Routine eye examinations for macular degeneration in patients without symptoms are probably not necessary.
Unlike conditions such as diabetic retinopathy, where the disease is likely to occur yet still be asymptomatic, macular degeneration is not “silent” and does have associated symptoms.
Once diagnosed with macular degeneration; however, routine examinations are important.
Family History Does Not Matter
While it is true that patients of northern European descent have a greater chance of developing the eye degeneration, brothers and sisters and children of patients with the disease are not necessarily at any higher risk.
For example, if I contract the disease, my twin brother is not necessarily going to get the disease.
Vision Must “Degenerate”
The most common symptoms of macular degeneration are decreased vision (e.g. blurry vision) and/or the development of distortion. Both signify a change in vision.
Without a change in vision, that is, if your vision remains 20/20 it is unlikely you have ARMD.
Signs vs. Symptoms of ARMD
Signs of a disease are those things we, as doctors, see or find during an examination. If you have no signs of macular degeneration, you do not have it.
For instance, drusen and pigment changes in the retina are common signs, or findings, of dry macular degeneration. Fluid, edema and blood are common findings of wet ARMD.
Pigment changes, fluid and blood may cause blurry and distorted vision….symptoms (subjective, what the patient experiences) of macular degeneration.
Often, patients are diagnosed with drusen. Drusen alone, especially without loss of vision, do not make the diagnosis of macular degeneration.
Advancing Age and Macular Degeneration
The National Eye Institute has a nice review of macular degeneration. The incidence of developing macular degeneration does increase with age. This means the chance of getting the disease does increase with age, but not without signs and symptoms.
What Does This Mean?
In short, unlike diabetic retinopathy, a disease that may develop without symptoms, you can safely monitor yourself for any symptoms of the ARMD, regardless of ethnicity, age or family history.
If you develop symptoms of decreased vision or if you develop decreased vision you should get an eye exam. Often, patients are directed to test themselves with an Amsler Grid. This is a simple way to monitor changes in your vision.
If you have signs of the disease, for example, drusen and changes in the retina, you might ask your doctor about getting examinations on a routine basis. This will be more important in the future if/when we discover changes in our diet or behavior (i.e. quitting smoking) alter the course of developing the disease.
If you have neither symptoms nor findings, you most likely require exams periodically as directed by your doc.