Macular degeneration

What is the macula?

The macula - also known as the yellow spot - in our eye is the central point of our vision. When you look through the viewfinder of a camera you normally see a small circle which is for focussing the image we want to photograph:


In this picture the macula corresponds to the inner part of the two red circles at the middle of the image. This is the only part of the retina which can be focussed and which sees a sharp image, with the sharpness gradually declining away from the centre.

Our field of vision, obviously, is much greater than that of a wide-angle lens.

Would you like to take part in a small experiment?

Why is this, and why is it sometimes called "yellow spot"?

It is yellow because it contains special pigments and it is designed by nature specifically for sharp-focus vision.

What happens exactly when this part of the retina degenerates? And how does it actually work in a healthy eye?

As you already know the image is projected on a layer of pigment inside the eye, comparable with a film in a camera. On a film, too, there are a number of pigment layers which first need to be developed in the laboratory. The equivalent of the film developing process is taken care of by the retina itself which is on top of the pigment layer, with its millions of tiny, point-form cells for scanning the image. This image sensing naturally takes place in real time. The electrical signals created in the process are collected together in a thick bundle of cables - the optic nerve - and transmitted across the brain, past the pituitary gland and via specially constructed switching centres in the brain making connections, for example, to our sense of balance organs and the cerebellum, arriving finally at the visual cortex - the part of the brain which we use to perceive visual images.

And what happens if degeneration sets in? Degeneration literally means "breakdown". What breaks down and what symptoms are there at the start of this disorder?

Everything has to start somewhere. At the beginning of retina degeneration there are only low level, if any, visual defects. From what we know today it seems that a wafer-thin layer which protects the retina from harmful metabolism breakdown products starts to crack. The result is a lack of vital nutrients and protective substances and oxygen. This deficiency is compensated for by newly formed blood capillaries which destroy the retina, slowly but surely.

Here are a few examples. The dimensions are those of a healthy retina. The macula covers an area of roughly 1.5 mm

At what age does this disease appear?

It appears mostly after the age of 40.

Other there any ways of spotting it at an early stage?

As a precaution, from the age of 40 you should be checked once a year by an eye specialist. A self-test is available, the Amsler test, which you can carry out here online, or obtain from any ophthalmologist as a small card with instructions. The main principle is, consult an ophthalmologist if you have any visual problems you are unsure about because most eye problems involving the retina can be treated successfully if caught at an early stage.

What is the current course of recommended treatment?

The first thing your ophthalmologist will do is conduct an angiography of the retina. This will identify any newly formed blood capillaries. These can either by treated with a laser, with x-rays or sometimes in an operation.

Is that all?

No, he or she will consult with your GP or internal specialist to optimise all metabolism and circulation parameters.

If no treatment seems possible what should I do then? Will I go blind?

Don't worry, you won't go blind. Nevertheless the diminished focussing ability in such a case will mean that you will not be able to drive, for example. Many things which require good focussing such as reading books and newspapers, watching TV etc will no longer be possible, or only to a limited extent. But even in such cases, help is at hand today in the form of magnifying optical aids. Close cooperation, thorough testing, sometimes with the help of centres for the visually impaired based on the Munich University Hospital Model, have restored a degree of quality of life to patients that they previously had thought no longer impossible.

If all of this is not successful where can I get advice, or can you give me the addresses of places where I can get help on macular degeneration or loss of sight?

Associations for the blind or loss of sight

How can I help myself?

It is clear that predisposition is not the only factor bearing on the disability. Domestic circumstances, stress factors and poor diet all contribute over time to symptoms of wear.

When we are young we don't want to hear any of this.
Why can't we let our hair down just once in a while?
Why are we often so selfish, thinking only of ourselves?
Why do we close our eyes to things that we don't want to see?

Can this inner blindness cause such unwanted illnesses?

Recommended reading:
Krankheit als ein Weg
Author : Thorwald Dethlefsen / Ruediger Dahlke
Publisher: C. Bertelsmann
ISBN 3-570-03579-4

As a precaution the following high dosages of dietary supplements are recommended:
2g vitamin every morning
2 capsules of Eusovit 300
At lunchtime 1 capsule CeTeBe

A final recommendation:
Find out about healthy, "balanced diets" from your GP. S/he will know what is best for you!