Age Related Macular Degeneration

An explanation by Dr. Aleksic’s treatment centre optometrist, Rianda.
Dr. Zoran Aleksic FCS (SA) Ophth, is an eye surgeon and Ophthalmologist specialising in cataract and laser refractive surgery (Lasik / PRK laser refractive surgery for short sightedness, far sightedness and astigmatism). Dr. Aleksic’s treatment centre is located in Sea Point in Cape Town.
Dr. Zoran Aleksic and his team have long been recognised both in South Africa and the rest of the continent for providing high quality eye care with a full spectrum of treatments, from prescribing glasses and contact lenses to complex and delicate eye surgery using the latest technological equipment, all in a relaxed and professional environment.
Visit our website: www.eyesurgery.co.za
Transcript:
What is the Macular?
This is macular degeneration due to your age. Now, first of all what is your macular? If you think of the form of a camera or the back of your eye, light rest travels through your cornea through your lens and it gets bent down to one point of focus and that very point of focus is your macula. That is basically the most important part of your eye.
What happens as we get older (it's more prevalent in Caucasians) is two types: Wet age-related macular degeneration or dry age-related macular degeneration. If Dr. Aleksic detects when he looks at the back of your eye and it looks almost as if a piece of metal that's flat got beaten like this and that's what we refer to as drusen; it's like dry drusen spots in the macular area that might affect your vision in terms of quality when you look at a straight line you can
see slight distortions. There is nothing really one can do for dry macular degeneration but there's also a very good chance that it will just stay like that.
Wet age-related macular degeneration. Now that is when fluid accumulates in that macular area. The reason why it's happening is age and as we get older. The fluid will distort your vision again.
The OCT scan that we do to just clinically see how much fluid and where the fluid is locate. It's a scale that measures the back of your eye which is your retina. Your retina’s got ten layers and it will give us a cross-section of your retina so we can clearly see there will be lumps and bumps filled with pockets of fluid at the back of the eye.
How to treat it?
The way to treat it is by putting a medication into the eye that's going to absorb the fluid in order for you to have your retina flatter again so that light rays can come down to one point of focus which is your macula. Avastin is a is a is a type of medication that we put into the eye in order for the fluids to be absorbed. We can't guarantee that Avastin works effectively on every person and some people need more or some patients need more series of Avastin.
We have certain Avastin days. It is not an in-hospital procedure; not something that you're going to go to theatre for. Doctor has a dental chair; he performs it in a small surgical facility in our rooms.
It is not a painful procedure. We will have everything that can potentially cause an infection to be away.Doctor is scrubbed completely as if he's going to do a surgical procedure in theatre. We use again a small speculum to keep the eye open so you don't have to worry about keeping the eye open.
We'll ask you to look towards your nose. If you think of your eye in terms of a clock the injection usually takes place at around 2 o'clock. Doctor then prepares everything that he needs. The whole procedure takes about 5 to 10 minutes; the preparation and the disinfection takes longer than the actual small procedure. You will see fluid floating around and that's the medication going into the eye.
For the next 2 or 3 days you'll be a little bit scratchy. We will give you lubricant drops to take home so as you need it you just put it in. You can do five, six times a day. If you don't need it, you don't have to put it in. You'll have small discomfort when you go home.
Do not expect your vision to improve in the next few days or weeks. We need to wait a month to do it again, another month, do it again, third month, do it again and then after another month we scan you. You can progressively maybe start to see an improvement and we want you to be critical. I want you to look at one thing maybe in your house on day one and then a month later you just look at it again. We will ask you subjectively when you come for your scan after four months if you notice an improvement in your vision.
If we see that you are really almost resistant to Avastin there's another medication called Lucentis that we can put into the eye.
The third option in terms of intraocular medication is something called Ozurdex. It is a small pellet with a slow release.
If you're diabetic and or maybe non-diagnosed diabetic, what can happen is you can have a bleed at the back of the eye.