hello everyone and thank you so much for joining us tonight for this educational webinar uh my name is Michael York and I will be your moderator for this evening um if at any point we like to make this interactive if you do happen to have questions please go ahead and utilize the question and answer function down below or you can use the chat whichever one you prefer you can go ahead and utilize those throughout tonight's webinar we'll take some questions during in the middle and we'll take some
questions at the end as well um but we're so glad that you're able to join us tonight tonight's webinar is on age related macular degeneration ormd uh and it will be presented by our very own Dr Sonia D Dr duut is a medical and surgical retina specialist with Harvard ey associat so obviously has an extensive knowledge on tonight's topic um first a little bit about Dr du she attended uh the renier polych Technic Institute in Albi Medical College for an accelerated undergrad and medical school pr
ogram after which Dr du then completed her residency uh in two years of vitrio retinal surgery fellowship at the University of Missouri so we we are so glad to have Dr du not only with us tonight um but as a huge part of the Farva ey family um and so without further Ado I will pass things along to Dr Duke thank you Michael and thank you all for joining us this evening um we used to do these webinars in person and so it feels a little bit in um just informal and um impersonal I guess I should say
doing it on zoom and so um please feel free to ask questions we really want to make this a learning experience for all of you whether it's you or your family member or loved one that's has macular degeneration we want this to be an educational experience for you um so please feel free to um interrupt Michael will interrupt me with questions and we'll have stop to take some questions at the very end as well um like Michael said um I'm Dr du for those of you who don't know me um I am a medical an
d surgical retina specialist um and my partner Dr Brian Kim also treats macular degeneration so I'm sure um if you're not familiar with me you may be familiar with him so um I'm just going to go ahead and get started um these are my financial disclosures so you know I think one of the big fears about hearing the word macular degeneration is the fear of blindness um and that's you know obviously probably why a lot of you are listening tonight um and that's that's the first thing that I wanted to
spell is no matter how advanced your macular degeneration you or your loved one will never wake up fully blind you'll never wake up completely black just from macular degeneration so macular degeneration in it its Advanced stages affects only the central vision um so anything we're talking about here on out is really just central vision loss so this is a picture of a retina um many of you probably recognized this um on the left hand side of here on the screen um that is the circle that is your o
ptic nerve that is the the the basically the cable that connects your eyeball to the brain everything you see goes through that um that um optic nerve gets transmitted to the brain for processing for us to be able to see um and then um there's the arteries and the veins that emanate from the optic nerve and really what we're going to be focusing on is that Circle um to the right of that area called the macula um or and the central most portion of the macula is a very very tiny area called the fo
bia um so you can see from here the macula is a very anatomically small area of the retina but it's very important because it has all of our color sensing cells and all of the um cells that are responsible for our central vision so what does someone with any macular problems see well you can see kind of like a black or gray spot in the center of your vision like in this picture here you'll also notice that those both of those buildings look a little wonky um this is not some weird um weird Pictu
re This is actually just um Distortion so people with macular problems a lot of times straight lines will start looking wavy to them and that's one of the first signs that there could be either macular degeneration or some sort of process happening in the macula that's affecting your ability to sense straight lines more advanced stages of macular degeneration um look like this so you can see you you know looking at this picture you can make out it's a picture of a family and there's a mom and a
dad and um probably two children children um but can't really make out their faces too well um and and and that's kind of um one of the complaints that we hear most is people with macular degeneration can see but for example if a person is approaching them they know there's a person approaching them but they can't tell who it is because they can't make out the face um if they're looking at a clock um they're able to see kind of usually the the numbers on the clock but they can't see where you kn
ow the clock hands are pointed because that's their central vision central vision is also very important more so than peripheral vision when it comes to reading and so reading difficulty is one of the things that patients with macular degeneration struggle with much more than distance Vision so the World Health Organization in 2023 um listed the most common um causes of blindness in the in the world um and so these are in order of prevalence so refractive error means needing glasses cataract um
both of those two are easy problems to solve either with glasses or surgery um and then the bottom three are much more difficult um so diabetes glaucoma and then of course macular degeneration is which is what which is what we'll be delving into more detail today so in North America these statistics are a little old they only update them every so many years but over the age of 40 12.6% of the population has macular degeneration um there's two types of macular degeneration which we'll get into a
