What is the Macula and why does Macular Health matter?

The recent changes to our social habits with the COVID pandemic has meant we are spending more time than ever reading and doing more detailed near work while cooped up inside.

What you don’t realise is that all the fine details you see, is the work of an amazing part of our eyes called the macula! Without a healthy macula, you simply won’t see clearly and in detail.

May is Macula Health Awareness Month and we want to 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 centre of the retina that processes sharp, clear, central vision. In the photo, it’s the clear zone in the centre 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.

Macular Degeneration

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 centre of the macula is the fovea, which contains the highest concentration of cones. We have millions of them packed in to give us fine detail vision.

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%>80yrs 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?

  • >50yrs.
  • Smoking; you are almost three times more likely to develop AMD if you smoke.
  • Poor diet deficient in vegetables and leafy greens and high in processed food and sugars.
  • Being Overweight.
  • The risk is greater with a family history.
  • Cardiovascular disease or hypertension.
  • A history of significant exposure to UV; i.e. 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 and 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?

Several treatment options are now available that will help control AMD and prevent severe vision loss. These include injections and laser therapy. Your 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 beneficial. 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. If you detect any changes contact us immediately for an appointment by calling or booking online.

Other common Macular conditions:

  • Epiretinal membrane
  • Diabetic macula oedema
  • Macular Hole
  • Myopic Macular degeneration which can affect younger patients
  • Best Disease
  • Central Serous Maculopathy
  • Vitreo-Macular traction
  • Retinal Vein Occlusion

Most of these conditions are treatable with early detection, further reinforcing how crucial it is to have regular eye health exams, and to never delay getting your eyes checked if you notice blurred or distorted vision.

In our next post we will highlight how important diet is in protecting against macular degeneration and the technology now available to help measure this risk.

Remember to have regular comprehensive eye health exams, so book for an appointment by phone or through our online booking at a time that suits you.