Age changes in the yellow spots cause you to get worse visual acuity. The changes can go fast or take a long time. The age changes can be dry or wet. Only the wet form can be treated.

What are the age changes in the yellow spot?

The yellow spot is an area in the middle of the retina of the eye. There the vision is as sharp as possible. An age change in the yellow stain makes the vision worse at close range. You will find it difficult to see details while the field of view is not affected. Often, the eyesight on one eye becomes worse first. Later, the vision becomes worse on the other eye as well. 

There are two types of changes, dry and wet.

Dry changes

Dry changes are the most common form of the disease. Nine out of ten who get age changes in the yellow spot get dry changes. Then the visual cells in the yellow spots are gradually broken down and the vision deteriorates slowly.

Wet changes

Wet changes are far more uncommon than dry changes, but come faster. Vision can deteriorate quickly, within a few weeks to a month. Wet changes are due to the formation of new blood vessels beneath the yellow spot. The new blood vessels are often very brittle and leak blood and fluid under the yellow spots. Then the yellow stain swells and affects the visual cells so that they work worse. Since the visual cells damage the fluid, you need treatment as soon as possible.

Symptoms of dry and wet changes

The symptoms you get depend on what kind of change you have.

Dry changes

For dry-age changes in the yellow spot, it is common to have one or more of the following symptoms:

  • Your visual acuity is slowly getting worse.
  • You see small blurred spots in the middle of the field of view.
  • Everything looks gray and blurred.
  • Letters or parts of letters fall away as you read.
  • You will find it difficult to recognize faces.
  • You will find it difficult to judge the distance if one eye has vision changes.

Sometimes the visual acuity can disappear completely in the middle of the field of vision and be replaced by a blurred, dark spot. But then the changes have often been going on for a long time.

It is common that you do not notice the vision changes if the age changes in the yellow spot are only in one eye. Sometimes it may take years before you notice anything. After a while, the other eye may also change in age. It is often only when you notice the visual changes.

Wet changes

The most common symptom of wet age changes is so-called crashing. Then you see straight lines as crooked. Even the faces may look distorted.

Unlike dry changes, wet changes make the vision change quickly, sometimes in just a few weeks.

Wet changes can cause the vision in the central field of vision to disappear and you instead see a blurred spot.

When and where should I seek care?

Contact a health care provider or optician if you experience that your eyesight has slowly deteriorated.

If you experience any of the following, contact a health care center or eye reception as soon as possible:

  • Your vision deteriorates quickly.
  • You feel that straight objects are suddenly crooked or oblique. 

You do not need to seek care elsewhere if it is closed. Wait until the medical center or eye reception opens.

It is important to seek care as soon as your vision deteriorates rapidly. Early treatment can often slow down vision changes and sometimes vision can be better.

Investigation

To find out if you have a change in an age in the yellow spot, the ophthalmologist does an eye examination.

These are some of the most common exams the doctor can do:

  • Eye exam.
  • Reading vision examination.
  • Eye microscope examination.
  • OCT examination.
  • Contrast photography also called fluorescence angiography.

Vision Screening

During a visual examination, you get to look at a blackboard with letters of different sizes. The smaller the letters you can read, the better the visual acuity. By measuring your visual acuity, your doctor can determine how vision has been affected by the disease. 

Reading vision examination

When examining your reading vision, you get to read a text about forty centimeters away. You can use reading glasses if you need to. Problems with reading up close are very common for people with age changes in yellow spots.   

You get eye drops that dilate the pupils

Before an examination of the retina, you receive eye drops that dilate the pupil so that the doctor can see the retina and yellow spots in the microscope. This applies to eye microscope examination, OCT examination, and fluorescence angiography.

Eye microscope examination

An eye microscope is an apparatus consisting of a magnifier and a lamp.

The eye microscope stands on a height-adjustable table. You sit on one side of the table with your chin and forehead against support so that your head is completely still for the duration of the examination. On the other side of the microscope, the doctor sits and examines the eye with the help of magnifying lenses. A lamp shines on the eye.

You may be dazzled by the lamp that is directed at the eye, but it usually does not hurt. The survey takes one to two minutes.

OCT examination

An OCT examination is a form of eye photography. Then pictures are taken on the retina and yellow spot through the pupil. The images from an OCT examination show yellow spots with a cross-section of the retina.

You may do an OCT angiography if the ophthalmologist suspects that new blood vessels have formed under the yellow spot. The doctor then sees how the blood circulation in the retina works and can detect the newly formed vessels. The survey takes one to two minutes.

Fluorescence Angiography

Fluorescence angiography examines the retina and blood vessels in the eye. It is also a type of bottom photography. First, you get a syringe with a dye in the blood through a vein in the arms fold and immediately thereafter pictures are taken through the pupil. The color makes the blood vessels in the retina and the retina visible.

You may be dazzled by the flashes from the camera but the investigation usually does not hurt. The survey takes twenty to thirty minutes. 