little bit more in a few minutes here um the dry type of macular degeneration which is typically the better of the two to have 90% of people have that form and then 10% of people have the wet macular degeneration um and because our population just continues to age um modern medicine has gotten so much better so people are living longer and longer we expect these numbers to increase 1.2 Times by 2030 so this is just a graph that um shows um the prevalence of macular degeneration by both sex and u
m ethnicity and um for whatever reason we know that macular degeneration tends to affect um Caucasians more commonly than um than people with other ethnic backgrounds and we think that's just because they tend to have lighter colored eyes um and then also there's just a large hereditary component so that's probably part of it as well um another graph um showing across the um different ethnic um populations how we expect these numbers to just keep growing um as our as our um population continues
to age um so interestingly some people say that um macular degeneration affects males more but I think um most most studies say that it affects females 65% more or 65% compared to 35% in males and again we're not 100% sure why that is so who gets macular degeneration um I mean the two big ones are family history and age and of course unfortunately neither of those are anything that we can control um like I mentioned earlier having a lighter iris color um so blue eyes green eyes those people tend
to macular degeneration at higher rates um and then we talked about females and Caucasians now the modifiable risk factors um we know that if you have ever been a smoker um whether currently or previously you are at two and a half to four and a half higher chance of developing macular degeneration and if you have macular degeneration and are currently a smoker we know that you will lose vision faster and you're um won't see as well as someone with the exact same same risk factors who's not a sm
oker so you really would be that's the biggest thing is doing yourself a huge huge disservice if you have macular degeneration and you're a smoker and then all of those things that are also good for your heart cardiovascular health are also good for your eyes so high blood pressure elevated cholesterol a diet high in fats a sedentary lifestyle obesity all of those things are also higher um risk for macular degeneration um development and progression so I'd say you know every so often now that ge
netic testing has become more prevalent um patients ask all the time well should we just get genetic testing to see what our risks are um so the American Academy of Opthalmology released a statement in response to these questions um and at this current time they avoid they they're recommending avoiding routine genetic testing for macular degeneration and the reason for that is because we know it tends to run in families and if you are already at higher risk unfortunately there's not really a who
le lot we can do other than tell you don't smoke and try to live a healthy lifestyle which we pretty much Advocate to all of our patients anyways um so unfortunately um knowing that you're at higher risk for macular degeneration at this time there's nothing that we can do for it so the academy hasn't recommended uh routine testing for those patients um there's really no screening guidelines recommended other than just annual vision checks with your eye doctor um a lot of optometrists will do scr
eening retinal photographs such as this one um this is your entire retina so it's much more zoomed out than the first picture I showed um and so the macula is that small little dot right there in the center um so you can see just how small that area is but um and then usually if the optometrist has any concern based on what these pictures look like um then they will recommend evaluation with a retina specialist to determine whether you have the diagnosis or not um ultimately um to to make the di
agnosis we do need to do a dilated eye exam where we put dilating drops in to um make your pupil larger and take a very detailed look at the macula um and that's much more sensitive than the photographs um the photographs as you could tell on the last slide um can miss things that are very um small because it's such a large photograph and when we look back there we're getting a 3D magnified image of your of your retina and so there's unfortunately still no substitute for just doing a good eye ex
am sometimes we will get um testing known as floring and geography what this is it's um basically a test where where we inject a vegetable based Dy in your vein in the office to see what's going on with the blood flow in the back of the eye this dye circulates in the blood vessels all over your body but as it's circulating in the back of the eye we take um photographs and the way that Dy behaves gives us information as to is there dry macular degeneration is there wet macular degeneration um and
oftentimes this test is not needed but sometimes in cases where it's really early and not sure if it's wet macular degeneration then the die test helps us quite a bit to try to figure out what exactly is going on in the back of the retina more often and you know those of you who see a retina specialist are probably very very familiar with these pictures um these are scans called Optical coherence tomography or ooc this is a non-invasive test that we do in the office and it's very quick it takes
about five seconds to do in each eye and it gives us very detailed IM um Imaging of all of the layers of the retina so there's 10 layers of the retina and then it's also Imaging the blood vessels underneath the retina and so um you know depending on what's going on these scans will kind of let us figure out um where the pathology is and and how we treat it so the top picture is a normal OCT scan and the one below is a patient that has wet macular degeneration there's a little hump and then to t
