A guide to reducing the risk factors for macular degeneration and dealing with the onset of the disease covers all the newest procedures and even assists readers in dealing with the depression that often accompanies the illness. Reissue.
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Lylas G. Mogk, M.D., is a practicing ophthalmologist and founding Director of the Visual Rehabilitation and Research Center of Michigan, part of the Henry Ford Health System. Dr. Mogk is a member of the American Academy of Ophthalmology's Low Vision Rehabilitation Committee. She lives in Grosse Pointe with her husband, John, and her father, Charles R. Good, who has advanced macular degeneration. Despite his severe vision loss, Dr. Mogk's father lives a full and active life following the principles presented in this book.
Marja Mogk is a freelance writer and editor based in Berkeley, California. She worked for several years in social welfare counseling and maintains an active interest in this field. She is Lylas and John Mogk's daughter.
Americans have age-related macular degeneration.
The disease will strike 200,000 more people this year.
It is the most prevalent cause of vision loss in the western world.
And most people have never heard of it . . . until now.
Dr. Lylas Mogk, the founding director of the Visual Rehabilitation and Research Center of Michigan and a member of the American Academy of Ophthalmology's Low-Vision Rehabilitation Committee, has a unique professional and personal understanding of macular degeneration. A doctor and loving daughter of a parent with this frightening though manageable condition, Mogk here explains the ailment and how to take steps to limit its effect on your life. Reassuring and comprehensive--complete with illuminating first-person stories of people with ARMD--Macular Degeneration will help you or someone you love with the newest information on
- Reducing your risk factors
- Experimental treatments and research
- Coping with depression and
CHAPTER 1: What is ARMD?
A Portrait
Macular degeneration is one of the biggest secrets in the world.
--Emil F. Hubka, Jr., ARMD patient
This has become a true epidemic of our time.
--Jerry Chader, Ph.D., Chief Scientific Officer, The Foundation Fighting Blindness
"I thought I needed new glasses," Zelda Grant remembers. "I was shocked to discover that I have age-related macular degeneration. 'Macular what?' I said to my doctor. I had never heard of it before, and I could hardly believe that some disease I had never heard of was stealing my eyesight." Alarmingly, Zelda's experience is very common. Age-Related Macular Degeneration, or ARMD, is the leading cause of adult vision loss in the United States. It affects more people than all of the better known eye diseases combined: glaucoma, cataracts, and diabetic retinopathy. According to the respected Beaver Dam Eye Study--the most comprehensive attempt to estimate the demographics of macular degeneration in the United States--18 percent of seniors aged sixty-five to seventy-four and nearly 30 percent of seniors over seventy-five show early evidence of the condition. One out of every twenty-five Americans over sixty-five, or 1,367,000 people, suffers significant vision loss from advanced macular degeneration. Clearly, if y
ou have ARMD you are not alone.
What is Age-Related Macular Degeneration?
Macular degeneration dismantles central vision painlessly and silently, leaving peripheral vision intact. As a result, people with advanced macular degeneration do not feel any change in their eyes, and they do not appear any different to their friends and family, but their experience of the world and of their own capacities changes radically. Because macular degeneration leaves peripheral vision intact, people with ARMD can see whatever rests at the edges of their vision, but cannot see clearly whatever they look at directly. They find it difficult to recognize their grand-children's photographs, for example, but can describe the check pattern of a black and white tile floor. They cannot read a bus sign, but can see a leaf on the sidewalk out of the corners of their eyes. This combination of visual ability and vision loss is enormously frustrating, not the least because it takes away what we most want to see, leaving visible what appears to be irrelevant. As Carolyn See, an English professor, remarks dryly i
n her candid memoir of living with macular degeneration, "It begins in the center of your vision and after a while you can't read or drive or recognize your relatives. They say you'll always be able to pick up a thread on the carpet. But even with full vision, picking up threads on the carpet wasn't high on my list of activities."
