Drusen: An eye condition in which the yellow concretions form in the macula, a sensitive area in the middle of the retina responsible for central and detail vision. Drusen indicate damage has occurred to the layers directly underneath the thin retina, including Bruch's Membrane and the retinal pigment epithelium. Often, the retina directly over the drusen is also damaged, often causing loss of central vision.
The "Dry" Form" of macular degeneration may have "hard" also called hyaline drusen, or "soft" drusen with unclear edges. The drusen may be distinct and separate or coalescent, in which the borders are joined. Drusen usually progress slowly but may cause central vision loss.
Drusen may cause enough damage to Bruch's membrane that abnormal blood vessels break through, causing the "Wet" Form of Macular Degeneration, which is rarer, and more severe. If this occurrs, it may progress rapidly causing significant central vision loss
WHO GETS IT: Drusen are most common in people over 60, but can appear as early as age 40. Drusen and macular degeneration is the most common cause of severe vision loss among people over 65, and, as life expectancy increases, the disease is becoming an increasingly significant problem.
CAUSES: There is no conclusive proof as to what causes it, however, some scientists believe heredity may play a part, as may ultraviolet light exposure and malnutrition.
PREVENTION: Although there is no hard evidence as to how to prevent the disease, several steps may be beneficial:
- Regular eye exams by your eye care professional. Your Eye Care Professional (ophthalmologist or optometrist) is specially trained to detect many vision-threatening conditions even before you develop symptoms. As with any medical condition, the earlier the problems are detected, the better chance of preventing vision loss.
- Protection from Ultraviolet-A and B rays. Some studies have suggested that prolonged or frequent exposure to UV-A and UV-B rays may be a factor in causing Drusen and other eye conditions. Therefore, it is recommended by many eye doctors that you always wear your sunglasses that block 99% to 100% of ultraviolet rays when outdoors.
- Proper nutrition. Although there is no concrete evidence that nutrition plays a role in Drusen, a healthy diet helps the body as a whole and can prevent many other health problems. Some Eye Care Professionals may recommend vitamins or minerals to supplement your diet.
TREATMENT: There is usually no treatment for the "dry" form of macular degeneration with drusen, but low vision rehabilitation can help those with significant vision loss to maintain an excellent quality of life. Laser surgery has now been supplanted with intraocular injections of medications for the "wet" form, and low vision rehabilitation can help those with vision loss.
CURRENT RESEARCH: There is a great deal of research and several major scientific studies being conducted to find the causes and develop effective treatments for all types of Drusen. Visit the National Eye Institute Web site
for additional information.
NEW DEVELOPMENTS: Intraocular injections of chemicals that block Endothelial Growth Factor for the "wet" type. It involves the injection of a drug (Avastin, Lucentis, or Eyelea) into the vitreous cavity. These injections often have to be repeated at monthly or bimonthly intervals to have continued benefit. The procedure is normally performed in the Eye Doctor's' office.
UNPROVEN TREATMENTS: Be wary of any treatment that promises to restore vision, or cure or prevent this disease. There are so many so-called "miracle cures" advertised (often in magazines or on the Internet) that have not been adequately tested for safety or efficacy. These treatments may be expensive and are generally not covered by insurance. If you are considering trying a new or untested treatment, make sure you talk to your Eye Doctor to ensure they are safe and won't interfere with the timely and effective treatment of any eye problems.
LOW VISION REHABILITATION: This can help people who have experienced mile to severe vision loss adjust to their condition and continue to enjoy active and independent lifestyles. Rehabilitation may involve anything from adjusting the lighting in your home to learning to use low vision aids to help you read and perform daily tasks. Your Eye Doctor can arrange rehabilitation or refer you to organizations that can help.
SUPPORT: Adjusting to vision loss can be difficult at first. Your Eye Doctor may be able to recommend some support groups for people with low vision. You can support friends and family by encouraging them in their rehabilitation efforts and providing help (such as rides to appointments) when needed.RESOURCES: Your Eye Doctor is your best source for any eye care question or need. An ophthalmologist is a medical doctor specially trained to provide the full range of eye care, from eye exams and prescribing glasses and contacts to complex surgery for eye problems.