Saving Vision – The Importance Of Early Care By A Retina Specialist
By Dr. Carolyn Glazer-Hockstein
Age-related Macular Degeneration (AMD) and diabetic retinopathy are the most common causes of vision loss and blindness in the United States and our goal is to save vision in these patients. In 2012 the American Society of Retina Specialists launched Retina 20/20. This is a program to raise awareness about potentially blinding eye diseases that can be prevented if caught early and treated. AMD and diabetic retinopathy are two such eye diseases that need greater recognition by our communities.
AMD
An estimated 15 million Americans have Age-Related Macular Degeneration and it is the leading cause of blindness among adults over the age of 65. The risk of developing AMD over the age of 75 is 30%. Left untreated, AMD would account for 50% of the blindness in the United States. As people age, some develop yellow deposits beneath the retina called drusen. As the drusen increase in size and number, they can interfere with the normal functioning of the retina, destroying the vision cells. This form of macular degeneration is known as dry AMD. 80% of people with AMD have dry disease. Wet macular degeneration occurs when new blood vessels grow beneath the retina. These vessels bleed and leak fluid damaging vital retinal nerve cells. While most people have dry AMD, wet AMD accounts for 80-90% of legal blindness associated with this disease.
Symptoms of Dry AMD
• Need for brighter light when reading
• Difficulty adapting to low light levels
• Increased blurriness of printed words
• Decrease in brightness of colors
• Blurred or blank spot in the center of field of vision
Symptoms of Wet AMD
• Abrupt decline in central vision
• Visual distortions (straight lines appearing wavy, objects appearing larger or smaller than they are)
• Well defined blind spot in the center of vision
Risk factors for age-related macular degeneration: age, family history of AMD, female gender, people of European descent, cigarette smoking, obesity, hypertension, excessive sun exposure, diet deficient in fruits and vegetables.
Diabetic Retinopathy
Diabetic retinopathy is a growing public health concern. If detected early in combination with good control of the underlying medical disease, most vision impairment can be prevented. Unfortunately 37% of patients who require screening for diabetic retinopathy do not get it. There is a tremendous lost opportunity at preventing vision loss in this patient population. Diabetic retinopathy occurs in more than half of the people who develop diabetes. The longer someone has diabetes or poor control of blood sugar levels increases the risk of developing diabetic retinopathy.
There are two general causes of vision loss from diabetic retinopathy: diabetic macular edema and proliferative diabetic retinopathy. Diabetic macular edema is swelling or leakage in the center of the retina (macula). Vision loss occurs when the retina tissue dies from poor blood supply and impaired delivery of oxygen through the swollen retina. Proliferative diabetic retinopathy occurs when new blood vessels grow in the eye that bleed and cause scar tissue formation. The eye can fill with blood (vitreous hemorrhage) or the scar tissue can cause a retinal detachment leading to vision loss.
It is possible to have diabetic retinopathy for a long time without noticing symptoms until substantial damage has occurred. Diabetic retinopathy typically affects both eyes.
Symptoms of Diabetic Retinopathy
• Blurred vision
• Difficulty reading
• Spots or floaters in vision
• Partial or total loss of vision
Risk factors for developing diabetic retinopathy: disease duration, poor control of blood sugar levels, high blood pressure, high cholesterol, pregnancy in someone with diabetes.
Today patients with AMD or diabetic retinopathy have more treatment options than ever before at preventing progression of the disease. But first, we have to find the patients and intervene early in the disease before there is irreversible damage done to retinal nerve cells. Regular dilated examinations and prompt referral to a retina specialist if appropriate is critical in our goal of preventing blindness. Patients need to be evaluated and identified before they have significant visual symptoms as it may be too late to restore vision in advanced disease. The key to avoiding blinding disease is early care
Dr. Carolyn Glazer-Hockstein and Dr. Paula Ko are retina specialists at Eye Physicians and Surgeons who are committed to helping patients with AMD and other retinal diseases. If you would like to learn more about AMD or to schedule an appointment call (302) 652-3353.
Dr. Glazer-Hockstein graduated Cum Laude from Jefferson Medical College. She was a member of the Hobart Armory Hare Honor Medical Society and was elected to the Alpha Omega Alpha Honor Society. She also received the Carol R. Mullen prize in ophthalmology. She completed her residency at the Scheie Eye Institute, University of Pennsylvania. During that time she was elected Chief Resident. After residency, Dr. Glazer-Hockstein completed a two years medical retina fellowship at the Scheie Eye Institute, University of Pennsylvania.
Dr. Glazer-Hockstein has published multiple articles in peer-review journals and has lectured on a variety of retinal disease subjects. Her specialization includes but is not limited to: macular degeneration, retinal vascular disease, and diabetic retinopathy.
Paula C. Ko, MD is with Eye Physicians & Surgeons, P.A., 1207 North Scott Street, Wilmington, DE 19806. Dr. Ko graduated with honors from the Ohio State University College of Engineering in 1984. Dr. Ko received her M.D. degree from the Ohio State University College of Medicine in 1989, again with honors. Following her residency in Ophthalmology at Temple, Dr. Ko served a prestigious fellowship at Georgetown University in diseases of the retina and vitreous, and is Certified by the American Board of Ophthalmology.
Dr. Ko has an area of special expertise in retinal problems, especially diabetic eye disease, macular degeneration, retinal detachment, and CMV retinitis. Dr. Ko has lectured extensively, and has published many papers on these topics. Dr. Ko is active in resident training, and is on staff at the University of MD and Temple University, as well as at the Medical Center of DE. Dr. Ko is at the forefront of ophthalmic technology, and utilizes the most advanced procedures, including laser treatment and intraocular injections, in the care of her patients.
