Retina & Macula

The macula is a small part of the retina responsible for your central vision. Tasks such as threading a needle, reading small print, reading street signs and seeing fine detail all rely on a healthy macula.

Many older people develop age-related macular degeneration (AMD) as part of natural ageing — often without realising it until a vision problem appears or it’s found during an eye exam. There are two types: dry and wet. Wet (exudative/neovascular) AMD causes more severe vision loss; the earlier it is diagnosed and treated, the better the chance of preserving central vision.

• Dark areas or distortion in the central vision; if unchecked it can cause permanent central vision loss — but it never causes total blindness.
• It usually begins in one eye and may affect the other later.
• An eye examination identifies the risk and distinguishes dry from wet AMD.

Yes. After an eye examination, you’ll be taught how to use a simple test to self-monitor early macular degeneration at home.

Some eyes are predisposed, but these guidelines help prevent or slow AMD:

• Don’t smoke.
• Eat plenty of dark, leafy green vegetables such as spinach, plus fruit and nuts daily.
• Consider a multivitamin/multimineral supplement and fish or fish-oil.
• Exercise regularly and maintain a healthy weight.
• Keep blood pressure and cholesterol under control.
• Wear appropriate sunglasses outdoors to block UV and blue light.
• Have regular eye exams with an ophthalmologist.

Some eyes have weak areas in the retina that can cause it to pull away from the back of the eye — a retinal detachment. A detached retina does not function normally, and vision becomes blurry.

Retinal detachment can only be treated with re-attachment surgery; untreated, it can cause irreversible blindness. It is diagnosed during an eye examination after full pupil dilation (sometimes with an ultrasound of the eye). Warning symptoms include seeing red dots, flashes of light, or a curtain-like shadow falling across the vision. Periodic dilated eye exams prevent it in most eyes.

In many cases, yes. Regular eye exams reveal early changes, and treating weak retinal areas helps prevent detachment. Use appropriate eye protection during risky activities — sports goggles with polycarbonate lenses, and protective eyewear when using machines, chemicals or tools, or while gardening. These special glasses are injury-resistant, unlike fragile ordinary plastic lenses.

Consistently high blood sugar, or long-standing diabetes, starts to damage the eye — a condition called diabetic retinopathy that usually affects both eyes. Early on there are often no noticeable changes, but as it progresses it usually causes irreversible vision loss. Sharing your recent blood-sugar control history is important.

Yes. An eye examination is the only way to detect diabetic retinopathy, and periodic comprehensive exams monitor its progression. On examination, visual acuity is measured, the front of the eye is examined on the slit-lamp, and the dilated retina, macula and optic nerve are checked for damage — after which drops, laser or further tests may be advised.

The American Academy of Ophthalmology recommends:

• Type 1 diabetes: within five years of diagnosis, then yearly.
• Type 2 diabetes: at the time of diagnosis, then yearly.
• During pregnancy: pregnant women with diabetes should see their ophthalmologist in the first trimester, as retinopathy can progress quickly.