Many people have vision problems as they age. Whether one experiences a need for new glasses or laser surgery to remove cataracts, most people are prepared for vision changes. Few people, however, are ever ready to receive a diagnosis of central vision loss.

What Is Macular Degeneration?
Macular degeneration is a catchall term for a group of diseases characterized by a breakdown of the macula. The macula is the very central part of the retina and is responsible for the sharp, direct vision needed to read or drive. There are many diseases and conditions that may affect this part of the eye: age-related wet or dry macular degeneration, angioid streaks, choroideremia, central serous retinopathy, Coat's disease, cystoid macular or myopic macular degeneration.

Macular degeneration can produce either a slow or sudden loss of vision depending on what type of disease the diagnosis is. Because these diseases are often completely painless, they frequently go unnoticed in their early stages. An eye care practitioner can detect early signs of central eye disease before symptoms appear, which is why it is so important to have regular checkups. If straight lines look wavy, your vision seems fuzzy or there are shadowy areas in your central vision, you may be experiencing early signs of a macular disease.

What Causes Macular Degeneration?
"Age-related macular degeneration is an age-related process," says Dr. Jason Slakter, clinical professor of ophthalmology for the NYU School of Medicine in New York City.

Although most macular degeneration diseases are age-related, the exact causes are still unknown. Factors that place you at a higher risk for these diseases include smoking, high blood pressure, farsightedness and obesity.

"One important modifiable risk factor is cigarette smoking," says Dr. Slakter. "By eliminating cigarette smoking, an individual can reduce their risk of progression of the disease significantly."

Consumption of omega-6 fatty acids, such as those found in vegetable oils, have been associated with a higher risk of macular disease. Conversely, omega-3 fatty acids have been found to have a protective effect against advanced macular degeneration.

Treatments for Macular Degeneration
Macular degenerative diseases remain difficult to treat even with advances in technology. Laser therapy, drug therapy, surgery and vitamin therapy are a few of the options from which patients can choose.

Dr. Allen Josephs, chief of neurology at St. Barnabas Hospital in Livingston, N.J., says that some promising studies have been done concerning vitamins and other nutrients. "There are some nutritional therapies that show great promise, not only for stabilizing the condition, but also reversing the condition," says Dr. Josephs.

The Age-Related Eye Disease Study from the National Eye Institute is the first large clinical trial to test the effect of high-dose antioxidant vitamins in preventing or delaying the progression of macular degeneration. According to the study, scientists found that people at high risk of developing advanced stages of age-related macular degeneration (AMD), a leading cause of vision loss, lowered their risk by about 25 percent when treated with a high-dose combination of vitamin C, vitamin E, beta-carotene and zinc.

Living With Macular Degeneration
Elizabeth Chapman from Rochester, Minn., was diagnosed with age-related wet macular degeneration (a specific type of macular degeneration) at age 75. Now, at 78, she has learned not only to live with the disease, but also to help others who are going through the same overwhelming shock she went through upon diagnosis.

"All of a sudden I could hardly see out of one eye," says Chapman. "I was sent to a retinal specialist who diagnosed me. My regular ophthalmologist was surprised, as he had seen me recently and had detected nothing."

Chapman had some complications and underwent several surgical procedures. Her friends were very supportive, but something was missing. "They did the best they could," says Chapman. "But I really needed to find people who had gone through the same thing. I found that support online, and now I can give that support to others who are living through it as well."

Dan Roberts knows just how she feels. After being diagnosed with central serous chorioretinopathy at age 58, he retired from a 23-year career as a public school teacher to help others find much needed information and support. In 1995, he founded Macular Degeneration Support Inc., which is a nonprofit public service organization offering assistance to people affected by macular degeneration and related retinal diseases.

"In some cases, a support system can make the difference between choosing to live or to die," says Roberts. "Vision is about 80 percent of our total sensory input. Losing it can be very traumatic, but fear of the unknown future is even more traumatic."

Roberts says the first three questions a newly diagnosed patient asks are: Why am I losing my vision? Are there any treatments or cures? How can I learn to live successfully with vision loss? These are the three questions that a good support system will answer, says Roberts.

"I have personally seen the turnaround time from diagnosis to adaptation diminished from months to weeks in people who have found this kind of help," says Roberts. "Just knowing that someone understands and cares is the first important step, because macular degeneration can be an invisible disease that is difficult to comprehend by sighted family members and friends."

Roberts believes it is much easier to find support now than it was 12 years ago. When he began searching for help, there was almost nothing on the Internet for patients with macular degenerative diseases. Then he came across a small e-mail group of about 30 people who were all trying to help each other and he thought it would be a good idea to put everything they learned on a Web site for others to read as well.

"Today, more than 350 people subscribe to our group, the Web site has grown to 400-plus pages and Macular Degeneration Support has become one of the leading support organizations in the world," says Roberts.

Macular degenerative diseases don't have to mean the end of the world. Between support networks and all the new research being done, people diagnosed with macular degeneration have hope of new treatments and a world of support and opportunity waiting for them.

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