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Macular Degeneration

Concerned about macular degeneration?

What is the macular?
It is the area at the back of the eye that is responsible for our detailed vision. It contains millions of cells and requires a large amount of nutrients to function plus a system to break up and dispose of the waste products.

What is Macular Degeneration?
When these cells cease to function, slowly but surely we lose our detailed vision. It has a variety of causes but when associated with age it is referred to as age related macular degeneration or AMD as people often call it.

Types
Dry - most common type, gradual onset.
Wet - new vessels grow behind the retina causing bleeding and scar tissue, develops quickly and accounts for 10% of all AMD.
It usually involves both eyes but not equally, so often people will have one good eye. Using the eyes will not increase the risk of damage so if you enjoy hobbies such as reading or knitting ñ carry on.
It rarely causes total blindness but it is the greatest cause of poor sight in the over 60's.

Risk Factors
Age - Those of us over 50 are more at risk.
Sex - women are more at risk probably because they live longer!
Family History - If it is in the family there is a 50% chance of developing it as opposed to 12% if there is no family history.
Smoking - doubles your chance of developing AMD.
Sunlight - UV significantly increases the risk so wear sunglasses.
Nutrition - evidence suggests that a well balanced diet or taking supplements can help delay the progression of AMD.

Symptoms
Blurred vision, distortion, straight lines appear wavy; often patterns or shapes can be seen that are not really there. Reading becomes more difficult.

More Information
RNIB
Macular Disease Society

Children

Visual development in childhood

At birth it used to be thought that babies were virtually blind. However, science has now caught up with what most parents already knew and we are now aware that babies can perceive most large, high contrast objects and have detailed acuity (level of vision) approximately 1/10th of adult levels.

At birth the two eyes do not necessarily work together but by 3 months of age a baby should be able to fix and follow an object.

Childrens Vision
By 6 months vision is approaching 50 ñ 60% of adult levels with acuity and colour discrimination improving. If by this stage there is any doubt that the eyes are working together and looking in the same direction then professional advice should be sought. Notice should be taken of the pupils that should be of equal size, round in shape and black in colour.

The time between birth and 8 years of age is known as the critical period of visual development. During this time, visual acuity develops rapidly, reaching adult levels.

Anything that interferes with the development of either eye during the critical period can lead to amblyopia (lazy eye) - where the amblyopic eye achieves poorer acuity than the ëgoodí eye. Causes of amblyopia include a squint (eye turning inwards or outwards), congenital abnormalities such as congenital cataract, or one eye having a significantly different spectacle prescription to the other ñ in this case, the weaker eye will be amblyopic. Children with an amblyopic eye will not develop good binocular (3D) vision, since the brain needs a clear image from each eye to use both images together.

Sometimes a lazy eye is easily identified if there is a visible turn in the eye, however often if the eyes have different prescriptions there is no visible sign of this and a weaker eye can easily be missed.

If amblyopia is diagnosed early enough, it can be treated to try and make the amblyopic eye ëworkí and develop normally. This can be achieved either by prescribing spectacles or using a patch over the good eye; this is usually done under the supervision of an orthoptist. The earlier this treatment is started, the greater the chances of a successful outcome, therefore it is essential that all children have at least one eye examination before they start school to ensure that both eyes are developing normally and equally. If all is well at this examination, we usually recommend seeing children annually.

If there is a family history of squint or amblyopia, or parents have noticed a squint or suspect that vision is not developing normally, an eye examination is recommended as soon as possible.

Between the ages of 8 and the late teens, vision is still developing and it is often at this age that children can become myopic or short sighted, which means they will have trouble seeing clearly at long distances. This can cause difficulties with the whiteboard at school. During study and working life, uncorrected low spectacle prescriptions that may not have previously caused problems can lead to eyestrain and any individual experiencing headaches or ëtired eyesí is advised to have a thorough eye examination.

FREE eye examinations
Eye examinations for children are funded by the NHS

We do not need children to be able to read letters to have an eye examination ñ there are various letter and picture matching tests available that most children aged three and over can manage well and will enable us to obtain a good assessment of their vision.

We try to make the test as relaxed as possible and generally the children enjoy the experience!

EYECARE

ASK MR. ALLPORT