Bebe Corts knew something was happening to her eyesight when she had to keep moving closer to the monitor during regular Bingo outings with a girlfriend.

Three years ago, she consulted an ophthalmologist near her hometown of Alpena, and he told her there was nothing that could be done to improve her vision. “I just figured he couldn’t improve on my lenses,” she said.

Corts, who lives in Texas and was recently back in the Northern Michigan area staying with relatives in Cheboygan, was diagnosed with macular degeneration. After the initial disappointment with the first doctor, she consulted with Dr. Joseph Doe IV, now an ophthalmologist at Bear River Eye Associates in Petoskey, who had a different message: New hope is available, via injectible medications.

Since receiving the injections, she has been regaining vision she thought would be permanently lost. “I think he’s just the greatest,” said Corts, 84. “I don’t even feel the needle going in. It feels a little like sand in your eyes, which must be the medicine.”

She began receiving the injections in November 2007 and continues regularly between her Texas doctor and Dr. Doe while up north. The regular therapy has allowed her to continue watching her favorite movies. “I’m getting better and better,” she said.

And so are medical advancements in treating macular degeneration, according to Doe.
 

Seeing is believing

Doe said he is the only trained ophthalmologist north of Traverse City who treats macular degeneration. The disease typically begins setting in after the age of 55, and involves the part of the eye called the “macula” that is responsible for central vision.

Macular degeneration can cause patients to completely lose central vision, where they may be looking at a person and not be able to see their face, yet they remain able to see around the periphery.

“They lose the ability to read a lot of the time and the ability to recognize other people. That’s a real hardship for them,” Doe said. “It brings a great deal of depression, and patients feel like they have to depend on other people.”

Many patients may not realize they are affected by the disease, because both eyes work in tandem to see the center of the person’s world. If the right eye isn’t working, the left eye is still seeing. “People can go a long time losing one eye and not knowing it,” Doe added.

Early detection and treatment is a key to restoring some vision.

Currently, the best available treatment — injections — treats the least number of people affected with macular degeneration, those with so-called “wet” degeneration. Of all those with the disease, about 10 percent have the wet type, which occurs when a new blood vessel forms in the eye and leaks blood, fluid or proteins that cause severe drop in vision.

(There currently is not a comparable treatment for the more common dry disease. Vitamin therapy, particularly with omega-3 fatty acids and flaxseed oil, has been shown to improve vision and prevent dry macular degeneration from becoming wet.)

Replacing, for the most part, the laser treatments of the past, injectible advancement with Avastin and Lucentis over the last couple of years has brought big changes for those with the wet type, Doe said.

One-third of patients reported seeing better than before with treatment, and up to 95 percent of reported at least some type of gain, the doctor said.

About 33 percent of patients were able to see three additional lines on the eye chart as well.

“It’s an excellent treatment and it works,” Doe said. “I’ve seen people go from being legally blind to seeing 20/30.”
 

‘Sounds worse than it is’

Getting the medication into the eye requires an injection into it; there’s no easier way to phrase it. “It sounds so much worse than it is,” said Doe. “The biggest problem is the anticipation of the first shot.”

(Corts said she felt no pain during the injection.)

Doe injects about 0.05 ccs of medicine about 3 1/2 millimeters behind the cornea. The eye is numbed first and sterilized with an iodine solution.

Most patients will need repeated treatments, approximately every couple of months, to continue seeing results. Improvements in vision can be expected within a few weeks, Doe noted.

It’s not just the patient’s vision that’s improved through the procedure, Doe added, but their outlook, too.

“I think what’s important to note is that there is hope for people with macular degeneration,” he said. “A lot of times, people become isolated, depressed, and there’s actually a very well-documented study correlating visual acuity, how well you see, and mortality rates.

“It’s important to let people know that there’s hope and new treatments, and in the future there will be some new treatments for dry macular degeneration as well.”

More Info:

Wet and dry: Two types

“Wet” macular degeneration occurs when abnormal blood vessels behind the retina start to grow under the macula. These new blood vessels tend to be very fragile and often leak blood and fluid. The blood and fluid raise the macula from its normal place at the back of the eye. Damage to the macula occurs rapidly.

Loss of central vision can occur quickly.

An early symptom is that straight lines appear wavy.

“Dry” macular degeneration occurs when the light-sensitive cells in the macula slowly break down, gradually blurring central vision in the affected eye.

As it worsens, you may see a blurred spot in the center of your vision. Over time, as less of the macula functions, central vision is gradually lost in the affected eye.

The most common symptom is slightly blurred vision. You may have difficulty recognizing faces. You may need more light for reading and other tasks.

It generally affects both eyes, but vision can be lost in one eye while the other eye seems unaffected.

Source: National Eye Institute of the National Institutes for Health

Check your vision at home

The Amsler Grid is a tool that can be used by people at home to see if they are starting to develop macular degeneration. The grid lines will begin to look crooked and warped to those with the disease.
The grid is easy to find online. Go to www.google.com, type in Amsler Grid, and three samples appear at the top of the page. Click on a grid to enlarge it. Another site to try, www.allaboutvision.com/conditions/amsler-grid.htm.

Vision loss support

Macular degeneration is the leading cause of blindness for those aged 55 and older in the U.S., affecting more than 10 million Americans.
A local low-vision support group meets at the Friendship Center in Petoskey, 347-3211.

Risk factors

Age: Over age 60; the risk is nearly 30 percent in those over 75. Annual exams are recommended for those over 55.
Smoking
Obesity
Race: Whites of northern European descent are more likely to lose vision than African Americans. Light-colored eyes also play a role.
Hereditary: involving immediate family members. Children with parents who have macular degeneration should begin testing in their early 50s.
Gender: Women appear to be at greater risk than men.
Diet: Mitigate your chances of developing macular degeneration by eating a healthy diet in green leafy vegetables and fish, taking omega-3 fatty acid supplements, not smoking, maintaining normal blood pressure and exercising.