What is the Macula and why does Macular Health matter?

Eye health and enhancing vision of our Gold Coast and Tweed Heads patients is our core focus here at Envision Optical. This month I want to highlight that its Macula Health Awareness Month and educate you all on this critical part of our eyes and the essential role it plays in our vision. The macula is a critical part of the eye essential for clear vision and is a word many of you will be familiar with due to the publicity that Macular Degeneration receives in the media. But what is the macula?

The macula is the region in the center of the retina that processes sharp, clear, central vision. In the photo, it’s the clear zone in the center with the darker spot and no blood vessels. When you look directly at something, light is focused on the macula allowing you to see detail and colour. Experiencing all of the visual wonders we see every day is dependent on having a healthy macula.

The macula is made up of several types of cells that play a critical role in vision. Rods and cones are the photoreceptor cells that allow us to see.  Cones work more in relatively brighter light and are responsible for finer detailed vision and colour perception. Rods help us see in dimmer light, and give us our peripheral vision. The center of the macula is the fovea, which contains the highest concentration of cones.


What is macular degeneration?

Macular degeneration (AMD) is the leading cause of vision loss and blindness in Australia. It blurs the sharp, central, fine detail vision that you need for “straight-ahead” viewing. AMD affects the macula, the central area of the retina at the back of your eye that allows us to see fine details. AMD mainly affects older people: 4%>40yrs, 9%>50yrs, 23%>65yrs, 31%>80 yrs have some form of AMD.


What Causes macular degeneration?

The causes are still not fully understood, however a lifetime of exposure to UV light, poor diet, production of free radicals and reduced blood flow to the retina may result in abnormal changes in the thin pigmented layer called the retinal pigment epithelium (RPE) There are two categories of AMD:

  • DRY:    80% of AMD and results in slow changing vision loss.
  • WET:   This occurs when abnormal blood vessels under the retina grow and leak and bleed easily causing scarring and potential loss of vision. It is less common but actually the more treatable form of the


What are the Symptoms of macular degeneration?

The most common symptom is blurred vision. In the wet form an early sign is that straight lines appear wavy. If you’re over 50 and having trouble seeing clearly, you must be checked to rule out macular degeneration.


What are the risk factors for macular degeneration?

The are several risk factors for AMD including:

  • >50 yrs
  • Smoking; you are almost three times more likely to develop AMD if you smoke.
  • Being Overweight
  • The risk is greater with a family history
  • Cardiovascular disease or hypertension
  • A history of significant exposure to UV eg always worked outdoors
  • Women are at a greater risk than men.


How do we assess macular degeneration?

At Envision Optical our optometrists always perform a thorough examination of  the retina and macula during a routine comprehensive vision and eye health examination. Blurred vision will prompt careful examination as to the cause.  We utilize OCT scanning technology which is like an MRI of the back of the eye to detect fine detail changes.


What is the treatment of macular degeneration?

If the presence of WET AMD is detected you will be referred to a retinal specialist for evaluation and treatment. Several treatment options are now available that will help control AMD and prevent severe vision loss. These include injections and laser therapy. You retinal specialist will advise as to which treatment options are best for your condition.

For dry AMD, no treatment currently exists, however several preventative measures are useful. Quitting smoking and wearing sunglasses whenever outdoors, as well as dietary changes are all proven beneficial actions. Regular 6 monthly follow up visits will be most common and will require ongoing photography and OCT scans of the macula to monitor for any progression. The Amsler grid we provide to you should be used every day to monitor your central vision for any distortion. If you detect any changes contact us immediately for an appointment.

Next time I will highlight how important diet is in protecting against macular degeneration and the technology now available to help measure this risk. Remember how important it is to have regular comprehensive eye health exams, so book for an appointment by phone or through our online booking at at time that’s suits you.


Post by: Andrew Bowden, Optometrist