he right of that hump there's a little black sliver and that is fluid that's accumulating underneath the retina and so that is a patient with wet macular degeneration so what is macular degeneration I know you know we've touched on it over and over but basically your macula is aging faster than you are so dry macular degeneration is when you get these lumps of calcium that build up underneath your retina like on the left side picture um those those little lumps are called drusin and they are a H
allmark of dry macular degeneration about 10 to 15% of people at some point in their life will convert from dry macular degeneration to wet and so if you look at the picture on the right I mentioned earlier there's a blayer of blood vessels underneath the retina called the choid um you can get new blood vessels from that choid break through that Green Layer which is called the retina pigment epithelium and start develop being into and underneath the retina and that those blood vessels are not he
althy they will bleed they will cause fluid and once that happens you have had you have basically been diagnosed with wet macular degeneration and that needs virgin treatment my partner Dr Kim likes this Photograph he likes to say that dry macular degeneration is like TI is like the tread on your tires slowly gets worse with age if your macular degeneration turns wet it's like running out of gas it gets worse very quickly so oftentimes we'll have patients who don't even know they have macular de
generation because they have the dry type and you know their vision's pretty good and they're progressing pretty slowly so they are coming along not realizing they have any problems and then all of a sudden they wake up one morning and they can't see out of the center of one eye um and that's when they convert to wet and unfortunately that's sometimes the first time that we see them in the office and they didn't even know they had macular degeneration so unfortunately that's not an uncommon stor
y um can be prevented with just making sure you're getting your yearly eye exams so again on the left um that's a picture of a normal retina um on the right um kind of hard to see but in that Center area there there's some tiny little yellow dots and those are the drusin or those calcium deposits I was talking about just seeing those drusin doesn't necessarily mean you have macular degeneration we see plenty of young PE healthy people that have drusin and don't necessarily have macular degenerat
ion so um again on the left is a normal and then you can see those calcium deposits are really starting to be more numerous in that right-handed picture and so this patient has early dry macular degeneration um again normal and you can see this is now an intermediate state of dry macular degeneration even more yellow deposits you're starting to get some changes of that RP which is the that layer the retina pigment epithelial layer underneath the retina um so we you know that that once that film
starts getting or once that layer starts um getting abnormal then we start calling it intermediate form of dry macular degeneration and um although I said that dry macular degeneration typically is the more preferred or the better of the two in advance stages dry macular degeneration can also cause pretty severe central vision loss and this picture here on the right um You can see you don't really see those Drews and deposits anymore but actually you see kind of like a yellow spot um the spot he
re in in the middle it looks like the huge chunk of the retina is missing this is what what is known as Geographic atrophy and this is the most advanced stage of the dry macular degeneration and this patient probably also has very very poor vision in the center even though it's not wet this is now end stage dry macular degeneration and you can see on that right there um all of those big what look like blood vessels that's actually the choroid which is that layer of blood vessels underneath the r
etina the RP layer which separates usually the retina from those blood vessels is so far damaged that it's totally gone so you can actually see through into the choid there because there's just so much damage it's like that whole area is just gone it's it's eaten a lot eaten up and so you can actually see layers underneath the retina that you're not supposed to be seeing and so this patient um also has very poor central vision so um this ooc um if you take an O um through a patient with dry macu
lar degeneration on the bottom so the top is normal on the bottom you see kind of that lumpy bumpy app appearance and those are the drusin that we actually see on um on the o correlating with dry macular degeneration um so now this is a patient with wet macular degeneration you can see there's a large hemorrage in the picture on the left um that's a usually that's a Telltale sign that the macular degeneration has turned wet however um you can have wet macular degeneration without actually having
a hemorrhage you can just have fluid on the ooc like on the bottom right picture without actually having a hemorrhage so both of those with or without the Hemorrhage would be classified as wet macular degeneration in advanced stages um so if you don't treat the wet macular degeneration um it basically just scars down and so this patient has a large scar in the center of their retina and if it gets to this point unfortunately there's nothing we can do to save the vision um this is now the advanc
ed stage and um you know at this point the goal of therapy would be to focus on the other eye and hopefully there's visual potential there because this eye is too far gone for treatment so we keep referencing treatment what is the treatment um it's kind of slow it's it's it's akin to what would slow down aging because that's ultimately what this is right it's an aging process of the eye so like we mentioned before all of those things that are bad for you overall with age um excessive drinking ci
