The macula is found at the center of the retina where the incoming rays of light are focused. The macula is very important, being responsible for what we see straight in front of us, the vision needed for detailed activities such as reading and writing, recognizing faces, fine work, and our ability to appreciate color.

Macular Degeneration is a condition whereby the delicate cells of the macula become damaged and stop working. We do not know why this is, although it tends to happen as people get older. Vision loss usually occurs gradually and typically affects both eyes at different rates. Causes & Development

• For many people the visual cells simply cease to function, like the colors fading in an old photograph - this is known as 'dry' degeneration. 70% of patients have this "dry" form, which involves thinning of the macular tissues and disturbances in its pigmentation.
• The other 30% have the "wet" form, which can involve bleeding within and beneath the retina, opaque deposits, and eventually scar tissue. The "wet" form accounts for 90% of all cases of legal blindness amongst macular degeneration patients. The dry form will often begin to convert to wet, with the appearance of abnormal choroidal blood vessels - angiogenesis. The reason why angiogenesis occurs is unknown but it is believed that this additional blood vessel development is somehow caused by deposits being left in the back of the eye. These deposits are similar to age spots on the skin. These new blood vessels are fragile and have a propensity to leak and bleed, eventually forming scar tissue and resulting in irreversible vision loss.
• Different forms of macular degeneration may occur in younger patients. These non-age-related cases may be linked to heredity, diabetes, nutritional deficits, head injury, infection, or other factors.
• Inherited macular degeneration, which appears in some families but not in others, is known as macular dystrophy. Since macular degeneration affects most patients later in life, it is difficult to study successive generations in a family. Recent studies of twins indicate that both genetic and non-genetic factors play important roles in age-related macular degeneration. If several members of a family are sufferers then it is very important that other members have their eyes checked regularly.
• It has been demonstrated that the blue rays of the light spectrum seem to accelerate macular degeneration more than the others. This means that very bright light, such as sunlight or its reflection in the ocean and desert, may worsen macular degeneration. Special sunglasses that block out the blue end of the spectrum may decrease the progress of the disease.
• Hypertension tends to make some forms of macular degeneration worse, particularly in the "wet" form where the retinal tissues are invaded by new blood vessels. The medications used to treat hypertension have not been shown to have any direct effect on macular degeneration, but they may slow progression of the disease by reducing hypertension.
• Any type of smoking or exposure to tobacco smoke can accelerate the development of the "wet" type of macular degeneration.

• Nutritional Intervention.
• Surgery. Laser surgery to remove the scar produced by macular degeneration has been successful in about 10% of people with disciform degeneration, mainly the younger patients. If the degeneration is associated with leaking blood vessels in the center of the macula and vision is worse than 20/70 then laser surgery called photocoagulation is recommended. This will not improve vision but generally reduces further vision loss. Unfortunately for most people, the area of degeneration is in the middle of the macula, at its focal point. This means that treatment cannot be given because the scars produced by the laser would make central vision worse rather than better. 'Dry' degeneration cannot be treated by laser.
  
  Retinal transplantation is a new experimental approach to macular degeneration, but will require research to determine its safety and effectiveness.
• Making the most of remaining vision. Low vision aids (such as brighter reading lights, magnifying glasses and more sophisticated devices) and techniques for maximizing the use of peripheral vision are used to help patients adapt better to their loss of central vision.

• The major risk factors: aging, atherosclerosis and hypertension.
• Straight lines appear distorted and, in some cases, the center of vision appears more distorted than the rest of the scene.
• A dark, blurry area or "white-out" appears in the center of vision.
• Color perception changes or diminishes.