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Macular
degeneration. Symptoms
- Blurred vision:
Those with nonexudative macular degeneration may by asymptomatic or
notice a gradual loss of central vision, whereas those with exudative
macular degeneration often notice a rapid onset of vision loss
- Central scotomas
(shadows or missing areas of vision)
- Distorted vision
(i.e. metamorphopsia) - A grid of straight lines appears wavy and parts
of the grid may appear blank
- Trouble discerning
colors; specifically dark ones from dark ones and light ones from light
ones
- Slow recovery of
visual function after exposure to bright light
The Amsler Grid Test is one of the simplest and most effective methods
for patients to monitor the health of the macula. The Amsler Grid is
essentially a pattern of intersecting lines (identical to graph paper)
with a black dot in the middle. The central black dot is used for fixation
(a place for the eye to stare at). With normal vision, all lines surrounding
the black dot will look straight and evenly spaced with no missing or
odd looking areas when fixating on the grid's central black dot. When
there is disease affecting the macula, as in macular degeneration, the
lines can look bent, distorted and/or missing
The traditional
Amsler grid test is a black and white pattern that may miss early defects.
Since treatment and vision preservation in macular degeneration is facilitated
by early detection of the disease, a more sensitive blue-on-yellow Amsler
grid test pattern has recently been introduced (IXMUS Home Test).
'Vision loss'
or 'blindness' in macular degeneration refers to the loss of 'central
vision' only. The peripheral vision is preserved. Blindness in macular
degeneration does not mean 'inability to see light' and even with far
advanced macular degeneration, the peripheral retina allows for useful
vision.
The loss of
central vision profoundly affects visual functioning. It is not possible,
for example, to read without central vision. Pictures which attempt to
depict the central visual loss of macular degeneration with a black spot
do not really do justice to the devasting nature of the visual loss. This
can be demonstrated by printing letters 6 inches high on a piece of paper
and attempting to identify them while looking straight ahead and holding
the paper slightly to the side. Most people find this surprisingly difficult
to do.
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