7 April: Q&A with Mr Bataung Mokete

My 70 year old husband has been referred to see an eye specialist as our doctor suspects he may be starting with macular degeneration. He is terrified this will mean he will go blind. I am trying to reassure him but I am scared too. If he is diagnosed with macular degeneration, what are the treatment options?

Mr Bataung Mokete, Consultant Ophthalmic Surgeon:

Age-related macular degeneration is caused by wear and tear at the back of the eyes. It occurs with age and can be classified into early, intermediate and advanced forms.  It is important to determine the type of macular degeneration your husband has as only a small proportion of people have the advanced forms of ‘wet’ or ‘dry’ types of macular degeneration that can cause severe visual loss.

‘Wet’ advanced macular degeneration is characterised by sudden onset distortion of lines and blurring of vision in the affected eye. This requires urgent treatment and anti-VEGF (e.g. Lucentis) injections are an option and can be effective in controlling the condition and result in improvement in vision in a significant number of patients. Other treatment options include laser and there are ongoing trials of newer forms of treatment.

‘Dry’ advanced macular degeneration (geographic atrophy or tissue loss) is more common and has no medical treatment but even in this situation, useful peripheral vision is normally retained.  Magnifiers and lenses including implantable telescope systems such as the IOL-VIP lens may help enhance the remaining vision. A large number of supportive measures exist to help sufferers and their families and carers (contact your local Social Services department to request an assessment or RNIB helpline for information 0303 123 9999).

In patients with severe visual loss in one eye, a recent study (AREDS) showed a reduction in the relative risk to the other eye in patients taking a preparation of high dose anti-oxidant vitamins.  Smoking is the most consistent risk factor for advanced degeneration. Smokers or recent smokers should not take supplements containing beta-carotene because of an increased risk of lung cancer.

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