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Macular Degeneration

bmac5_smMacular degeneration is a disease of the macula, an area of the retina at the back of the eye that is responsible for fine detail vision. Vision loss usually occurs gradually and typically affects both eyes at different rates. Even with a loss of central vision, however, color vision and peripheral vision may remain clear.

Symptons of Macular Degeneration:

  • Early macular degeneration may cause little, if any noticeable change in visionSymptoms of macular degeneration
  • Difficulty reading without extra light and magnification
  • Distorted or blurred objects

    Distorted or blurred objects

    Seeing objects as distorted or blurred, or abnormal in shape, size or color

  • The perception that objects “jump” when you try to look right at them
  • Difficulty seeing to read or drive
  • Inability to see details
  • Blind spot in center of vision

There are two forms of age-related macular degeneration, wet and dry.

Wet macular degeneration

Dry macular degenerationWet macular degeneration occurs when abnormal or leaking blood vessels grow underneath the retina in the area of the macula. These changes can lead to distorted or blurred vision and, in some cases, a rapid and severe loss of straight ahead vision.

T

Blind spots

Blind spots

he vast majority of cases of macular degeneration are the dry type, in which there is thinning or deterioration of the tissues of the macula or the formation of abnormal yellow deposits called drusen. Progression of dry macular degeneration occurs very slowly and does not always affect both eyes equally.

Causes of or contributing factors to macular degeneration:

The root causes of macular degeneration are still unknown. Women are at a slightly higher risk than men. Caucasians are more likely to develop macular degeneration than African Americans.

  • Age: Macular degeneration is the leading cause of decreased vision in people over 65 years of age.
  • Heredity: Macular degeneration appears to be hereditary in some families but not in others
  • Long-term sun exposure
  • Smoking
  • High blood pressure
  • High cholesterol
  • Hypertension
  • Nutritional deficiencies
  • Diabetes
  • Head injury
  • Infection

Diagnosing macular degeneration:

An Amsler Grid

An Amsler Grid

Please go to Patient Forms to download the Amsler Grid test and receive instructions on how to test your vision at home.Your eye doctor can identify changes of the macula by looking into your eyes with various instruments. A chart known as an Amsler Grid can be used to pick up subtle changes in vision.

Angiography is the most widely used macular degeneration diagnostic test. During the test, a harmless orange-red dye called Fluorescein will be injected into a vein in the arm. The dye travels through the body to the blood vessels in the retina. A special camera takes multiple photographs. The pictures are then analyzed to identify damage to the lining of the retina or atypical new blood vessels. The formation of new blood vessels from blood vessels in and under the macula is often the first physical sign that macular degeneration may develop.

Optical Coherence Tomography (OCT) uses light waves to create a contour map of the retina and can show areas of thickening or fluid accumulation.

Treatment for macular degeneration:

In the early stages of macular degeneration, regular eye check-ups, attention to diet, in-home monitoring of vision and possibly nutritional supplements may be all that is recommended.

Diet and nutritional supplements

There has been active research on the use of vitamins and nutritional supplements called antioxidants to try to prevent or slow macular degeneration. Antioxidants are thought to protect against the damaging effects of oxygen-charged molecules called free radicals. A potentially important group of antioxidants are called carotenoids. These are the pigments that give fruits and vegetables their color. Two carotenoids that occur naturally in the macula are lutein and zeaxanthin. Some research studies suggest that people who have diets high in lutein and zeaxanthin may have a lower risk of developing macular degeneration. Kale, raw spinach, and collard greens are vegetables with the highest amount of lutein and zeaxanthin. You can also buy nutritional supplements that are high in these and other antioxidants.

Low Vision Aids

Unfortunately, the vast majority of cases of wet macular degeneration and virtually all cases of dry macular degeneration are not treatable. In these cases, low vision aids may help make it easier to live with the decreased vision of macular degeneration. Low vision aids range from hand-held magnifying glasses to sophisticated systems that use video cameras to enlarge a printed page. Lifestyle aids such as large print books, tape-recorded books or magazines, large print playing cards, talking clocks and scales and many other devices are available.

Injection

LUCENTIS  and Macugen are new treatments for the wet form of age-related macular degeneration. These injections block abnormal blood vessel growth and leakage.

Laser Treatments

In rare cases of wet macular degeneration, laser treatment may be recommended. This involves the use of painless laser light to destroy abnormal, leaking blood vessels under the retina. This form of treatment is only possible when the abnormal blood vessels are far enough away from the macula that it will not damage it. Only rare cases of wet macular degeneration meet these criteria. When laser treatment is possible, it may slow or stop the progression of the disease but is generally not expected to bring back any vision that has already been lost.

Some cases of wet macular degeneration can be treated with photodynamic therapy or PDT. In those cases where PDT is appropriate, slowing of the loss of vision and sometimes, even improvement in vision are possible.

