Franklin Kury has a small blind spot in the vision of his right eye. When he looks at an eye chart with his right eye only, he can’t read anything. As a result, Kury’s left eye is the workhorse of the two. As a lobbyist and consultant with Malady and Wooten in Harrisburg, Kury does a lot of reading and memo writing.
So when he had a problem with a blood vessel in his left eye about two and a half years ago, sending his vision from 20/40 to 20/200 in a day, Kury, 74, found himself eye-to-eye with some of the worst that age-related macular degeneration exacts on its victims.
Today, Kury’s vision in his left eye is back to 20/40. Working together, Kury’s physicians at Premier Eye Care Group in Harrisburg (717-232-0843; www.premiereyes.com) and Pennsylvania Retina Specialists in Camp Hill (717-761-7080; www.paretina.com) have been able to stabilize his retina and return his vision to what it was.
The key treatment in stabilizing his retina has been monthly injections of Lucentis into Kury’s left eye. After the first injection, Kury says, his eye improved rapidly. In about three days, it was back to normal.
“It’s a miracle,” says Kury. “It is stunning how quickly [my vision] came back.”
Although glaucoma and cataracts are two eye diseases much better known by the general public, age-related macular degeneration affects more Americans than cataracts and glaucoma combined, says Dr. Jerome V. Benz Jr. of Eyes of York (717-767-2000; www.eyesofyork.com).
Age-related macular degeneration, or ARMD, is a breakdown of the sight-sensing cells in the macula, says Benz. The macula is the most important part of the eye and is part of the retina, which lines the eye. The macula is at the center back of the eye. When the cells in the macula break down, you lose central vision, meaning there could be a dark spot or loss of vision in the exact center of what your eye sees.
As people age, the incidence of ARMD increases, usually at around 50, says Dr. Geoffrey J. Brent of Premier Eye Care in Harrisburg. “There are other types of macular degeneration that can affect younger people,” he says.
“There are more than 10 million people over the age of 55 currently affected by this incurable eye disease,” says Benz.
Other things that can increase your risk of developing ARMD, in addition to age, are having a family history of the disease, being obese, having high blood pressure and high cholesterol and being a smoker, says Brent. The disease is also more common in females and in Caucasians.
Benz notes that people with light colored irises also have a higher incidence of ARMD. Other risk factors, says Benz, are exposure to UV light and eating a diet high in fat and cholesterol.
“We may not be able to control getting older or our inheritable traits, but there are some things we can do when it comes to lowering our risk of ARMD,” says Benz.
Sometimes people don’t realize they are developing the disease until they are having an eye exam. Benz says that can happen because we all have an eye that is dominant. For him, it is his right eye. “If my left eye starts to slowly lose its clarity over time, then I may subconsciously let my right eye do most of the work without knowing anything is happening,” he says.
It is not known what causes ARMD, but it is likely that genetics and the environment play a role, says Benz.
The early symptoms of ARMD can be varied. “Some report distorted vision causing straight lines to appear wavy or blank all together. Some will have trouble telling the difference between close shades of color such as blues and purples or reds and oranges. Others may experience a slower recovery of vision after exposure to bright lights,” says Benz.
Brent cites the many things that people have to adapt to with the loss of vision related to ARMD. “People struggle with recognizing faces and learning to recognize people by their voices. Many miss reading and find large-print books and magazines helpful, or turn to books on tape. Everyday things like paying bills, cooking, shaving and grooming also become more difficult,” says Brent.
But Brent has also gotten to see successes, such as with his patient Franklin Kury being treated with Lucentis.
“Some new medications in the last few years have made an incredible advancement in the treatment, with much better results than laser treatment. Medications such as Lucentis and Avastin interfere with the growth of the abnormal blood vessels responsible for the vision loss. They cannot undo scarring from prior damage, and the medications need to be given on an ongoing basis,” says Brent.
In addition to receiving his monthly injection of Lucentis, Kury also takes PreserVision tablets, which contain the specific daily amount of antioxidants and zinc found to be beneficial in the Age-Related Eye Disease Study done by the National Eye Institute.
Kury also takes fish oil capsules daily, wears glasses that protect his eyes from ultraviolet rays, and wears a ball cap for added protection from the sun while golfing.
Kury does all he can to protect his eyes. “I feel very fortunate, very blessed.”
How Diet and Supplements Can Help A.R.M.D.
The Age Related Eye Disease Study by the National Eye Institute, completed in 2001, found that combinations of antioxidant vitamins, such as vitamins C and E, beta carotene, zinc and copper can slow down the progression of age-related macular degeneration (ARMD), says Dr. Geoffrey J. Brent of Premier Eye Care in Harrisburg. Omega-3 fish oils, zeaxanthin and lutein, which are carotenoids, might also help. Brent says he recommends that patients eat lots of vegetables, especially green leafy ones, and fish, such as salmon, which has lots of omega-3 oils. Supplements such as Ocuvite or Icaps have the levels of nutrients used in the NEI study.
Two Types of ARMD
Age-related macular degeneration has two forms: wet and dry.
The dry form represents about 85 to 90 percent of all ARMD, says Dr. Jerome V. Benz Jr. of Eyes of York. “It is the early stage of macular degeneration,” he says. This is when the cells of the macula begin to thin and dry out, or atrophy, says Benz. “The visual loss from dry ARMD is typically gradual and not as severe as the wet form,” says Benz.
In the wet form of ARMD, new blood vessels grow beneath the macula, and these vessels leak both blood and fluid, says Benz. This leaking can cause scarring, which leads to permanent damage, causing a blind spot in the central vision, he says.
There is no effective treatment for the dry type of ARMD, says Dr. Geoffrey J. Brent of Premier Eye Care in Harrisburg, but there are some treatments available for the wet form, including medication and laser treatment. According to the National Eye Institute, once dry ARMD reaches the advanced stage, no treatment can prevent vision loss, but treatment can delay and possibly prevent intermediate ARMD from progressing to the advanced stage.
