What is Macular Degeneration?

Macular degeneration is a retinal disease which can lead to legal blindness. More specifically, it affects the macula, the portion of the retina important for detailed vision like reading.

There are two forms of macular degeneration: wet and dry. Dry macular degeneration is usually slower in destruction of the macula, causing gradual to little loss of central vision. The wet form is more aggressive and destroys the central vision faster. The wet form is associated with the presence of abnormal blood vessels growing somewhere within the layers of the retina. These abnormal blood vessels can leak and bleed.

ARMD wet before treatment

Dry macular degeneration causes a slower loss of tissue. While there is treatment for the wet form, there is no approved treatment for the dry form.

Drusen (800x533)

Symptoms of Macular Degeneration include blurry central vision and/or distortion. In some cases, there may be blind spots within the central vision. The vision loss in both types is progressive. It is the rate at which vision loss develops which differentiates the wet form from the dry. Remember, wet macular degeneration causes faster and more devastating loss of vision compared to the dry form.

Treatment for Macular Degeneration

There is no treatment for dry macular degeneration. While AREDS (Age-Related Eye Disease Study) vitamins may be indicated for a small subset of macular degeneration patients, it does not improve the condition or vision. The supplements are primarily preventative. There are different formulations of “eye vitamins,” but the contents of the supplement used for the study were 500 milligrams of vitamin C; 400 International Units of vitamin E; 15 milligrams of beta-carotene (often labeled as equivalent to 25,000 International Units of vitamin A); 80 milligrams of zinc as zinc oxide; and two milligrams of copper as cupric oxide. Copper was added to the AREDS formulations containing zinc to prevent copper deficiency anemia, a condition associated with high levels of zinc intake.

Other preventative measures for both types of macular degeneration include not smoking, regular exercise and a healthy diet.

The mainstay of treatment for wet macular degeneration involves injections into the eye with anti-VEGF (Vascular Endothelial Growth Factor) medications.

These medications (Lucentis, Avastin, Eylea) attach to the abnormal blood vessels, preventing additional leakage and bleeding. Often there can be improvement in vision.

Early treatment is key to maintaining vision. Regular dilated eye examinations are advised.

What is an Epiretinal Membrane

An Epiretinal Membrane (ERM) is also known as Cellophane Maculopathy or Macular Pucker. Sometimes it is simply referred to as a “wrinkle.” In most cases, a Posterior Vitreous Detachment (PVD) has occurred. This vitreous activity causes the macula to generate cells and create a scar-like membrane. This thin tissue layer can contract and cause a wrinkle.


In the above picture of the inside of an eye, the whitish irregularities on the left side is the membrane. The photo below shows a normal macula, note the the smooth and regular color on the left side. The dark spot to the left in each photo is the macula.

The macula provides sharp, central vision and allows us to see details. Any change in the surface, like a wrinkle, will cause distortion and blur. ERM usually occurs in one eye only. The initial onset of the blur and distortion can be very alarming, but most people get used to it depending on the extent. Sometimes it resolves on its own, but mostly it stays the same. If you are noticing this type of vision change it is very important to have an examination for a correct diagnosis. Blur and distortion can be symptoms of other conditions, such as a macular hole.

In cases where the vision is significantly impaired a surgical procedure can be done. A vitrectomy is performed to remove the vitreous, then very delicately the surgeon peels the membrane off of the macula. This often reduces distortion and improves the vision, but not completely. Retinal surgery is not without risks, the most common risk is the development of cataracts, but any damage to the macula during the procedure can cause permanent visual impairment.

ERM is not the same as Macular Degeneration.