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Macular Degeneration
in Visalia

As eyes age, retinas degenerate. In some people this takes the form of degeneration in the macula, the sensitive part of the central retina responsible for visual acuity and color vision. Common symptoms include blind spots, blurred or distorted vision, or even a sudden dramatic drop in vision loss if bleeding is occurring. With more people living longer lives, Dr. Bianco is seeing more and more patients experiencing age-related macular degeneration (AMD). While there is not yet a cure for AMD, there have been significant advances in treatment over the past 5-10 years. For the “wet” form of the disease, which can lead to more serious vision loss, successful new injectable medicines (such as Luscentis) have been developed that can stabilize and significantly improve the loss of vision. The injections must be repeated periodically (about every four to six weeks) to maintain their effectiveness against the progression of AMD.

What is macular degeneration?

Macular degeneration is age-related wearing-out of the retina and the layers of the retina at the back of the eye—specifically those that provide direct central vision (for seeing details, people’s faces, hands on a clock).

There are two types of macular degeneration: wet and dry. About 80% of people experience dry macular degeneration, while 20% present with wet.

What is dry macular degeneration?

Dry macular degeneration is age-related wearing out. Symptoms include difficulty seeing or reading when light levels are low or print is very small. Treatment entails over-the-counter vitamins that help slow down its progression.

What is wet macular degeneration?

Wet macular degeneration consists of abnormal blood vessels growing in and around the areas of the eye that are wearing out. Wet macular degeneration causes a more rapid drop in vision, because the vessels bleed and cause swelling. Treatment entails a retinologist getting into your eye quickly, injecting one of three different medications that dry out the eye, reduce swelling, and bring back vision. The three injections Dr. Bianco offers patients are Lucentis, Eyelea and Avastin. Wet macular degeneration treatment requires one intraocular injection per month.

Is macular degeneration treatment covered by insurance?

Yes, the vast majority of the time it is covered by insurance.

How is macular degeneration diagnosed?

During every eye exam, Dr. Bianco checks eyes for signs of macular degeneration. He always dilates the patient’s pupils so he can get the best look into the back of the eye and see details. He also checks pressure ,which helps him find macular degeneration as early as possible.

What can patients expect after treatment?

Expected outcomes are different for patients with wet and dry macular degeneration. For patients with the dry form, the goal is to maintain vision as best as we can for as long as we can. Oftentimes, dry macular degeneration can change to wet macular degeneration, though.

After patients with wet macular degeneration come in for 3-4 injections, we usually have a pretty good idea of how much of their vision they’ll get back. About 50% of patients who get the monthly shots will be able to read 3 lines further down the eye chart than their non-injection counterparts.

Before 2005, when the intraocular injections were unavailable, laser treatments were well known—however, they do not help patients. Now, with the intraocular injections, patients can achieve clearer vision, and the injections don’t hurt. Unlike full-body medicines, there are no significant complications from the injections. Our biggest concern is always infection, but that, too, has a super-low risk.