Henry Greene: Macular degeneration is a disorder that affects our central vision. There are a number of different diagnoses, macular degeneration, age related macular degeneration, dry, wet, Stargardt’s Disease, albinism, macular holes. There are a host of different disorders that can affect central vision. Our central or macular vision is responsible for letting us read detail, to see small print, to recognize faces. There are actually 2 different parts to the functional aspect of the retina; the macular area for detail and the peripheral retina that’s responsible for motion detection. Matter of fact, we can all relate to seeing a fly in our side vision and then turning our head to look at it. So the peripheral retina is responsible for where things are, and the central retina is responsible for what things are. The central macula is responsible for working in bright light, and the peripheral retina works in low light. When we have macular degeneration, rarely if ever is the peripheral retina involved. So folks with macular degeneration or other central vision disorders need not worry about going completely blind. It’s rare that we have individuals that can’t function adequately despite their macular degeneration.
Frequently I have patients that ask me, why can’t you just change my glasses so that I can see better with my macular degeneration? And a convenient explanation as to why that doesn’t help is to imagine going to a movie theater where the screen is nice and clear and you can see the actors perfectly well and then having someone paint a splotch of black paint in the middle of the screen. Changing the focus won’t get rid of that black splotch in the middle of the screen, but let’s say we blow the actors face up twice as large or three times as large. So now the black splotch only covers their cheek or their eye or their nose, so you’ll see a lot more of their face, and that’s what happens with macular degeneration. We have to make things large enough so you can see them. Changing the focus doesn’t make any difference.