The Problem
Age related macular degeneration, as its name implies is a disease that is more frequent as we increase in age.
There are certain risk factors which cannot be helped such as: age, genetics, fair skin, and being more common in females.
However, there are some risk factors of Age Related Macular Degeneration that can be reduced by: a diet high in green and yellow vegetables, not smoking, controlling blood pressure and wearing sun glasses or a hat on bright sunny days. AREDS antioxidant vitamins can reduce the risk of progression in individuals that have signs of macular degeneration. AREDS stands for the Age Related Eye Disease Study. These vitamins have not been proven to prevent Age Related Macular Degeneration in people with no signs of this disease. There are two types of Age Related Macular Degeneration; these are classified as dry and wet.
1. Dry Age Related Macular Degeneration
The information described above about reducing the risk factors of ARMD are important for individuals with this disease. This disease occurs due to waste products called “drusen” building up under the retina. Atrophy, or death of the tissue, can also occur in late stages. There is no treatment for Dry Age Related Macular Degeneration; however, steps can be taken to reduce the risk of progression as described above.
2. Wet Age Related Macular Degeneration
This condition occurs when the blood vessels under the retina grow up into the retina and leak into or under the retina. This leakage leads to scaring if left untreated. With treatment, vision can be maintained 90% of the time. In up to 40% of patients, the vision can improve with treatment.
The Procedure
Treatment consists of injections in the eye of medications that decrease and prevent leakage. Although this sounds horrible, the procedure typically feels like a pin prick. These Anti-Vascular Endothelial Growth Factor (Anti-VEGF) agents are our best treatments and have largely replaced laser treatment for this condition. With treatment, vision can be maintained 90% of the time. In up to 40% of patients, the vision can improve with treatment.
Risks?
The main risk is 1 in 5,000 of bleeding, infection, or retinal detachment. The eye can feel itchy or scratchy on the day of the injection; this usually improves by the following day. The eye is frozen, so most people do not feel the treatment. After the treatment, Dr. Adatia suggests using preservative free artificial tears every 15 minutes for 2 hours. The reason for this is that, as the eye is frozen, we do not blink normally, and the eye can get dry and painful from decreased blinking. Using the drops help prevent that and often people will remain comfortable even on the day of treatment.
If there is persistent pain and decreased vision that does not improve on the following day, Dr. Adatia would like to see you back right away. Often this is just from a scratch or an abrasion on the cornea or front of the eye. However, infection would need to be ruled out. If pain and decreased vision persists and does not improve the next day, please call in to see Dr. Adatia. If it is an evening or a weekend, patients are advised to go to the Rockyview Emergency Department in Calgary.
Otherwise, the white of the eye can be red if there is a small bruise around the injection site. Like a bruise, this typically changes color and goes away on its own over the next few weeks.
At the time of the injection, you may notice floating material; that is the medication and it should disperse over hours.
In general, this is a very safe and common procedure.