Do you have macular degeneration? Find out the symptoms and causes of macular conditions
21 January 2021
What is the macula?
The macula is a part of the retina, which is at the back of your eye. It is responsible for your central vision, as well as your colour and detailed vision. The rest of the retina is responsible for your peripheral vision. The macula is very small – about 5mm – but it’s absolutely crucial that it functions properly in order for you to have good eyesight. The macula is where your photoreceptor cells are, meaning you can detect between light and dark, and it is these cells that send signals to your brain for you to process images.
How common is macular degeneration?
A huge number of people in the UK suffer with macular disease. If left untreated, it can often lead to loss of vision, and it most commonly affects people aged over 55. Over 1.5 million people in the UK have some form of macular disease, with age-related macular degeneration (AMD) affecting over 600,000 people. AMD is the single biggest cause of sight loss in this country. On a global scale, the number rises to 196 million (8.7% of the global population) and, by 2040, it’s thought that 288 million people will be affected.
The figures are expected to increase dramatically as a result of a number of risk factors which are also on the rise. These include smoking, alcohol consumption, and obesity. It’s a growing problem, with 5% of global blindness occurring as a result of AMD. As the “age-related” part of the name suggests, AMD tends to affect people aged 50 and older, with 1 in 200 people aged over 60 suffering with it. This rises to 1 in 5 for 90 year olds clearly illustrating that AMD is a natural part of the ageing process.
AMD can either be 'wet' or 'dry'. The Macular Society notes the differences between the two conditions as:
- Dry age-related macular degeneration
Dry age-related macular degeneration (AMD) is a slow deterioration of the cells of the macula.
- Wet age-related macular degeneration
Wet age-related macular degeneration (AMD) develops when abnormal blood vessels grow into the macula which leads to rapid loss of central vision.
What about other macular conditions?
There are other conditions which can cause issues with your macula, some of which are rare inherited conditions. The Macular Society has identified some of them and provides great resources for people who may be suffering macular dystrophies or degeneration. Other macular conditions can include:
When people experience changes in their retina and there are areas of abnormalities, it can be known as early AMD and, if left untreated, may lead to other forms of AMD. In the early stages of AMD, you might not even notice any changes to your vision, which is why it’s important to have your eyes checked regularly by your optician.
Retinal vein occlusion (RVO)
This is a condition whereby the retinal vein becomes blocked. Symptoms include a sudden, painless loss of vision and it usually occurs in people over the age of 60.
Diabetic macular oedema
People with diabetes can experience issues with the blood vessels in their eyes, causing fluid to build up and damage the macula. This can, in turn, cause loss of central vision.
A macular hole can develop in the retinal layer and typically affects around 3 in 1,000 people. Being aged over 55 increases your risk of developing a macular hole.
Myopic macular degeneration
Myopic macular degeneration is a type of macular degeneration that occurs in people with large myopic prescriptions (i.e. severely short-sighted).
This is a genetic condition which causes macular dystrophy in young people, due to a small alteration on one gene, and causes loss of central vision. Typically, peripheral vision is unaffected.
Mutations in the BEST1 gene can cause any one of five macular conditions, usually occurring during the first two decades of a person’s life. If a young person is suffering with a macular condition, it is likely to be caused by the BEST1 gene.
This is a condition whereby the cells in the cone of the eye stop working, affecting a person’s central vision and colour vision.
Doyne honeycomb dystrophy
This is a dystrophy which causes loss of vision from a person’s late teens, and occurs as a result of a mutation on a single gene. It looks like small white spots in your vision, which can then come together to create a honeycomb pattern.
Sorsby fundus dystrophy
The symptoms of AMD are very similar to the symptoms which come with Sorsby fundus dystrophy, although it affects people in their 20s and 30s, as opposed to 50+. If you're in this age group and are experiencing issues with your central vision, this may be why.
Bull’s eye maculopathy
Several different macular conditions cause a ring shaped pattern to appear around a darker damaged area on the macula, resembling a bull’s eye.
Pseudoxanthoma elasticum (PXE)
PXE is a genetic disease which affects elastic fibres in tissues all over the body. If it affects a person’s eyes, it can cause loss of vision.
Central serous retinopathy
This is a condition in which the macular separates from the eye tissue behind it, allowing fluid to build up in the space.
Punctate inner choroidopathy
Risk factors for this condition include being female and short-sighted. PIC is caused by inflammation at the back of the eye, leading to a loss of vision.
Charles Bonnet Syndrome
Almost 50% of people with some form of macular degeneration experience visual hallucinations, even after sight loss.
The Macular Society provides further resources and information on these conditions, as well as support for anyone dealing with macular degeneration and dystrophies.
Good macular health is crucial and if you notice any changes to your vision (especially as your central vision is essential for performing even the most basic of day-to-day tasks), you should see your optician as soon as possible. Eating a healthy diet, exercising often, and avoiding alcohol and smoking where possible, goes a long way to keeping your macula healthy.
Check out some of our previous blog posts for more information:
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