Will Macular Degeneration in Both Eyes Lead to Further Vision Loss?

Will the vision continue to deteriorate with macular degeneration in both eyes?

Hello Dr.
Hu, I underwent bilateral cataract surgery in May 2003.
Due to high myopia, I developed wet macular degeneration with hemorrhage in my left eye in September 2004, which was treated with laser therapy.
In February 2005, the same eye experienced retinal detachment, and after surgery, my vision was approximately 0.3.
In July 2008, my right eye's vision rapidly deteriorated, and upon examination, it was also diagnosed with wet macular degeneration with hemorrhage.
Between August 2008 and January 2009, I received three injections of medication, but the effects lasted only about one and a half to two months each time.
Initially, in March 2008, the hemorrhage had stopped and scar tissue formed, but in May of the same year, the doctor informed me that the scarred area had bled again, which was ultimately treated with photodynamic therapy.
Since then, there has been no further bleeding.
I would like to know if the damaged photoreceptor cells can regenerate over time.
Is there a chance for my central vision to recover? If recovery is not possible, can I maintain my current level of vision, or will it continue to deteriorate? Is there a possibility of future bleeding episodes? Currently, my left eye vision is only 0.1, and after correction, my right eye can see 60 characters, but why do I experience blurriness and difficulty focusing on near objects while wearing glasses? I have to remove my glasses to read documents or see the computer screen clearly.
Can I apply for a disability certificate due to the vision impairment caused by macular degeneration?

t.u, 30~39 year old female. Ask Date: 2010/02/23

Dr. Hu Yusheng reply Ophthalmology

In response to your inquiry regarding high myopia in both eyes, post-cataract surgery in both eyes, retinal detachment surgery in the left eye, and wet age-related macular degeneration in the right eye, which has been treated with intravitreal injections and photodynamic therapy: If your vision has been stable for over a year post-surgery, the risk of photoreceptor degeneration is unlikely to increase.
However, high myopia may still lead to a decline in vision, and there remains a small chance of recurrent bleeding.
The issue of blurred vision while wearing glasses may be due to the difference in visual acuity between the two eyes; you may notice clearer vision when viewing with one eye after removing your glasses.
Vision impairment, regardless of the cause, can be assessed for disability certification based on visual acuity or visual field standards.
Thank you for your question, and I wish you good health and safety.

Reply Date: 2010/02/23

More Info

Macular degeneration, particularly in the context of your history with high myopia and previous ocular surgeries, can indeed lead to further vision loss if not properly managed. Given your detailed medical history, including the occurrence of wet macular degeneration and retinal detachment, it is crucial to understand the implications of these conditions on your vision.

1. Will Macular Degeneration Lead to Further Vision Loss?
Yes, macular degeneration can lead to further vision loss, especially if it is of the wet type, which is characterized by the growth of abnormal blood vessels under the retina that can leak fluid or blood. This can cause rapid and severe vision loss. The fact that you have experienced episodes of bleeding and have undergone multiple treatments indicates that your condition is serious and requires ongoing monitoring. While some patients may stabilize after treatment, others may continue to experience deterioration in their vision.

2. Will Damaged Photoreceptors Regenerate?
Unfortunately, once photoreceptor cells in the retina are damaged, they do not regenerate. The potential for recovery of central vision largely depends on the extent of the damage and the effectiveness of the treatments you have received. In some cases, if the underlying cause of the degeneration is managed effectively, there may be a chance to preserve existing vision, but significant recovery of lost vision is unlikely.

3. Can You Maintain Current Vision or Will It Continue to Deteriorate?
Maintaining your current level of vision is possible, especially with regular follow-ups and appropriate treatments. However, there is always a risk of further deterioration, particularly if new bleeding occurs or if the condition progresses. It is essential to adhere to your ophthalmologist's recommendations and attend regular check-ups to monitor any changes in your condition.

4. Will There Be Future Episodes of Bleeding?
The risk of future bleeding episodes can vary based on individual factors, including the severity of your macular degeneration and how well it is managed. While treatments like anti-VEGF injections can help control the growth of abnormal blood vessels, there is still a possibility of recurrence. Your ophthalmologist will be the best person to assess your risk based on your specific situation.

5. Why Is There Blurriness When Wearing Glasses?
The blurriness you experience when wearing glasses for near tasks could be due to several factors. It may be related to the difference in vision between your two eyes, the degree of your refractive error, or even the quality of the lenses in your glasses. If your left eye has significantly poorer vision, your brain may struggle to fuse the images from both eyes, leading to difficulty focusing on near objects. It may be beneficial to have your prescription re-evaluated to ensure that it meets your current visual needs.

6. Can You Apply for a Disability Certificate?
In many jurisdictions, individuals with significant vision impairment due to conditions like macular degeneration may qualify for disability benefits. The criteria can vary, but typically, it involves demonstrating that your vision loss severely impacts your daily activities. It would be advisable to consult with a healthcare provider or a legal expert familiar with disability claims in your area to understand the process and requirements.

In summary, while macular degeneration poses a risk for further vision loss, proactive management and regular monitoring can help maintain your current vision. It is crucial to stay in close contact with your ophthalmologist and report any changes in your vision promptly.

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