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Retina
Macular degeneration is the major cause of loss of vision in people over the age of 50 in
our country. It rarely causes total blindness and is often called age-related macular
degeneration (ARMD) because it is most often caused by aging. (There are some unusual types
of macular degeneration that start very early in life).
Macular degeneration usually
begins with the appearance of spots on the retina. These spots are called drusen (see the
images above). Drusen are like age spots and do not directly cause changes in vision. Most
patients with drusen never have a serious loss of vision and seldom develop severe macular
degeneration with vision loss.
Loss of vision from macular degeneration usually
begins in one eye and only later may affect the other eye. In some people, vision in the
second eye is never affected. When a person loses their central vision from macular
degeneration in one eye, the loss of vision may not even be noticed because the healthy eye
maintains detail (or central) vision. The healthy macula compensates for the loss of vision
in the affected eye. It is only when macular degeneration severely affects both eyes that it
becomes difficult, or perhaps impossible, to do the kind of work that requires detail
vision.
A person with severe macular degeneration, who has lost the ability to see
detail with each eye, rarely loses peripheral vision and is able to get along fairly well.
It is very rare for someone with macular degeneration to lose both macular (detail) and
peripheral (side) vision. Macular degeneration rarely causes total blindness. Almost all
people with severe macular degeneration in each eye can see well enough to take care of
themselves and continue activities that do not require detail vision.
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