Health Information – 5

5. Dry macular degeneration

Definition
Dry macular degeneration is a chronic eye disease that causes vision loss in the center of your field of vision. Dry macular degeneration is marked by deterioration of the macula , which is in the center of the retina — the layer of tissue on the inside back wall of your eyeball.
Dry macular degeneration is one of two types of age-related macular degeneration. The other type — wet macular degeneration — is characterized by swelling caused by leaky blood vessels in the back of the eye. Dry macular degeneration isn’t associated with swelling and is the more-common form of the disease.
Dry macular degeneration doesn’t cause total blindness, but it worsens your quality of life by blurring or causing a blind spot in your central vision. Clear central vision is necessary for reading, driving and recognizing faces.

Symptoms :
Dry macular degeneration symptoms usually develop gradually. You may notice these vision changes:
• The need for increasingly bright light when reading or doing close work
• Increasing difficulty adapting to low light levels, such as when entering a dimly lit restaurant
• Increasing blurriness of printed words
• A decrease in the intensity or brightness of colors
• Difficulty recognizing faces
• A gradual increase in the haziness of your overall vision
• A blurred or blind spot in the center of your field of vision
• Hallucinations of geometric shapes or people, in cases of advanced macular degeneration
Dry macular degeneration may affect one eye or both eyes. If only one eye is affected, you may not notice any or much change in your vision because your good eye compensates for the weak one.

Cause:
The exact cause of dry macular degeneration is unknown, but the condition develops as the eye ages. Dry macular degeneration affects the macula — a small area at the center of your retina that is responsible for clear vision, particularly in your direct line of sight. Over time the cells that make up your macula break down.

Complications:
At any time, dry macular degeneration can progress to a more severe form of the disease called wet macular degeneration, which causes rapid vision loss. There’s no accurate way to predict who will eventually develop wet macular degeneration and who won’t.

Tests and diagnosis
Diagnosing dry macular degeneration

Diagnostic tests for dry macular degeneration may include:
• Testing for defects in your central vision-
During a complete eye exam, your eye doctor may use a test called the Amsler grid to test for defects in the center of your vision. If you have macular degeneration, when you look at the grid some of the straight lines may seem faded, broken or distorted.

• Examining the back of your eye -
Your eye doctor will examine the back of your eye to look for a mottled appearance that’s caused by drusen — yellow deposits that form in people with macular degeneration. To examine the back of your eye, your eye doctor will dilate your eyes using eyedrops and then use a special magnifying lens.

• Creating images of the blood vessels in your eye (angiogram) -
During an angiogram of your eye, a colored dye is injected into a vein in your arm. The dye travels to the blood vessels in your eye. A special camera is used to take pictures of your eye. The pictures show the dye highlighting the blood vessels in your eye. Your eye doctor uses the information from the angiogram images to determine whether the back of your eye shows blood vessel or retinal abnormalities, such as those that might be associated with wet macular degeneration.

• Optical coherence tomography -
This noninvasive imaging test helps identify and display areas of retinal thickening or thinning. Such changes are associated with macular degeneration. It’s often used to help monitor the response of the retina to macular degeneration treatments.

Determining the stage of your dry macular degeneration :-
Dry macular degeneration is categorized in three stages based on the progression of damage in your eye:

• Early stage. Several small drusen or a few medium – sized drusen are detected on the macula in one or both eyes. Generally, there’s no vision loss in the earliest stage.
• Intermediate stage. Many medium-sized drusen or one or more large drusen are detected in one or both eyes. At this stage, your central vision may start to blur and you may need extra light for reading or doing detail work.
• Advanced stage. Several large drusen, as well as extensive breakdown of light-sensitive cells in the macula, are detected. This causes a well-defined spot of blurring in your central vision. The blurred area may become larger and more opaque over time.

