DEAR DR. DONOHUE: I have read about macular degeneration many times. Always, it’s about dry macular degeneration. I have the wet kind, and I would like to see something printed about it. How about letting the public know there are two different kinds of macular degeneration? Is there anything new for treating the wet kind? – W.I.

ANSWER:
The retina is the backmost layer of the eye. Here, incoming light produces an image that’s transmitted to the brain – it’s the brain that actually sees. In the center of the retina is a small spot that’s 0.12 inches by 0.2 inches (3 mm by 5 mm) – the macula. It’s the area, small as it is, that’s responsible for the kind of vision that’s most sensitive and most important for such tasks as reading, driving and recognizing faces. When the cells of the macula deteriorate – macular degeneration – fine sight and central vision disappear. Off-to-the-side vision, or peripheral vision, remains intact.

As you say, there are two kinds of macular degeneration: wet and dry. Both have similar vision loss. Dry is the more common variety, accounting for 85 percent to 90 percent of cases. In wet macular degeneration, tiny, fragile blood vessels sprout under the macula. They leak fluid and blood, hence the name “wet.” Wet macular degeneration can progress more rapidly than the dry kind, and it is responsible for the greatest degree of vision loss.

Treatment for wet macular degeneration centers on eliminating the newly formed, delicate blood vessels so they stop oozing fluid. That can be done with lasers and with drugs that sensitize those blood vessels to a special kind of light that dries them.

There is a new treatment for wet macular degeneration. It’s the drug Lucentis (ranibizumab). An eye doctor injects it into the eye. It stops the growth of new blood vessels. It’s been shown to maintain vision for 90 percent of patients for a full year, and some have even noted improved vision with it.

The booklet on macular degeneration discusses this common condition. The discussion is mainly devoted to dry macular degeneration. People can obtain a copy by writing: Dr. Donohue – No. 701, Box 526475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I think I’m anemic. I’m tired all the time. Years ago, I remember an iron tonic being advertised for “tired” blood. Would it help me to take an iron tonic? – B.K.

ANSWER:
It would help if you need it.

Tiredness is one of the most common complaints a doctor hears, and its possible causes are so many that I can’t begin to list them. Anemia is only one. Furthermore, the causes of anemia are almost equally as numerous. Iron isn’t the treatment for all of them.

Have your doctor diagnose the cause of your tiredness.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com


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