No, it never causes physical discomfort as we are unable to feel any sensation from our retina. That’s why you need someone to check your retina – macular degeneration can occur without you being aware of any visual symptoms.

The front of the eye gives us no indication of what happening at the back or vice versa. Symptoms such as bloodshot eyes, dry or itchy eyes and watery eyes have no relationship to the retina. Any disease or damage to the retina does not affect the front of the eye in any way.

Spectacles help our vision by ‘assisting’ the natural lens inside the eye to better focus the image onto our retina at the back of the eye. If the retina is damaged, as with MD, it cannot ‘take a good picture’ regardless of how strong the lens or spectacles are.

No. Other eye diseases or complaints have no impact on the incidence, severity or outcome of macular degeneration. Of course, other eye conditions may also have impact on your vision, potentially adding to or exacerbating the visual problems caused by MD. However they do not affect the actual disease process.

It is common for people with severe MD, where most central vision is gone, to experience strange visual symptoms. It is the brain trying to make sense of or “fill in the gap” caused by the damage of MD. These symptoms can be mildly irritating or quite distressing – in the case of those who experience vivid, random images of everyday objects or scenes at the most inappropriate times. Be assured you are not going crazy – it just seems like it – and images often settle down with time. Please discuss your concerns with your eye specialist.

When we use the term degeneration to describe something in the body, it means a gradual breaking down of tissues resulting in reduced function of the parts affected. We are all familiar with the medical term arthritis; it means the degeneration or wearing out of our joints. Likewise macular degeneration is a wearing out of our macula.

Age-related is the most common form of the disease, affecting those over 50 years of age. Younger people can get other special forms of macular degeneration and these are mainly inherited.

There are a number of other retinal diseases classified as dystrophies, including Stargardt’s disease and Best’s Macular Dystrophy.

These have a different disease process to macular degeneration and involve the retinal receptors, or cells, degenerating. Macular dystrophies are inherited and the majority are diagnosed before the age of 30 years.

Macular degeneration is a progressive disease. It begins in the special layer of cells known as the retinal pigment epithelium (RPE), which lies underneath the retina. Early changes can be detected by your doctor when they examine your eyes. These changes appear as drusen or pigment changes and suggest that you may go on to visual loss.

Dry MD is more common qne 9 out of 10 patients with MD have the dry type. Dry MD varies in severity and rate of progression – so not all patients with dry MD will experience severe vision loss. In this condition there is slow degeneration and loss of the photoreceptors (cones) at the macula which leads to reduced vision. The progression of dry MD can be slowed by quitting smoking, dietary changes, or vitamin supplements.

Any patient with dry MD, even mild disease, can suddenly ‘convert’ to wet MD. It occurs in about 1 in 10 patients with dry MD. The mild damage occurring in dry MD can promote a healing response that causes new blood vessels to grow under the retina. Unfortunately, these abnormal blood vessels don’t help, and instead they leak and bleed causing swelling of the macula, hence the name ‘wet’ MD.

The change to wet MD occurs suddenly and the damage to vision occurs much more quickly – without treatment most people with wet MD will lose all central vision over the course of a year. However, early treatment with injections of anti-VEGF medication into the eye blocks the healing response and reduces swelling and bleeding of the macula, This is very effective at improving or stabilising vision.

The progression of macular degeneration is different in each person. Some people have only the dry form for decades and never develop the wet form. However, if you have the dry form, even if very mild, you are at risk of developing wet MD. This is why it is so important to use the Amsler Grid regularly to check for any changes that might indicate a change from dry to wet MD.

There is clearly a genetic component and your risk of MD is higher if there are other family members who have it. Much of MD research is focused on identifying the genes involved and figuring out why some people get it and others don’t. It appears some genes predispose to developing MD, whilst others can be protective, and your unique combination of these genes gives the overall risk of developing MD. Unfortunately, we don’t yet have all the answers to this question yet.

Factors other than family history/genetics also contribute to the development of MD. You may have developed it because of age or lifestyle factors such as diet, smoking, high blood pressure or exposure to ultraviolet light. Smoking is the biggest modifiable risk factor. Smokers are 3 times more likely to develop MD and tend to develop MD 10 years earlier than non-smokers.

For more information and support visit the Macular Degeneration New Zealand website at https://www.mdnz.org.nz/

Macular Degeneration New Zealand has a variety of information sheets on MD you can download or you can order them to be delivered for free – follow this link https://www.mdnz.org.nz/services-1-1