MACULAR DEGENERATION

What is Wet Macular Degeneration: The retina has a barrier to separate blood vessels from critically important retinal cells that specialize in sensing light and color. If these cells are disrupted by fluid buildup they can decompensate and degenerate or die off. Hence, the word wet macular degeneration. When abnormal blood vessels break through and damage those cells the treatment involves injections the deliver medications to the retina. These medications are biological agents the blocks the growth signal for the blood vessels. 
 
These medications have different binding strengths that tell growing blood vessels to stop growing or regress. Generally, the stronger the medication binds to the blood vessels the more expensive the medication and longer its effects can last. There are different strategies to treat those blood vessels. Unfortunately, in many patients they need chronic injections that never stop. There are multiple studies that try to determine the optimal schedule for injections and there are no one standard protocol. There are multiple protocols depending on the condition, what has worked and what has failed. At some point as the blood vessels regress, there will be a taper in dosage. 
 
Prognosis depends on several factors including initial discovery of the new blood vessels before retinal cell death, scarring, continued damage from recurring growth after tapering, aggressiveness of the blood vessels and general health of the patient. A healthy diet, early detection and a special formula of vitamins can slow down progression considerably. 
 
Lenza Eye Center and Dr. Alsheikh, specialize in early detection protocols through advanced testing, counseling regarding nutrition, treatment of ocular surface to improve quality of life, constant refractions and updating of glasses prescription and statistical analysis of diagnostic imaging to determine early changes in the retina. Lenza Eye Center and Dr Alsheikh focus on minimizing the unpleasant side effects of injections. With standards above the national average for infection control and pain from the injections. Majority of patients feel very little or no pain from the injections.

What is Dry Macular Generation: The retina barrier starts to degenerate with accumulation of a substance called Drusen. The accumulation of the Drusen material overtime leads to weakening of the barrier and at the same time reduces ability for the barrier cells to support the critically important cells that function in sensing light and color. During the time of the Drusen build up, those critically important cells are functioning well, and sign remains very good to excellent. At this stage, slowing the accumulation of drusen is important is slowing the disease. Unfortunately, there are no FDA approved treatments to stop drusen deposits or reverse it. There is also some researchers evaluating whether drusen deposit CAUSE macular degeneration or are simply a SYMPTOM of macular degeneration. The reason for this debate is because retina specialist SOMETIMES have seen Drusen dissolve as the macular degeneration progresses. This is an active research field and currently these questions have not been answered. At the early disease phase, the most effective tool is monitoring the disease and improving general health, especially by changing one diet. Lenza Eye Center and Dr Alsheikh use advanced diagnostics to catch macular degeneration early and will help you monitor your retina and discuss different strategies to slow drusen deposits.

What is Dry Macular Degeneration with Geographic Atrophy: As discussed above the barrier cells have two functions; act as a barrier and support the critical cells called photoreceptors. If the barrier fails, you end up with Wet Macular Degeneration. However, if the support function fails, then those cells responsible for sensing light and color can simply atrophy and die. This leaves a atrophic region that is irreversible and that causes irreversible loss of vision. Unfortunately, there are no current FDA approved treatment to resurrect dead photoreceptor cells. Prevention of their degeneration is the best strategy. There are currently injections available to slow down the atrophy process. These medications do not reverse the disease but slow it down. 

Lenza Eye Center and Dr Alsheikh are committed to building a customized treatment plan for your eyes. This includes strategies to improve general health and early detection, treating other conditions that impact the quality of your vision. Many patients that have seen other retina specialists are told this is the best they can do. Often those specialists focus only on the retina and don’t have the individual expertise or resources to manage other aspects of their vision. They will often rely on other specialists to manage the other segments of the eye. Lenza Eye Center and Dr Alsheikh believe that there is a significant reduction in the information available to the treating doctor when multiple specialists are involved. Many patients are told that this is the best they will see and to learn to adapt to their new visual disability. While this is true most of the time, about 30% of patients that seek Dr Alsheikh see a 2-line improvement in their vision.

MACULAR DEGENERATION EXAMS AT LENZA EYE CENTER

Lenza Eye Center and Dr. Alsheikh take a holistic approach to visual disability from macular degeneration, considering not only the macula but also other parts of the eye, such as the cornea and tear film (ocular surface). Repeated refractions for glasses can lead to an average improvement of two lines in visual acuity. Dr. Alsheikh specializes in evaluating the eye as a complete optical system, tailoring treatments to improve daily functions like driving and reading. While many patients at other centers are advised to simply live with moderate visual disabilities, such as 20/60 vision (where a smaller number indicates better acuity), Dr. Alsheikh and Lenza Eye Center aim for 20/40 vision, which greatly enhances quality of life, as it meets the legal standard for nighttime driving and represents normal print size. Through his personalized approach, Dr. Alsheikh has helped many patients who previously struggled with reading or driving regain the ability to function at a higher level. In his practice, approximately 30% of patients benefit from this comprehensive care.

MACULAR DEGENERATION EXAMS AT LENZA EYE CENTER

Each macular degeneration exams involves the following:

• Check up for best corrected vision with lenses
• Dilated exam
• Detailed drawing of the retina
• High definition retinal scan
• High definition retinal photography
• Visual function questionnaire
• Comprehensive counseling about macular degeneration
• Instructions on weekly monitoring of your vision