Macular Degeneration

Age-related macular degeneration affects individuals aged 50 and older. It is the leading cause of blindness in the United States in patients over 65. As our population ages, we can expect the incidence of macular degeneration to increase. Fortunately, this is another disease in ophthalmologyin which there have been excellent advancements in treatment.

There is often debate as to whether or not cataract removal will help patients suffering from macular degeneration. There are several important issues to consider. Light exposure is considered a risk factor for the development and progression of macular degeneration; therefore, removing a cataract, which allows more light to enter the eye, theoretically could put you at greater risk of macular degeneration onset or progression. However, the intraocular lenses that are utilized today have specialized UV protection. It is generally considered safe to remove your cataract and replace it with an IOL. That being said, it is still important to wear a hat and glasses with UV protection if you are in a situation that exposes you to UV light. This will decrease the amount of ultraviolet light that reaches the skin around your eye and the tissue on the surface of your eye, both of which can develop cancers associated with UV light exposure.

In addition, a clear view to the retina is important to determine the appropriate care for your macular degeneration. So, if your cataract is limiting your eye doctor’s view to the retina, cataract surgery may be recommended to improve visualization of the retina in order to make appropriate treatment recommendations for the macular degeneration.

There is also debate as to whether or not removing a cataract will actually improve vision in patients with macular degeneration. This is best determined on an individual, case-by-case basis. There is now excellent evidence to suggest that removing cataracts does, in fact, improve subjective vision, and also the performance of activities of daily living in patients with macular degeneration, even if it does not specifically improve the best-corrected visual acuity determined by the line one reads on the eye chart. Removal of the cataract may improve color perception, peripheral vision and possibly depth perception, even if it does not allow you to read smaller letters. All of these elements contribute to overall visual performance. Therefore, improving one or more of these may improve a patient’s ability to function.

Lastly, improving and maximizing visual function in patients who have visual compromise from diseases other than cataracts is important for fall prevention. Visual performance improvements may make important differences for these patients, thereby decreasing their risk of falls and resultant fractures.

© Vision Information Services, LLC, Mooresville, NC 2012