Health Information – 6

6. Wet macular degeneration

Wet macular degeneration is a chronic eye disease that causes vision loss in the center of your field of vision. Wet macular degeneration is marked by swelling caused by leaking blood vessels that affect the macula , which is in the center of the retina — the layer of tissue on the inside back wall of your eyeball.
Wet macular degeneration is one of two types of age-related macular degeneration. The other type — dry macular degeneration — is more common and less severe. Wet macular degeneration almost always begins as dry macular degeneration. It’s not clear what causes wet macular degeneration to develop.
Early detection and treatment of wet macular degeneration may help reduce the extent of vision loss and, in some instances, improve vision.

Symptoms :
Wet macular degeneration signs and symptoms typically appear and progress rapidly. Signs and symptoms may include:
• Visual distortions, such as straight lines appearing wavy or crooked, a doorway or street sign looking lopsided, or objects appearing smaller or farther away than they really are
• Decreased central vision
• Decreased intensity or brightness of colors
• Well-defined blurry spot or blind spot in your field of vision
• Abrupt onset
• Rapid worsening
• Hallucinations of geometric shapes, animals or people, in cases of advanced macular degeneration

It’s not clear what causes wet macular degeneration. The condition almost always develops in people who have had the dry form of macular degeneration. But doctors can’t predict which people will go on to develop wet macular degeneration, which is more severe and progresses more rapidly than dry macular degeneration.

Types of wet macular degeneration
Wet macular degeneration can develop in different ways:
• Vision loss caused by abnormal blood vessel growth. The choroidal neovascularization type of wet macular degeneration develops when abnormal new blood vessels grow from the choroid — the layer of blood vessels between the retina and the outer, firm coat of the eye called the sclera — under and into the macular portion of the retina. These abnormal vessels leak fluid or blood between the choroid and macula. The fluid interferes with the retina’s function and causes your central vision to blur. In addition, what you see when you look straight ahead becomes wavy or crooked, and blank spots block out part of your field of vision.
• Vision loss caused by fluid buildup in the back of the eye.Another type of wet macular degeneration, called retinal pigment epithelial detachment, occurs when fluid leaks from the choroid and collects between the choroid and a thin cell layer called the retinal pigment epithelium (RPE). Abnormal choroidal blood vessel growth is usually not seen when the RPE is detached. Instead, fluid beneath the RPE causes what looks like a blister or a bump under the macula.

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 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.

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
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 eye drops 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 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.

These are body nourishing therapies to rejuvenate the body and mind after the Panchakarma treatments. They keep the enzymes in the tissue cells in their normal functioning condition, restore and balance the body functions and maintain the overall health and well being of an individual for much longer periods after the Panchakarma course. Rasayana includes oral medicines and diet regulation.

Oral medicines for Glaucoma
used for treating glaucoma 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 cure glaucoma. kashayams and Arishtam – herbal decoctions and fermentationslehyams – semi solid formulation are commonly prescribed. Some of the herbs and spices used in the preparation of kashayams and lehyams for treating glaucoma patients include Aniseed, babul, carrot, coriander, Indian Gooseberry etc

If you have elevated intraocular pressure or glaucoma, follow these lifestyle tips.
• Sip fluids frequently . Drink only moderate amounts of fluids at any given time during the course of a day . Drinking a quart or more of any liquid within a short time may temporarily increase eye pressure.
• Exercise safely. Regular exercise may reduce eye pressure in open-angle glaucoma. However, eye pressure may increase after exercise in one form of secondary glaucoma — pigmentary glaucoma, an inherited disorder marked by dispersion of pigment granules throughout the eye. With vigorous exercise, the pigment granules can become stirred up and deposit themselves on the trabecular meshwork causing an increase in pressure. With pigmentary glaucoma, it’s especially important to avoid head-down yoga positions and stretches, since these positions may increase intraocular pressure. Talk to your doctor about an appropriate exercise program.

* If you don’t have pigmentary glaucoma, you needn’t restrict your physical activities.

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.

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