Science & Research

Age-related macular degeneration has no known association with trauma. However, trauma can cause injury to the macula and may result in problems such as a macular hole. Usually this is due to blunt trauma to the eyeball itself (such as being hit in the eye with a baseball or fist).

Without examining your father, it is difficult to determine the exact cause of the decreased vision in his left eye. Decreased vision after cataract surgery can result from a variety of causes including corneal edema, corneal epitheliopathy, cystoid macular edema, inflammation in the eye, etc. Age-related macular degeneration is one possible cause and may limit visual acuity after cataract surgery. If he has dry age-related macular degeneration, there is no proven therapy to improve vision in that eye. If he has wet age-related macular degeneration causing bleeding or thickening in the macula, his retina specialist may suggest injecting an anti-VEGF medication (Lucentis or Avastin) into the left eye. These medications have the potential to improve vision in patients with wet AMD.

Zinc has been proven to be one of the most important components of the AREDS vitamins, which decrease the rate of progression from dry AMD to wet AMD by about 25% over 6 years. Although zinc in high doses may cause problems, it is generally recommended to continue supplementation at the AREDS* dose (80mg of zinc oxide daily) if you have dry AMD with high risk characteristics. The current AREDS2 study includes an assessment of whether or not a reduced dosage of zinc is as effective as the current AREDS dose is in reducing the risk of progression to wet AMD. The results of this study are still pending, but your physician should be able to keep you updated on this information and provide you with treatment recommendations based on your specific medical history.

*AREDS is the acronym for the Age-Related Eye Disease Study

The main concern with stopping the Lucentis injections is that if abnormal blood vessels continue to grow, they could cause bleeding, fluid leakage, and result in decreased vision. While Lucentis has been shown to improve vision in patients with wet macular degeneration, the ultimate goal in most patients is to preserve and stabilize the current level of vision. Some patients respond so well to Lucentis after a few injections that their eyes remain stable after stopping injections. Other patients have recurrent leakage (active choroidal neovascularization) after stopping, and need maintenance injections at steady intervals. It is important to realize that not all patients respond the same and therefore should not be treated the same. Your husband's ophthalmologist would have the best understanding of his individual case, and would be able to make the best recommendation as to whether or not to continue with injections.

1IU of beta carotene = 0.6 micrograms of beta carotene. Using this conversion, 15 milligrams of beta carotene = 25,000 IU of beta carotene.

It sounds like your physician is recommending anti-VEGF injections to keep your wet macular degeneration from worsening. Anti-VEGF medication helps abnormal blood vessels in wet age-related macular degeneration regress, and decreases the chance of bleeding or leakage that can further reduce your vision. These injections do not "cure" wet age-related macular degeneration, but they are one of the most effective treatments for the disease that we have available today. It is not uncommon to have both types of the disease, one in each eye. Dry age-related macular degeneration is the first stage of the disease, and sometimes will progress to the wet form. Although you are relatively young to have this eye disease, it does occur and is not extremely rare.

There is a phenomenon known as Charles Bonnet syndrome, in which people with severe visual loss can have complex, highly detailed visual hallucinations. It occurs in people with macular degeneration, advanced cataracts, glaucoma, and other optic neuropathies. The theory is that the brain is attempting to compensate for the loss of visual stimuli by creating these hallucinations. It is important to reassure your grandfather that people who experience these hallucinations are mentally healthy and do not have a psychiatric disease. Sometimes the hallucinations will spontaneously resolve within a year or two. There is no known treatment for Charles Bonnet syndrome.

Vitamin A in high doses can be toxic to the liver. Vitamin A has only been proven to have benefit for typical retinitis pigmentosa (a condition not related to age-related macular degeneration). Due to its potential toxic effects in high doses, vitamin A supplementation for macular degeneration is not recommended.