After the investigation

Your pupils will continue to dilate for a few hours after the examination. During that time you will look a little blurry and you should not drive.

You can also be dazzled by bright light and it can, therefore, be good to wear sunglasses.

Read more about how different eye exams are done.

Treatment of macular degeneration

There is no effective treatment for dry age changes. But it is being researched in the field.

Pre-stage to wet age changes

Sometimes wet age changes have a precursor, so-called drusen. The drusen is age-related deposits in the yellow spot that the doctor can see in an eye examination.

Sometimes your doctor can advise you to take extra vitamins and minerals if you have a lot of drunkness, as it can have a curbing effect on the risk of developing wet age changes. The vitamins are not a drug and are not available on prescription. You can buy them yourself at a pharmacy or in a health food store.

There is no scientific evidence that vitamins have any positive effects on the yellow stain if you do not have drusen.

Treatment for wet changes

Wet changes are treated with drugs in the eye. The drugs slow down the formation of blood vessels beneath the yellow spots and prevent them from leaking as much fluid.

The treatment does not cure the disease but slows it down. Often you need to receive the treatment several times. You also need to have regular eye exams at the ophthalmologist.

You often look better after treatment.

Then the treatment goes on

First, you get eye drops that stun and cleanse your eye. Then the skin is washed around the eye with bactericidal drugs to reduce the risk of infections. Thereafter, the drug is injected into the vitreous of the eye using a thin needle. Since you are stunned, it usually does not hurt. The treatment takes a few minutes.

You are often given the treatment of yellow spots once a month for three months. Usually, several treatments are needed. It varies from person to person.

Side effects

You may get side effects from the injection in the eye. For example, it could be any of these:

  • It becomes an irritation to the eye.
  • It can drain tears from the eye.
  • The eye is extra sensitive to light
  • It may feel like it is rubbing in the eyes.

These side effects go away within a day.

Sometimes there may be air in the syringe and you will see a black ring at the bottom that slowly shrinks and disappears within a few days. You may also have blood precipitation on the eye white, a type of bruise, which disappears within one to two weeks.

After the treatment

You may undergo regular eye exams after receiving treatment for age changes.

You can control your eyesight yourself. You do this by keeping one eye at a time.

Contact an eye clinic if you notice that your vision is getting worse, or if you are beginning to have a crashing eye, or if you have a crashing eye but it has gotten worse. 

What happens in the body?

The yellow spot is an area in the middle of the retina of the eye. The retina contains photosensitive visual cells called rods and pins. The rods are the most sensitive to light and allow you to see in the dark. The pins allow you to see colors and details. The tighter the pins are, the sharper the vision. Most of the pins are in yellow spots and you see that as sharpest. The rods and pins have contact with nerve cells that are also located in the retina. The long projections of the nerve cells together form the optic nerve, which in turn conducts electrical signals from the optic cells to the brain.

In the event of an age change in the yellow spot, you may find it difficult to see sharply up close. Often the eyesight on one eye becomes worse first, later on the other eye also becomes worse.

Age changes in yellow spots are also called macular degeneration or AMD, age-related macular degeneration.

The risk increases the older you get

It is not clear why you get age changes in the yellow spot, but the risk of getting the disease increases the older you get. Most people who get the disease are older than 65 years. You may get the disease sooner than that but it is unusual.

There are a few other factors that also increase the risk of age changes in the yellow spot:

  • You have one or more relatives who have the disease.
  • You smoke .
  • You have  elevated cholesterol levels .

There are many benefits to quitting smoking. Here you can read more about how you can do it.

Living with age change in the yellow spot

It may feel difficult to get the message that you have age changes in the yellow spot because it is a disease that can affect everyday life. Talk to your ophthalmologist if there is anything you wonder about.

You may find it difficult to read newspapers

You will not be completely blinded by the disease, but you may have reduced vision which makes it difficult for you to read newspapers, watch TV or go by public transport. It is usually easier to manage in environments that you recognize.

Most often, you can continue to live an active life despite the disease. This is especially true if the eyesight is only worse on one eye. You can try increasing the size of the text on screens or using sunglasses if you are easily dazzled. 

There is a risk that vision becomes so impaired that you no longer meet the requirements of the law to drive a car. Your ophthalmologist will then inform you about this.

You can get tools that make your everyday life easier

You get a referral from your ophthalmologist to a vision center if the disease makes you look very bad. There are opticians, vision educators, and curators who can help you with the problems you have. For example, you can get help with trying out reading glasses, magnifying glasses or other electronic magnification systems. You can also get help with, for example, adjusting the lighting in the home.

Here you can read about how it is possible to get visual aids and find out which ones are available where you live.

It may feel good to talk to others in a similar situation

Having impaired vision means that you do well in some situations but do worse in other situations. It can be difficult for the environment to understand. For some, it may feel good to talk to others who have impaired vision for advice and support.

Ehtisham Nadeem

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