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Macular Degeneration
What is macular degeneration?
 To a person with the problem, it
is difficulty in seeing fine details clearly. They may have good side
vision, and still not be able to read a clock.
To a doctor, it is a problem
associate with the central part of the retina called the macula. This
area is responsible for the detailed vision, and several different
"degenerations" can happen to us with advancing age.
What causes macular
degeneration?
Age is the culprit, but why one
person gets it and another doesn't is still uncertain. There are two
types:
So-called "dry" macular
degeneration is caused by a thinning of the tissue of the macula. 90%
of the cases are of this type. The onset is gradual, and may go
unnoticed for years.
10% are "wet" macular
degeneration, where the blood vessels in the macula grow out of
control and leak a substance that clings and hardens on the surface of
the retina. Usually, this type is sudden and severe.
How do you know if you have
it?
If words are blurry, or tasks
like sewing or reading are hard, take this simple test. Using an
enlarged version of the grid below, cover one eye and stare at the
center while holding it 10-15 inches from your face. If any part of
the is blurry or the lines are distorted, further evaluation by a
doctor or ophthalmologist may be useful.
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Normal |
Problem |
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 |
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(Click on the grid above
for a larger
version that you
can print out and use at home.) |
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You may have symptoms in one eye
and not the other, or you may have symptoms in both. As the disease
progresses, both eyes are usually affected.
What are the
alternatives for treatment?
Until recently, options for
macular degeneration were extremely limited. For some patients with
"dry" macular degeneration, nutritional supplements have been
effective in slowing the progression of the disease. For patients with
"wet" macular degeneration, laser surgery is an option. In this
outpatient procedure, a high-energy light is used to seal the blood
vessels that are leaking. Although a small, permanent blind spot is
left at the point of laser contact, the procedure can preserve more
sight overall.
Microstimulation is an
alternative therapy that is receiving more attention. Patients and
practitioners who have received good results are enthusiastic about
it. Many traditional health professionals and health insurance
companies are waiting for more scientific studies to verify the
results.
What's microstimulation?
For many years bio-electric
stimulation has been used in Western medicine in the treatment of
problems with muscles, joints, tendons, and bones. The technology is
used extensively by professional sports teams and physical therapists
to speed recovery and reduce internal scarring.
Microstimulation is a form of
bio-electric stimulation that has been modified for use around
sensitive eye tissue. It is being used by doctors and licensed
acupuncturists as an aid in treating macular degeneration.
It is not a cure, and must be
continued on a regular basis.
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What evidence shows it works?
Clinical results from several
clinics indicate positive response in many of the patients being
treated. Although some scientific studies indicate reasons for
optimism, scientific literature is still well short of the extensive
double-blind and randomized studies that will provide the kind of
proof that will make insurance companies add microstimulation to their
lists of approved treatments. Microstimulation is only one component
of treatment, and should be administered by a doctor experienced in
all aspects of visual health. Not every patient with macular
degeneration responds to treatment.
Patients who have undergone
treatment and been helped believe that the results speak for
themselves.
Use of microstimulation under the
supervision of a doctor is legal, and the device itself is approved by
the FDA for the treatment of pain, although it has not been certified
to be effective in reversing the effects of macular degeneration.
What is the treatment like?
 The MicroStim™ is the size
of a portable tape recorder and connects to a pair of eyeglass frames
to hold the stimulators in place over the eyes. The patients eyes are
closed throughout the treatment. Over a 5-minute period, minute
electric impulses stimulate the area, and the instrument shuts itself
off. When adjusted for maximum effect, there is no sensation or pain
in the treatment.
The treatment is repeated daily
for six months, and continuously after that on a reduced schedule. For
convenience and reduced cost, patients typically purchase their own
device for home use.
Where can I get additional
information or evaluation?
Dr. Evelyn Brust at Westside
Family Clinic in Bend, Oregon is in a position to help you evaluate
your options. If indicated, she can prescribe the appropriate
nutritional supplements and a regimen of visual care that may include
the use of a MicroStim and/or additional evaluation and treatment by
an ophthalmologist.
Every patient is different, and
treatments are individual.
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