with macular degeneration does not see the straight lines but wavy or deformed and even some missing, and the central point is seen as a spot in the middle of the box.
  • Tonometry, through which a device allows the pressure inside the eye to be measured.
  • Imaging studies, such as angiograms or CT scans, may be required to pinpoint differential diagnoses.

The macular degeneration can progress from mild to severe, so it is advisable to seek the specialized evaluation in a timely manner, allowing guide the patient based on their particular characteristics, monitoring and prevention of risk factors that may influence the development of conditions in the macula, such as high blood pressure, diabetes, smoking, hypercholesterolemia, among others.

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