Charles D. Fritch MD,
FACS, is a renowned
ophthalmologist, founder
of Fritch Eye Care Medical
Center, and Medical
Director of a fully equipped
Ambulatory Center.

Fritch Eye Care Medical Center
8501 Brimhall Road, Suite 401 & 402
Bakersfield, CA 93312
Tel: 661-665-2020


Macular Degeneration

The Most Common Cause Of Irreversible Loss of Central vision For Senior Citizens

The macula is located in the center of the retina, the micro-thin membrane that lines three-fourths of the back inside of the eye. The retina is imbedded with millions of light-sensitive nerve cells that capture images focused on the retina by the cornea and the inner lens of the eye. The captured images are transmitted to the brain by the optic nerve, and thus the miracle of sight is created.

The retina performs two types of vision functions: Central and Peripheral. Central vision is required for highly-focused, straight-on requirements, such as reading, driving a car, operating a computer or engaging in face-to-face conversation. All central vision originates in the macula, although it is only about one-fourth of an inch in diameter. The rest of the retina's nerve cells handle peripheral requirements.

Any damage to the macula will result in some loss or even total loss of the individual's powers of central vision. Since peripheral vision is not affected, people with macular degeneration can adapt to the loss of central vision. By imaginative use of their remaining peripheral vision, they can pursue many normal daily activities that do not require sharp central vision abilities. In order to focus on a particular object, the person must turn his head at the angle required to bring the peripheral light-sensitive cells into play and thereby create the best possible image under the circumstances.

While there are some rare forms of macular degeneration that occur early in life, most cases begin to develop in later life, generally after age 50. For this reason, the disease is often reffered to as age-related macular degeneration or ARMD. There are two types of macular degeneration: The Dry Form and The Wet Form.

The Dry Form

This form affects approximately 90% of those who have macular degeneration. It is simply a case of deterioration of the macula. The process is gradual and for a period of time - months or years - it may affect only one eye. What happens in this situation is that the "good" eye often takes over the central vision functions of the "bad" eye. Thus, the victim is not usually aware of the loss of central vision powers in the affected eye unless there are certain noticeable symptoms. The person may perceive that it is more difficult to see with one eye than the other. Some straight line types of objects, such as a telephone, door frame or side of a building may appear to be distorted. It is also possible that small, dark spots may appear in the field of vision. As with all eye problems, regular examinations are the best method for early detection and prompt treatment in order to assure the best possible chances of preserving vision.

The dry form of macular degeneration is more prevalent, but comparatively less serious. At this time there are few effective medical treatments. There are some low-vision aids and devices available. The best treatment is learning to use the remaining peripheral vision capabilities. We provide ARMD patients with the most up-to-date vision aids and the most current information available on the types of treatment for this serious eye disorder.

The Wet Form

As noted, only about 10% of all victims of age-related macular degeneration are diagnosed as having the wet form of the disease, yet it accounts for approximately 90% of the most serious loss of vision cases. Since the dry form is simply a matter of the macula wearing out with age, the loss of central vision tends to happen gradually over the years. The wet form occurs when tiny blood vessels in the retinal pigment epithelium (RPE), the micro-thin layer of tissue that lies beneath the retina and provides it with nourishment, begin to degenerate with age causing tiny leaks. This can cause the development of swellings, breaks or lesions in the retina, thereby creating damage to the retina's light-sensitive nerve cells. If any of this damage occurs within the macula, serious and rapid deterioration of the person's central vision capabilities can result.

Several types of lasers have been used with varying degrees of success in treating the wet form of ARMD, but usually the best result is a slowing down of the deterioration process. The function of the laser is to cauterize the leaking blood vessels and/or "tack" the detached retina back into place. The objective is to prevent further development of the problem and hold off invasion of the macula for as long as possible. However, if the problem is already within the macula area, use of the laser can possibly cause more damage to the macula than the damage being created by the leaky blood vessels. There is an effective procedure known as a fluorescein angiogram that allows the eye doctor to determine if there is any hemorrhaging which may be occurring in the retina. Both the angiogram and laser procedure are virtually painless.

Home Test For Early Detection Of Macular Degeneration

While there is no substitute for regular examinations by your eye doctor, there is available a simple home test for early detection of macular degeneration. This home test, called the Amsler Grid, was developed a number of years ago by a Swiss eye doctor. It is especially useful if macular degeneration has already been detected in one eye with the other eye being normal. The odds are that sooner or later the "good" eye will also become affected and early detection increases chances for treatment that will help preserve central vision capabilities.

When you come in for your eye examination, we will happy to provide you with more information on the use of the Amsler Grid Chart as home test for macular degeneration.

Other Serious Eye Problems Which Early Detection Through Regular Examinations Can Result in More Effective Treatment:

  • Glaucoma
  • Cataracts
  • Presbyopia
  • Dry Eye
  • Diabetic Retinopathy
  • Retinal Tears and Detachment
  • Flashes, Floaters and Vitreous Detachment
  • Refractive Vision Problems

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The physicians of Fritch Eye Care Center specialize in treating Bakersfield LASIK, glaucoma, and cataracts patients. Using cutting-edge technology in their state-of-the-art medical facilities, these Drs. are considered to be specialists in their field.

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