Macular degeneration is sometimes referred to as ARMD (Age-Related Macular Degeneration). The macula of the retina is the centermost portion of the retina. The aging process itself, as the name suggests, indicates a breakdown of this segment of the retina, the area that is most responsible for central vision as opposed to peripheral vision.
The breakdown of this tissue generally leads to the loss of central vision while maintaining vision peripherally. Seeing things directly in front of the patient becomes difficult, if not impossible. It is not uncommon to see a patient with macular degeneration frequently turning their head sideways where they can see clearly instead of facing forward where images are extremely difficult to process. Often, they are unable to recognize people or objects directly in front of them.
It has been estimated that by the age of 70, one in five adults suffers from some degree of macular degeneration. It is the most common cause of blindness of all the diseases of the retina.
This disorder is a true representative of a disease associated with advancing age. Effective measures can be taken to abate and reverse macular degeneration. Those patients afflicted with it are not irrevocably destined to lose their vision. The earlier those efforts are initiated, the greater the likelihood that vision will return sooner and more profoundly.
There are two types of macular degeneration.
The most common form is known as dry ARMD. More than 90 percent of all cases are of this dry type. The other form of the disorder is known as wet ARMD. This disorder is characterized by the development of diseased blood vessels, which have the capacity to leak fluid or blood into the macula.
In these cases, it is quite common for retinal specialists to inject directly into the diseased portion of the retina with drugs and attempt to decrease and/or arrest further bleeding.
On its face value, it sounds as though injections should be a good idea. The conventional literature is replete with citations that support the benefits of this type of direct intervention. If you are afflicted with wet ARMD, you must become informed about the hazards of these eye injections.There are many. In some cases, they are quite serious.
One would hope that a dutiful informed consent obtained by the doctor performing the injections would alert patients of these complications. Whether purposefully ignored or accidentally omitted, this discussion does not occur.
In the conversations I have with the majority of patients who have had the misfortune of having these anti-VEGF injections (VEGF is a hormone secreted by arteries that lead to the formation of these diseased blood vessels), they tell me they were not informed of anything detrimental that could happen as a result of receiving them. In fact, they describe what they felt their doctor essentially told them amounted to “It’s either have the injection or go blind.” It was expected that they would receive not just the first injection but as many in the future that the eye doctor determined to be necessary.
Very few patients with wet ARMD ever raise an objection or even hesitate to consider some other course of action. They also confide to me that they dread their next appointment with their eye doctor because of the likelihood that each visit will lead to their all-too-“automatic” next injection.
It is not my intention to interfere with the relationship between a doctor and his patient as to whether or not to pursue a treatment option proposed by him. It is apparent to me, however, that this situation is completely out of hand.
It would be a disservice to not honestly explore a logical approach as to whether or not anti-VEGF injections should be considered. This logical approach would then permit the patient to:
- feel as though they are actually a part of their overall management
- fell their opinions and concerns actually will be listened to,
- actually decide what their treatment will be
- actually have the right to refuse the injections
- feel they are justified in terminating their relationship with their current eye doctor in search for another, if need be. It also means they should consent to the injections if all other options do not produce the desired result.
The first point to be introduced is that eye patients with wet ARMD, or for that matter any retinal disease, are always placed in a defensive position. That position has only one objective: to minimize the future loss of their vision. If loss is their only motivation, they will continue to grasp at the only option presented to them by their eye doctor who is quite adamant about declaring, “You either have the injection or go blind.” How can you argue or even have any discussion with your doctor after having been presented with that ultimatum?
What makes that situation even worse is that from all their training and experience, they are actually correct. They are the one working from the “nothing-can-be-done” premise. They do not know anything about a “three-day,” “three-step,” or for that matter a twenty-step program to turn your eye disease around and begin the process of restoring your vision.
They do not know about that possibility today, and they will not know about it tomorrow. They will not even know about it after your eye function actually returns. It makes no sense to think that your success will do anything more than confuse them.
I want to help educate you; to form a strong and confident attitude concerning your health choices. You should no longer be fearful. You will no longer be defense oriented or worried about further vision losses. You will learn you are now on offense, and are a force to be reckoned with.