Macular Screening Clinic
Peter and Craig have been at the forefront of Macular Screening since setting up the UK’s first nationwide macular screening service in 2007/08. We have continued our work in this area since, being actively involved in research and development of new screening techniques and protocols, lecturing on the subject throughout the UK and Europe, published articles on the screening techniques and teaching the subject to Glasgow Caledonian’s 4th year undergraduate students.
What is Macular Degeneration?
Age-related Macular Degeneration (AMD) is the leading cause of blindness in the developed western world. Approximately 1 in 3 people of the age of 75 will suffer from mild AMD. It can be split into two main types: dry AMD and wet AMD, both of which affect the macula – the most sensitive area of the retina at the back of your eye. The macula is responsible for detailed vision, the ability to read, recognise faces and colour vision etc. Damage to the macula will affect the central vision only, meaning someone with AMD may have perfect peripheral vision, seeing everything well except the very thing they are looking directly at.
What causes Macular Degeneration?
The exact cause of AMD is as yet unknown, however both genetic and environmental factors play their part. The general consensus at present is that it is a disease of increasing age meaning our risk increases as we grow older; this is particular important in the over 60’s. A positive family history of AMD may also increase your risk, meaning individuals with a parent or sibling with a positive history should be particularly careful. These are unfortunately unmodifiable risk factors. The most important modifiable risk factor is smoking. Smokers are significantly more likely to develop AMD in their lifetime with some studies stating it may double the risk, while others suggesting smokers may be 8 times as likely to developed macular disease.
Other risk factors which have been linked to AMD development are:
- Light iris colour (blue eyes)
- Ethnicity – White northern European Caucasians are more at risk
- Hypertension (high blood pressure)
- Hypercholesterolemia (high cholesterol)
- Low Macular Protective Pigment Density levels
- Low levels of antioxidants
- Excessive exposure to UV light
- Excessive exposure to high energy visible blue light
- Damage by free radicals within the eye as a result of oxidative stress
What can I do to reduce my risks?
Some of the risks listed above are non-modifiable risk factors such as age, genetics, female gender, race and light colour iris. However, the remainder are modifiable risk factors which with lifestyle changes can reduce ones risk of developing AMD. Simple advice like quitting smoking could significantly improve the likelihood of long-term healthy vision.
What is involved in macular screening?
Our macular screening service involves a detailed comprehensive examination of the macula using our state-of-the-art, cutting edge diagnostic equipment and monitoring software. High definition retinal photographs will be taken of the macula for future comparisons in their appearance using the Zeiss Visucam 200.
A series of high definition 3D images will be produced using our Zeiss Cirrus 3D HD-OCT utilising optical coherence tomography (OCT), which allows highly accurate measurements to be taken of the macula. These measurements can be used to diagnose incredibly small and subtle changes in the macula over time. The images produced by the OCT can also be used to diagnose the earliest signs of AMD, but also to accurately distinguish between dry and wet AMD, which is crucial for quick and efficient treatment of wet AMD.
We will also measure, baseline and monitor Macular Protective Pigment Density (MPPD) levels within the macula. Macular Pigment (MP) cannot be made by our bodies but must instead be ingested through our diets. MP is comprised of 3 hydroxycarotenoids: Lutein, Zeaxanthin and Meso-Zeaxanthin which can be found most commonly in fruits and vegetables such as spinach and kale. Unfortunately in our western diets we often do not consume enough of these foods to build a dense layer of MP. MP acts as a protective barrier for our maculae; like a pair of natural sunglasses, without a dense layer of MP we are left more exposed to long-term damage which can lead to AMD. We aim to establish whether you have enough MP or whether changes to your diet may be required to increase MP levels. In some cases where the MP levels are particularly low we may advise the use of a dietary supplement rich in MP to boost levels. Products such as Macushield, Ocuvite Complete or I- Caps can be beneficial in some cases.
We will offer personalised advice based on your family history, risk factors and macular health and ensure you are given all the information and tools to ensure long-term macular health. For patients already diagnosed with AMD we have a Low Vision Clinic which aims to maximise your remaining vision. We can also give advice and refer you to a number of other disciplines to ensure you have everything you need at home and work to live a normal
Macular screening is free to all members of our Eye Care for Life programmes. All new patients to our practice are screened free-of-charge during their first examination at our practice. Advice regarding follow-up examinations will be made on an individual basis. For more information on macular screening please free to contact us on 0141 943 3300
To download our Top 10 Tips for a Healthy Macula – click here
To download our Lutein and Zeaxanthin Content in foods – click here