AstigmatismBlepharitis
CataractsConjunctivitis (Pink-Eye)
Corneal AbrasionsCorneal Disease
Corneal UlcersDiabetic Retinopathy
Dry EyeFarsightedness
Flashes & FloatersFuchs Dystrophy
KeratoconusLow Vision
Macular DegenerationMonovision
Narrow-Angle GlaucomaNormal Vision
NearsightednessOpen-Angle Glaucoma
PresbyopiaPterygium
Retinal DetachmentRetinal Vein Occlusion
StrabismusUveitis

Patient Testimonials:

  • I have had eye surgery with both Dr. Kevin Dinowtiz and Dr. James Pasternack. I was very pleased with the results and the wonderful follow-up care after surgery.

    Ruth, East Granby, CT
  • When I started to experience problems with my vision, I was concerned about what could be done. The staff at Primary Eye Care were wonderful in explaining Blepharoplasty (eye lid) procedure and alleviating my fears. The surgery went just as planned and now my vision has been restored just as promised. I couldn’t be more satisfied.

    Michael, Canton, CT
  • After having cataract surgery and eye lid surgery at Primary Eye Care Center they are number ONE! Dr. Castner, Dr. Pasternack and the staff at Primary Eye Care Center did an excellent procedure to restore my vision. I will always recommend Primary Eye Care Center.

    George, Enfield, CT
  • Dinowitz and the staff at Primary Eye Care Center restored my vision to nearly 20/20. The surgery was painless, the care top notch, and the results better than I expected. The entire staff was professional and informative. I have recommended Primary Eye Care to several of my friends with complete confidence that they will receive the same outstanding service and results.

    John, Avon, CT
  • My experience at Primary Eye Care was a very good one. Before my eye lid surgery, my ability to see was greatly limited. Since the surgery, I am back to driving and my normal routine. I highly recommend this procedure for others that have the same situation that I did.

    Linda, Bloomfield, CT
  • For years I have had problems seeing because of droopy eyelids. I felt as if I had a curtain over the upper part of my eyes. Thanks to Dr. James Pasternack, I can see more and I am told I look much younger. The operation was painless from start to finish. It has been two weeks and I feel great! Thanks to Dr. Pasternack and his staff.

    Leda, Windsor, CT
  • Prior to my cataract surgery I saw halos around lights, my distance vision was poor and I kept thinking my contacts were dirty. Since surgery, the distance vision is great, I can read street signs and no more blurring. I love to read and I am thrilled with the results! Everyone at Primary Eye Care Center was professional and friendly. I was completely at ease for all visits and both surgeries on each eye. I want to thank everyone at Primary Eye Care Center for a comfortable and successful procedure.

    John, Simsbury, CT
  • My experience with Primary Eye Care Center was outstanding. I had cataracts and could not see to read or drive. I love reading novels with a happy ending and thanks to Dr. Dinowitz all of my novels always have a happy ending now that I can see them without the cataracts. Dr. Dinowitz also made it possible for me to see all the glory of the fall colors here in New England that I had been missing out on!

    Arline, East Granby, CT
  • I would never hesitate to recommend Primary Eye Care Center or Dr. James J. Castner to anyone needing eye surgery or any procedure necessary for vision problems. The care given prior, during and after cataract surgery was exceptional.

    Catherine, Windsor, CT
  • I am very pleased with my eyelid surgery performed by Dr. Pasternack in the Eye Surgery Center at Primary Eye Care. I have received many comments such as; “How do you manage to stay looking so young”? The procedure was without discomfort and didn’t take very long.

    Arthur, Avon, CT
  • Before having this procedure done at Primary Eye Care Center, my sight required me to wear eyeglasses on a daily basis. I had to change glasses whenever I wanted to use the computer. Now that I have had cataract surgery, I no longer need to wear glasses on a daily basis at all. However, I do require reading glasses for fine print up close. Now that I have my total vision back I can show off my “beautiful eyes” thanks to Dr. James Pasternack. He was so gentle; the procedure took less than 20 minutes and pain free. I would recommend everyone to have this procedure done and be set free from glasses forever!

    Mary, Bloomfield, CT
  • It has been a year since I had cataract surgery on both of my eyes at Primary Eye Care Center. I was able to see the same day each of the surgeries were performed. There was no pain, and no way to tell I had eye surgery. Dr. Castner recommended Restor lenses, which he explained would mean “no glasses” after surgery. Dr. Castner and his staff were very professional and caring. I will always be grateful to them. Restor lenses really opened my eyes!

    Phyllis, Granby, CT
  • Before I had the Restor cataract surgery, my vision was cloudy and small print was becoming hard to read. After seeing the video, and being an avid reader, I decided to go with the Restor. Now, I never pick up a pair of glasses to read books, street signs or a recipe! Also, the colors are sharper and brighter. Everyone at the Eye Surgery Center put me at ease and were very informative.

