Living in the Lehigh Valley: Eye Health

Hello and welcome to Living In The Lehigh Valley, where our focus is your health and wellness.

I'm your host, Brittany Sweeney.

If you're over 50, you might want to make sure you're getting an annual or at least regular eye exam.

Our own Grover Silcox is here to tell us why.

Grover, always great to see you.

- Good to be here.

- What do you have for us?

- Well, yeah, for the 50-plus crowd...

I know it comes as a shock, I happen to be included in that group.

- No, 29 and holding.

- 20th year in a row.

But it's important for the older folks to get that annual eye exam, because one of the most serious causes of visual impairment is macular degeneration, called age-related macular degeneration or AMD.

- OK, so is this something that your general eye doctor would diagnose when you go in?

- Correct.

You probably aren't having any symptoms.

And so this would be detected by your general optometrist, ophthalmologist, eye care provider.

- OK, so then they send you to a specialist, I assume?

- Correct.

So with AMD, in its most severe stage, you will have blurriness or distortion in your center vision.

According to the National Institutes of Health, 11,000 people in the US have age- related macular degeneration.

There's really no cure for it, but early diagnosis and treatment can help slow the progression in most cases.

I spoke with a retina specialist who directs retina services for Wills Eye Hospital, a leader in eye health.

We explored the condition and what it means for those who have it.

It can come as a shock to learn you suffer from age-related macular degeneration or AMD, because there are generally no symptoms of the condition in the early stages.

- Most people would not know they have age-related macular degeneration in that dry early stage, so it's picked up on a routine examination.

So a patient would have to go to an eye care provider, a general ophthalmologist or optometrist and have their eyes examined.

That's how it's diagnosed.

- AMD typically progresses slowly, leading to blurred, wavy central vision, the need for brighter light to see and difficulty recognizing faces.

- So macular degeneration is, as the name implies, a degenerative condition of the macula.

The macula is the center of the retina.

That's where we focus our image.

It's what we need to see clearly, to see color in the center of vision.

- There are two forms of AMD, dry and wet.

- Early on, there's little to no vision impairment from the early stages of dry degeneration.

If it turns wet, of course, that's where central visual difficulties and impairment come into play.

- After the initial diagnosis of AMD, patients are instructed to take a daily vitamin supplement to impede the condition's progression.

- There is a treatment even for the early dry stage, and that's an antioxidant vitamin formulation called the AREDS 2 formula, which can reduce the risk of going from dry to wet.

So by doing that, it will decrease your chances of having severe vision loss or having that wet transformation.

- A retina specialist like Dr Carl Regillo and his team at Mid Atlantic Retina use advanced technologies to determine the severity of the patient's AMD and whether it has changed from dry to wet.

They also depend on patients to self-monitor their vision and notify them of any changes.

- Patients can do that at home by self-monitoring, using what's referred to as an Amsler grid, checking each eye independently, looking for new visual change.

In the office, the way we check, we use an imaging technology called Optical Coherence Tomography, OCT.

It's a cross-sectional image of the macula and it will show us all the features of AMD, and that includes both dry and wet.

- If patients report changes in their vision, the specialists can compare newer images with their older ones.

- We can then compare for progression compared to older images, look for conversion or changes that could indicate the new wet transformation that we're aiming to catch as early as possible, because catching wet AMD early, we get our best vision outcomes.

- So how do the specialists treat the wet, more severe form of AMD?

- If it turns wet, that's where a retina specialist gets involved, like myself, to administer the treatments, that are now very effective, again, especially if caught early.

And these are relatively new.

They're called anti VEGF drugs.

They're biologics that are injected into the eye, into the vitreous cavity.

And that helps to prevent vision loss and in many people can improve the vision when the condition is first diagnosed.

It is very well tolerated, it's very low risk and it doesn't really hurt.

Patients might feel a little pinch or pressure.

The eye is numbed up with drops and sterilized with drops.

When we start these treatments, we can say that they're so effective that over 90% of patients will not lose more vision.

The good news is that at least a third, if not more, patients will have a big increase or improvement to vision, and many patients will see at least a little better.

- According to Dr Regillo, the key is keeping on top of the treatments and not missing any, because gaps can cause problems and the condition can worsen.

- The future's really bright for treatments that either work better or last longer, particularly the latter.

And we're making a lot of progress there.

We are on the cusp of now using drugs that maybe patients need every three or even four months rather than every two months.

And that could also help us maintain the best possible vision outcomes for our patients, because having drugs that are more durable, that don't need to be administered as frequently, is easier for patients and is more forgiving.

- Laser surgery is also an option for some to slow the progression of wet AMD.

As Dr Regillo mentioned, AMD doesn't cause total blindness.

Peripheral vision remains intact and there are support technologies and education services to assist people with reading and adjusting to visual impairment from the condition.

- So, Grover, to reiterate how you began, if you're over 50, just don't miss those regularly scheduled eye exams.

- Absolutely, because there are no symptoms, generally speaking, in the beginning.

- Especially if it's in your family, you want to make sure you're following up.

- Yes, there's a big hereditary component.

I know in my own case, my mother and her sister, my aunt, both had macular degeneration.

So my siblings and I are very much on top of getting those exams.

- Sure, you're staying on top of it and making sure you're taking care of yourself.

- It's good advice.

- That's exactly it.

Thank you so much, Grover Silcox.

And that'll do it for this edition of Living In The Lehigh Valley.

I'm Brittany Sweeney, hoping you stay happy and healthy.