Top 5 eyesight threats: 2 of 5


In this series, Mary Browne FAOI continues to let us know about  the top five threats to your eyesight. The blog is a bit longer than our unusual ones as we “deep dive” into these top five threats  to your eyesight.  Today we look at Macular degeneration. Macular degeneration can have a devastating impact on your independence.  One of my colleagues died a few years ago, and then his widow developed macular degeneration. Her independence was completely gone and her social life changed dramatically. By our nature we are more optimistic than realistic. We over estimate how long we will live, how much money we will earn etc. However with a few sensible precautions, we can help our optimism become more realistic and live that quality of live we desire.

Again the principle messages are :

1. Have a regular eye examination, particularly when you hit 40 years of age.

2. Find and stick with an optician that you are going to have a relationship with over a long period of time.

3. Eat well, exercise, don’t smoke and avoid excessive UV sunlight.

Mary Browne is our resident optometrist of many years experience at our Rathmines practice.  Mary explains what’s happens in a non technical manner as much as possible.



  • The macula is the part of the eye that is responsible for central vision.  It allows you to see fine detail for things such as reading, driving and recognising faces
  • As you get older, this part of the eye can degenerate, causing a loss of central vision.
  • It usually starts in one eye first, but often the second eye will also be affected over time.
  • The peripheral vision remains unaffected, so macular degeneration doesn’t cause total blindness.


 Types of Macular Degeneration

  • Dry
    • This is the most common form.
    • Slow, progressive loss of central vision
    • No known treatment, apart from nutritional supplements to help slow progression (see below)


  • Wet
    • Sudden loss of central vision
    • Due to leaking of blood vessels in the macular area
    • Will notice distortions of straight lines (see Amsler Grid photo below)
    • Can be treated, but must act quickly.  Helpful treatments include laser and injections.



 Ways of detecting macular degeneration

Amsler Grid

  • This is a grid used to check for distortions in central vision.


  • If you use glasses for reading, wear them for this test.


  • The grid should be viewed in good light.


  • Check each eye separately (cover the other eye).


  • Stare at the central dot on the grid.
    • Do any of the lines seem wavy, distorted, missing or blurry?
    • Are any of the boxes different in size or shape?


  • Any distortions on the grid could be an indication of problems at the macula, and should be checked urgently with your optometrist (wet macular degeneration can be treated, but must be treated quickly).



Normal Amsler Grid



Distorted Amsler grid in wet macular degeneration



Risk Factors

  • Smoking:

Smokers are up to five times more likely to develop the condition.  This is thought to be because smoking reduces the oxygen supply to the retina


  • Age:

One in three people over 75 develop the disease


  • Prolonged sun exposure:

UV light can damage the retina


  • High blood pressure reduces the oxygen supply to the retina
  • Presence of the condition in one eye

means the other eye is more likely to be affected.


  • Poor diet


  • Lack of exercise

Means that blood flow won’t be as good



  • Studies have shown that what you eat can help slow the progression of macular degeneration
  • Helpful foods include:
    • Dark green leafy vegetables such as spinach and kale
    • Brightly coloured fruit and vegetables such as peppers, oranges and red grapes
    • Oily fish three times per week
    • Supplements specifically for macular health are also available, such as ‘Macushield’ and ‘Lutein Omega 3’
    • Eat less saturated fat