Macular Degeneration — vision problems

Why and How Macular Degeneration Affects Vision

Why and How Macular Degeneration Affects Vision 0

Why and How Macular Degeneration Affects Vision

Why and How Macular Degeneration Affects Vision

Age-Related Macular Degeneration (AMD) affects vision because the macula is part of the retina of the eye. The macula is located behind the lens on the back of the eyeball and helps images get to the optic nerve so they can be interpreted by the brain. The macula has the specific purpose of focusing fine details and enables people to read, drive, and see things like facial expressions.

So when the macula starts to break down and become dysfunctional, the central field of vision also suffers, though it leaves peripheral vision intact. This often causes confusion for those who are close to the person with macular degeneration because their eyes still look normal from the outside, so people don’t know why so much is missed by the one with AMD. At its worst form, what a person with AMD sees is almost like those scratcher cards that haven’t been scratched off yet — a blank circle covering the center area of where they look. Before that, the central vision may be distorted or partially “scratched.”

People with AMD are not blind, but they don’t have a full range of vision either. They are somewhere in between – as the former National Association for Visually Handicapped’s founding director, Dr. Lorraine Marchi, coined the phrase for AMD as being “hard of seeing.” A loved-one with AMD may not see the eyes of the person they are looking at, but they can usually see the general shape of the face. Since they know where the eyes are generally located, they can look at the eyes without seeing them.

In America, AMD — usually in the form of age-related macular degeneration— is the leading cause of vision loss for those who are over the age of 60. Studies show that exposure to UV rays, obesity, and smoking may increase the risk of AMD, and it seems to be more prevalent in Caucasians than in African-Americans. It has hereditary links and is also more common among women than men. Though there are two forms of AMD (wet and dry), 90% of those suffering from AMD have the dry, less severe form.

No cure has been found yet for AMD. With early detection, there are treatments that slow the progress of the disease, extending full vision longer. Have you been diagnosed with macular degeneration?

One Love,

Dr. Travis Zigler, Eye Love

Dr. Travis Zigler


Avastin: Reliable Vision Improvement For AMD Patients

Avastin: Reliable Vision Improvement For AMD Patients 0

Avastin: Reliable Vision Improvement For AMD Patients

The wet type of age-related macular degeneration (AMD), which occurs when the disease has progressed from the dry type, is one of the leading causes of blindness in the United States, according to the Center for Disease Control (CDC).

The drug Avastin is used to treat the wet type of macular degeneration. According to, “Avastin was developed by Genentech to treat colon cancer. It uses the same antiangiogenic approach to stop the growth of blood vessels to the cancer tumor.”

What is Avastin?

Avastin is the brand name for “bevacizumab,” a drug injected into the eye in order to slow vision loss in people who have wet AMD. Avastin is part of a class of drugs that block the growth of abnormal blood vessels, which are the cause of wet AMD. Avastin is also used to treat macular edema, swelling of the macula, which is often associated with diabetic retinopathy. Since Avastin was approved as a cancer treatment, this use of the drug is considered “off-label” use but this is permissible if a drug is demonstrated to be effective for treating other diseases.

According to the American Academy of Ophthalmology, when asked about the risks of injecting Avastin into the eyes to treat AMD, Dr. Richard Bensinger responded, “Avastin has been a terrific improvement in the treatment of wet macular edema and bleeding as well as new disease states of the eye, which seem to be introduced each day.” The list of potential side effects is long and concerning, as with any cancer treatment, but the amount used to treat the eye is very small, also reducing the risks of side effects.

What are the side effects of Avastin?

Avastin can cause infection in the eye as well as bleeding and inflammation, but these are uncommon. It can also cause the pressure in the eye to rise as well as increase the risk of cataracts but again, these occurrences are rare.

In addition to Avastin, there is another drug frequently prescribed called Lucentis (ranibizumab). It received FDA approval in late June 2006 and the new macular degeneration drug was celebrated as a major breakthrough. Many Americans with the more severe or wet forms of AMD endure gradual loss of central vision. In clinical trials Lucentis has been shown to stop and, in many cases, reverse at least some vision loss. These findings clearly indicate Lucentis is the most effective FDA-approved treatment currently available for AMD.