Why Has Macular Degeneration Been a Big Secret?
Macular degeneration is coming out of the closet. Three years ago, patients came to appointments asking me to check their eyes for signs of glaucoma. Today they arrive asking about macular degeneration. But macular degeneration has been a leading cause of vision loss in seniors for decades. Why did it take us until the late 1990s to talk about it? No one is quite sure.
The first explanation may lie in the physiology of ARMD. Even though macular degeneration was first named by a German scientist in 1885, the technology used to understand it in detail was not developed until the 1960s. Unlike cataracts, which can easily be seen, or glaucoma, which can easily be measured, macular degeneration is more difficult to analyze and to treat. Ophthalmologists have tended to focus their energies on developing fine new surgeries that have helped improve the sight of hundreds of thousands of people with many different eye conditions. But macular degeneration never looked like a condition that would respond readily to surgery, so it wound up a bit lower on the research priority list.
A second explanation of why ARMD has not been talked about may lie in the category of people affected by it: seniors. Until about ten years ago, ARMD was called senile macular degeneration, which may be another clue to its anonymity. Although senile is a word we commonly associate with declining mental health, senile macular degeneration simply means macular degeneration in older people. But no matter how you define it, senile still connotes decline, and for much of this century declining vision was simply accepted as the result of "just growing old." But seniors like Zelda and Carolyn are now living longer and in better health than their parents and grandparents. Healthy longevity is on the rise: a sixty-five-year-old may have twenty to forty more years of reading, entertaining, traveling, and sports ahead of her; she may not even feel ready to retire. Seniors today are also less willing to accept adversity from aging as quietly as their parents and grandparents did. Zelda and her peers want to know, justifi
ably, why there is so little attention paid to macular degeneration, why their insurance companies don't cover visual aids or therapy for low vision, and when a cure will be developed. Vision loss is no longer an expected part of just growing old, nor should it be.
Macular Degeneration Gains Attention
Macular degeneration has become a major health issue, and more and more physicians, pharmaceutical companies, and laboratories are searching for cures and for a clearer understanding of what causes ARMD. But even with this new attention, the total amount of research dollars devoted to ARMD is still small considering that it is the biggest cause of irreversible vision loss in the country:more than cataracts, glaucoma, and diabetic retinopathy combined. The National Eye Institute (NEI), a division of the National Institutes of Health, has ranked ARMD its number one priority, but for the magnitude of the problem a relatively small percentage of the national health budget is devoted specifically to ARMD research. Unless we speak up, this situation is unlikely to change, and prevention and cure will be that many more years away.
Many seniors depend on the American Association of Retired Persons (AARP) to lobby Washington on their behalf, but the AARP follows a policy of not addressing any one disease. That means there is no major voice in Washington telling Congress that macular degeneration research is important to Americans. Write your representatives in Congress and ask them to support the NEI and promote additional funding for macular degeneration research. Fortunately, ARMD has been in the news enough that they should understand the urgency of your request.
Newsweek, Time, Prevention, US News and World Report, The New York Times, and CNN have all reported on new studies since early 1996. News reports, however, are not always entirely complete. While celebrating and encouraging scientific breakthroughs, the media have a tendency to trumpet results prematurely. Experimental treatments and special curative diets are sometimes presented as if their success has already been confirmed. The hopes of many combined with the relative lack of public information on the topic (at least until 1999) give these news reports great weight. Patients often call to ask about new cures and requesting treatments that haven't really been proven effective or safe. The truth is that macular degeneration is complicated; there is no easy answer. Chapter 2, "ARMD Treatments and Medical Research," and Chapter 3, "Genes and Greens: The Causes and Prevention of ARMD," accurately explain the latest information on research, treatment, and prevention. It is important to understand what we really
do and do not know, and it's also important to keep faith in the future since it will hold new solutions.
Macular Degeneration Isn't Just About Your Eyes
Unfortunately, few authorities...
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