Friday, January 30, 2015


February is national "AMD/Low Vision Awareness Month"

In honor of the month, we are encouraging readers to submit their questions and MHVLVN's Dr.James Cayea, Low Vision Specialist, will answer them!  Just reply to this post with your questions.  We will also be posting other related topics through the month of February.

Here are some that have already been submitted with their corresponding answers. (Thank you Dr. Cayea!)

Question:  I was told I have the beginning of macular degeneration. What is a macula and where is it in my eye?

Answer:  The retina is the light sensing tissue lining the back of the eye.  The center of the retina is a region called the macula. This is where the cells we see with are packed very tightly together. As a result the resolution and detail are very high in the macula. That is the part of the retina we use for seeing faces and signs at a distance, for reading and watching TV.  The rest of the retina is responsible for our peripheral or side vision.  Macular degeneration only affects this central area making your straight-ahead vision poor while the side vision is not affected.  In mild cases the central vision may become blurred or distorted.  In advanced cases there may be no central vision at all, just a large blind spot in the middle of whatever you are looking at.  

Question:  I have macular degeneration and blurred vision.  My doctor said she can't change my glasses. Why can't she just make them stronger?

Answer:  I hear this question all the time. The macula is the very sensitive center of the retina. The eye works like a camera.  The retina is like the film in a camera. In macular degeneration the "film" in the camera is damaged.  Glasses focus the eye like focusing a camera.  But if there is bad film in the camera no amount of focusing will give a clear picture.  If glasses are too weak the picture will be blurry and if the glasses are too strong the picture will be blurry - just like a camera that is under or over focused. Unfortunately, we do not know how to change the "film " in the camera. In other words we do not know how to do a retinal transplant and put a new retina into the eye.

Stronger glasses can sometimes help when reading by magnifying the print. When using glasses like this you may have to hold the book or newspaper very close - sometimes as close as 3 or 4 inches from your eyes.  For distance or far-away vision some people find help with telescopic glasses.  These work like small binoculars making the object you're looking at appear larger and closer than normal. A low vision doctor can assess whether these types of glasses would be of benefit for you.

Question:  My sister and I both have macular degeneration.  She can still read with special high power reading glasses but I can only see some letters and an occasional word.  If we both have the same condition why is our vision so different?

Answer:  The degeneration causes small spots on the retina to slowly die creating blind spots.  The size and location of the blind spots makes vision different from one individual to another even though you have the same disease. It may even make the vision different  from one eye to the other. A friend of mine always says " Eyes are like children.  No two are the same."

Larger blind spots hide more of the letters and words.  Because we read from left to right, spots on the right side make it hard to see what is coming next. We normally subconsciously anticipate what word is coming next. When we can't see what is hidden in the blind spot it starts to slow us down  and reading  by piecing words together. This make us read like a first grader with a lot of hesitation or not at all. As time goes by the blind spots get larger and more numerous making it harder and harder to read.  Sometimes special magnifying glasses and electronic magnifiers can help.  They make the print bigger than the blind spots so the letters don't disappear in the holes.  There are many different strengths to these magnifiers and your low vision doctor will try to find what power might work for you. There are much stronger magnifiers than the ones people often buy over the counter in the stores. The electronic closed circuit television magnifiers are the strongest.  

Dr.Cayea received his Bachelor's Degree from St. Bonaventure University and his Doctor of Optometry from the Pennsylvania College of Optometry. He did post grduate work at The Gisell Institute of Child Development and has certification as a low vision specialist. Dr. Cayea is a consultant for the Lighthouse, Inc. and the Commission for the Blind and Visually Handicapped. He has been in private practice since 1977 in the Hudson Valley.
For information about Dutchess Optometry, go to