Risk factors
Factors that may increase your risk of macular degeneration include:
• Increasing age. Your risk of macular degeneration increases as you age. Macular degeneration is most common in people over age 60.
• Having a family history of macular degeneration. If someone in your family had macular degeneration, your odds of developing macular degeneration are higher.
• Being white. Macular degeneration is more common in whites than it is in other races, especially after age 75.
• Being female. Women are more likely than are men to develop macular degeneration.
• Smoking cigarettes. Smoking cigarettes increases your risk of macular degeneration.
• Being obese . Being severely overweight increases the chance that early or intermediate macular degeneration will progress to the more severe form of the disease.
• Eating few fruits and vegetables. A diet that includes few fruits and vegetables may increase the risk of macular degeneration.
• Having high blood pressure. Diseases that affect the circulatory system, such as high blood pressure, may increase the risk of macular degeneration.
• Having high cholesterol . An elevated cholesterol level in your blood is associated with an increased risk of macular degeneration.

Treatments and drugs in Ayurveda
After the diagnosis, the doctor sets out to treat the patient in a very systematic manner. This would include a set of appropriate Panchakarma treatments and Rasayana therapies .

The Panchakarma Treatments are meant to flush out the toxins, They are classified as pre-purification, main purification and post purification phases and include various types of therapies like oil massages, fermented liquid massages, medicinal enemas, herbal purification methods.

After body purification rasayana therapies along with Netra Kriya-kalpa’s were started such as:
1.Sekam :- An eye wash using medicated kashayam.
2.Anjanam :- An application of medicine in the form of paste to he eye.
3.Aschotanam :- An adminestration of eye drops to the eye.
4.Tharpanam :-  Keeping medicated ghee over the eye for a stipulated period, making concentric boundary around the orbit.
5.Puttapakam :- Keeping medicaments prepared out of plant extracts,Fats & certain minerals  over the eye for a stipulated period, making concentric boundary around the orbit.

*In all the above kriya-kalpa different types of drugs are selected by your doctor according to the doshas involved.

Oral medication:
The oral medicine used for treating the disease will be extracts of pure medicinal herbs, leaves, spices etc. These are prepared specifically to restore the lost balance and to provide the needed inputs to improve the condition of patient. kashayams and Arishtam – herbal decoctions and fermentations lehyams – semi solid formulation are commonly prescribed.

Diet :
Brinjal, Lady finger, Jackfruit, Curd, Pickles, Lemon, Oily-Spicy food should be avoided .
• Include a variety of colorful fruits and vegetables in your diet . The antioxidant vitamins in the fruits and vegetables contribute to eye health. Eating a variety of colors ensures that you’re getting a variety of vitamins.
• Choose healthy fats. Healthy unsaturated fats, such as the fats found in olive oil, may help protect your vision. Choose these healthy fats over saturated fats, such as butter, and trans fats, such as partially hydrogenated oils found in packaged foods.
• Choose whole grains over refined grains . Choose whole grains, such as whole-wheat bread, over refined grains, such as white bread.
• Add fish to your diet. Fish contain omega-3 fatty acids that may help reduce the risk of vision loss related to macular degeneration. Fish that contain high levels of omega-3 fatty acids include salmon, sardines and tuna. Omega-3 fatty acids can also be found in supplements and nuts, such as walnuts.

Prevention
The following measures may help you avoid macular degeneration:
• Have routine eye exams. Ask your eye doctor how often you should undergo routine eye exams. A dilated eye exam can identify macular degeneration.
• Manage your other diseases . For example, if you have cardiovascular disease or high blood pressure , take your medication and follow your doctor’s instructions for controlling the condition.
• Stop smoking . Smokers are more likely to develop macular degeneration than are nonsmokers . Ask your doctor for help to stop smoking.
• Maintain a healthy weight. If you need to lose weight, reduce the number of calories you eat and increase the amount of exercise you get each day. If you have a healthy weight, work to maintain your weight by exercising most days of the week.
• Choose a diet rich in fruits and vegetables. Choose a healthy diet that’s full of a variety of fruits and vegetables. These foods contain antioxidant vitamins that reduce your risk of developing dry macular degeneration.
• Include fish in your diet . Omega – 3 fatty acids , which are found in fish , may reduce the risk of dry macular degeneration. Nuts, such as walnuts, also contain omega-3 fatty acids.

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