But some eye doctors suggest that Avastin remains just as effective and is a more realistic option for lower-income people with advanced AMD. The issue remains that Avastin is approved by the FDA only for treatment of colon and other cancers, but not for AMD. Many eye doctors have been using Avastin off-label to treat advanced AMD. Like any treatment plan, one should investigate not only the available options but the risks and side effects of each option in order to make the most informed decisions. Do you suffer from AMD? Have you undergone injections to treat it?

One Love,

Dr. Jenna Zigler 

Other Macular Degeneration articles by Dr. Zigler: Managing Macular Degeneration: Diet and LifestyleHow Fast Does Macular Degeneration Progress?Will I Go Blind From Macular Degeneration?

We would love for you to join our Macular Degeneration Support Community on Facebook.


Stages and Treatments for Age-Related Macular Degeneration

Stages and Treatments for Age-Related Macular Degeneration 0

Stages and Treatments for Age-Related Macular Degeneration

The macula is a small spot in the center of the retina at the back of the eye. It is responsible for clarifying objects, perceiving color, and distinguishing fine details. The macula controls the ability to read, drive, recognize faces, and see objects directly in front of the viewer.

When the macula becomes damaged, the vision in the center of the eye is affected rather than the periphery. Age-related Macular Degeneration (AMD) is the most common form of vision loss, more so than glaucoma and cataracts combined.

Stages and Treatments for Age-Related Macular Degeneration

Early Stage

In this first stage, vision loss is rare. During an eye exam the doctor will notice yellow deposits, called drusen, in the macula. Drusen is believed to be cholesterol deposits that cause deterioration and are damaging to the macula.  For this stage (also known as "dry AMD", which can progress to "wet AMD"), there are no FDA-approved therapies, although clinical trials are currently underway. At this point, the only treatments to slow or stop progression are diet, vitamin supplementation, and lifestyle.

Experts agree on these four recommendations:

  1. When outdoors, wear 100% UV protective sunglasses and a brimmed hat to shade the face.
  1. Walk 30 minutes a day or get other forms of consistent exercise.
  1. Eat large quantities of green leafy vegetables such as spinach, broccoli, kale, and collard greens. Also eat red, orange, and yellow fruits or vegetables, such as tomatoes, carrots, apricots, and peppers. The carotenoids that give them their color are particularly beneficial to the macula. Twice a week, eat fatty fish such as salmon, lake trout, sardines, herring, and albacore tuna.
  1.  Do NOT smoke and avoid secondhand smoke.

Over 80 percent of patients diagnosed with AMD fall into the dry category. This is the best time to take action to protect oneself against further macular damage and keep good vision as long as possible.

Intermediate Stage

At the intermediate stage, the drusen might have become larger, causing more damage and possibly some vision loss.  Even during this stage, the above recommendations will help to slow the progression. The recent AREDS2 study found that daily supplementation with certain vitamins and minerals may slow the progression of the disease when in the intermediate stage. Our Macular Health Supplement, which contains the studied AREDS2 formula, can be found on our website!

Late Stage

The later stage is known as “wet AMD” because the area has tried to grow new blood vessels to deliver oxygen and nutrients to the deteriorating macula, but there is scarring so the vessels leak blood and fluid. In this stage, several medical treatments are available and can be very effective if applied early.

The most recent treatment is the sealing off of leaking blood vessels with lasers and the administration of light-sensitive drugs. There are several choices of medications called anti-angiogenic medications which are administered via injection and are proven to prevent blood vessels from growing back.

Another course of action is a cold laser treatment called photodynamic therapy. It may be used in conjunction with anti-angiogenic medications. A hot laser method called photocoagulation therapy is rarely used anymore but was the original treatment. Injections of anti-angiogenic medications such as Avastin and Lucentis are the main method used today.

Yearly Eye Appointments

People 55 years and older are at the highest risk of AMD. Dilated eye checkups once a year are crucial in order to catch Age-Related Macular Degeneration early enough to stop its progress.

The macula is only a small area in the back of the eye, but must be taken care of with diet, exercise, and 100% UV protection so that it continues to perform its many very important functions. Do you currently have AMD or know someone who does? Which treatments have made an improvement?

One Love,

Dr. Travis Zigler

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Use the code HEALTHYEYES for $15 off your first order of our Ocular Health Formula Vitamin that has been studied to prevent the progression of macular degeneration according to the Age-Related Eye Disease 2 (AREDS-2) Study.




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