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"TWO LAST THINGS"

TWO LAST THINGS….that is, two final points to cover in our recent discussions of Age-Related Macular Degeneration  The first is, “What are the symptoms of Macular Degeneration” or “how can I tell if I’m developing Macular Degeneration?” and the second is, “What can I do about it if I am developing Macular Degeneration?”

Unfortunately, in early Macular Degeneration, there may literally be no symptoms or signs that one is developing the disease.  Early symptoms may be as innocent as the fact that one might notice the need for more light when reading small print.  Many patients may delude themselves into thinking that this need for more light when reading is just a natural consequence of ‘getting older’ and may tend to ignore the fact.

And then, others may complain of ‘small black spots’ that present themselves at times and become particularly more annoying when one is trying to read.  And, too, often the disease will develop in one eye and may not affect the other eye for many years.  None of these symptoms are to be taken lightly or merely attributed to the aging process but should immediately be brought to the attention of a qualified professional eye physician.

Recently, I have seen an increased number of patients complaining of what they usually describe as :Flashes”  These ‘flashes may occur at any time and usually take place to the side of one’s vision and may involve either side alone or both sides together.  They may be more commonly noticed when entering a darkened room or when shutting a light off.  They may also be associated with a passing alteration to one’s vision often described as a “shimmering light” or “shooting stars” or a “spinning space ship like kind of vision.”  The fact that these ‘attacks’ are occurring is frequently not brought to the attention of the eye doctor.  The eye doctor often discovers them when he asks if one is experiencing any ‘flashes’ of light.  Although many patients tend to ignore them, they are very serious and should always be investigated.  They are called AMAUROSIS FUGAX and can often be the earliest sign of impending stroke, heart attack or Macular Degeneration.

There is usually one basic root cause for the attacks of Amaurosis Fugax.  That is, the decrease of blood flow through the artery that feeds blood to the back of the eye.  This tissue in the back of the eye is called the “Retina.”  ANYTHING that reduces the flow of blood through the small Central Artery of the Retina will result in an attack of Amaurosis.  This can be as simple as poor circulation, hardening of the arteries, high blood pressure or as serious as plaque formation in any artery especially the Carotid Artery or even plaque formation in the heart itself.  These plaques can ‘break away’ and travel through the body until they reach the very small arteries of the retina where they will become stopped up and result in the loss of circulation to the retina.  I will want to explore this subject in more detail later……….stay tuned!

John Colombo, M.D.

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