    Irene, Glastonbury, CT
  • After 50 years, all I can say is WOW no more glasses! The experience of cataract surgery was amazing. Dr. Castner and his staff were very professional and made me feel comfortable from the very first visit. On the day of surgery it was all about me, the nurses kept me relaxed and Dr. Castner was very professional, caring and comforting throughout the procedure. After I came home I was able to take off the eye patch and was amazed how well I could see the alarm clock the very next day without squinting. I asked my husband if he had cleaned the TV screen because it was so white and the colors were very vibrant like never before. It was like a new world and only one day after surgery. The Toric Lens I chose for my cataract surgery corrected my distance vision and astigmatism, I am now able to drive, watch TV and do so many things without the hassle of glasses. I highly recommend Dr. Castner and his amazing staff.

    Diane, Springfield, MA
  • Primary Eye Care Center’s staff are the most friendliest group of people whom I have met. They are very knowledgeable about the eye care industry and are attentive to the needs of their patients. I find them to be friendly and pleasant. The doctors always ask if you have any questions after the diagnosis process and they are so accommodating.

    Millicent, Windsor, CT
  • I am so happy to tell you about my “new” vision. I started wearing glasses at age 11. Though the years my vision has changed many times. As a senior it had become more challenging. My appointment with Dr. Castner in 2011 was to be a reversal in how I saw. I was told about the new AcrySof Toric lens and how it could correct my astigmatism and distance vision. I had the surgery and can’t believe my distance vision is so good. I can now drive at night. What a blessing.

    Thank you Dr. Castner for a new lease on life.

    Joan C., Windsor, CT
  • I was extremely pleased with my entire experience at Primary Eye Care Surgery Center in Bloomfield. There was adequate and timely communication throughout my experience before, during and after my cataract surgery with the AcrySof ReStor multifocal lenses. Everyone was so courteous, professional and caring. My experience there could not have been more satisfying! Thank you!

    Doris C., Enfield
  • Prior to my surgery, I had worn glasses for almost 60 years. As long as I can remember, the first thing that I did in the morning was put them on and the last thing was take them off. The only good thing about that was that I always knew where they were. Over the years, I tried and lost several pairs of prescription sunglasses and clip-on’s and I never seemed to have them available when I needed them.

    When we discussed my lens options for cataract surgery, I knew immediately that the need to carry a pair of glasses to see anything within arm’s length would be a constant irritation so the decision to use the AcrySof Restor lens was a slam dunk for me. The surgery itself was easy; absolutely no pain, discomfort and no after effects. I had both eyes done one week apart. On the day of surgery, the vision in the first eye was so good that I’ve never worn glasses again. Even with only one corrected my distance vision seemed better than it had been for years even with my glasses.

    The AcrySof Restor lens has had a real impact on my life and I strongly recommend them to everyone.

    Tom C., Windsor , CT
  • Dr. Castner has been my ophthalmologist for many years and has performed cataract surgery in both of my eyes over five years ago. All of my experiences at Primary Eye Care Center have been timely, professional and pleasant. My eyes are doing very well thanks to Dr. Castner. I highly recommend Dr. Castner and his staff.

    Eleanor K., Poquonock
  • I chose to have the ACRsof Toric Lens at Primary Eye Care in the hopes of better vision. It was the best choice I’ve ever made. Prior to my surgery, my eyesight was horrible. I’ve had to wear glasses since I was 5 years old and my eyesight got progressively worse over the years. After my surgery, I felt like a walking miracle. Never before was I able to open my eyes in the morning and be able to see so clearly. I am so grateful to Dr. Castner and his entire team. They were kind, professional and able to put me at ease. I couldn’t be happier or more grateful.

    Irene, Suffield, CT
  • In October 2013, Dr. James Castner performed cataract surgery on both of my eyes. I have needed glasses for 60 years. Over the past 5 years I developed cataracts and my vision deteriorated. There was no pain during surgery. I elected to have the ACRsof Toric lens and I amazed at the improved quality of colors and visual clarity for distance vision. My astigmatism was also corrected. The overall results exceeded my expectations. Dr. Castner is outstanding and the staff is very professional.

    Joseph, Windsor, CT
  • I went into Primary Eye Care Center wearing glasses all the time, I left with 20/20 vision after my cataract surgery. The procedure was painless and I would highly recommend having the surgery.

    Elaine, Windsor, CT
  • My experience was amazing. I had stopped night driving because my vision was so terrible in addition to having trouble reading. The surgery was quick with very little discomfort and the results were amazing. My vision is 20/20 after surgery and colors are now very brilliant. I couldn’t ask for more.

    Fred L., Granby, CT

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