garette smoking we know those are going to make your macular degeneration progress faster um the picture on the light on the left um green leafy vegetables high in antioxidants um kale brussel sprouts collared greens all that stuff no one likes um but I'm sure your cardiologist tells you is good for you same thing is good for the eyes whereas that greasy burger on the right no matter how Juicy and Delicious it looks um not good for your coronary artery and definitely not good for your eyes eithe
r um and then exercise um you know we touched on that earlier as well so the aeds 2 vitamins um so they have looked extensively at what vitamins help slow down the progression of macular degeneration and they've looked at who should be taking those vitamins do we give it to everybody so all of the Studies have shown that in patients that have wet macular degeneration in one eye and dry macular degeneration in the other eye taking these a Reds 2 vitamins which are pictured um up on the top right
slow down or reduce the chance that the that the dry macular degeneration eye turns wet by about 27 to 30% patients that just have dry macular degeneration in both eyes patients whose parents have macular degeneration but don't have it all of the Studies have shown that the aed's vitamins do not um don't affect those patients for the better or the worse however because they're basically just high do vitamins we do recommend all of our patients to with macular degeneration to take an aeds 2 vitam
in because the risk of taking it is pretty low um and the benefit is is potentially um warding off wet macular degeneration but you look straight at if you look just at the studies um that's what the statistics show um dark green veggies like we talked about fresh fish um which is also high in antioxidants um is recommended three times a week and then um you know we talked about no smoking exercise blood pressure cholesterol control really all of um all of our dry macular degeneration patients t
he biggest thing is monitoring monitoring monitoring because the sooner we catch wet macular degeneration and jump on treatment the better um and so you know patients are given an Amsler grid which on the right is what it looks like um and what we're looking for is straight lines looking wavy like in that picture I showed you at the beginning black or gray spots there that are not normally present um those are all things we need to hear about the big thing is actually checking each eye once or t
wice a week um I can't tell you how many times people have a large bleed lose vision in one eye the other eye is normal so they walk around not realizing they have a problem um and then unfortunately it's not till they come into our office that we cover one eye and they go oh my gosh I didn't realize I didn't have Vision in that eye um and that's because with both eyes open their good eye is compensating um so there's also um recently since the Advent of covid and things have been pushed more an
d more remotely um an option to do remote patient monitoring which is a website that patients log into about once a week and they it's an electronic version of this grid and if there's any changes in their responses the company actually will email the doctor so that we can bring them back and hopefully catch any wet macular degeneration conversion sooner rather than later um in general uh because reading is more difficult because we're relying so much on our central vision to read reading is the
thing that we hear the most about challenges so um we recommend Bright Lights reading a small print menu in a dimly dimly lit restaurant is is the worst so lots of Bright Lights um magnifying glasses tablets are really nice if um if you can have family help you use one and get comfortable with one almost everything nowadays literature wise is available in in you know in either like a an e-reader or um on the tablet and so the tablets are nice because you can actually change the contrast between
the background and the text font and you can also blow up the font so that you can see things um basically make it as ideal as possible for you to be able to read um there are low vision optometrists that can kind of figure out what you're having the most difficulty with and try to um give you telescopes or that sort of thing to get you to to get you to get you to do what you want to do with as as little difficulty as possible but really what it boils down to is that early detection of wet macu
lar degeneration is what's going to save your vision this is again another picture of a patient who has a large Hemorrhage in their macula from wet macular degeneration and would benefit from starting treatment ASAP so in the past maybe 20 25 years ago the only options were really whenever you had wet macular degeneration was just to laser the macula and lasering the macula basically just burns the entire thing new blood vessels and immacula so it was a great way to stop bleeding but it was also
damaging healthy macula and leaving patients with not such great [Music] vision um since then we've come a really really long way um and so um I'm sure you all have at least heard of somebody getting injections in their eye for wet macular degeneration um and so we've come we've come a long way um and every couple of years there's excuse me new medications that are released for um wet macular degeneration treatment and these are all of the drugs that are currently available to us on the market
today um last year there was a um surgical implant that was FDA approved which has actually been removed from the market because of some safety concerns but this was actually surgery where a little device was implanted into the eye and then refilled in the office um with the goal of reducing the burden of injection treatments these are some o scans of patients with wet macular degeneration um the top two images um the patient has some fluid and their Vision was about 2070 um and then on the bott
om you can see that same patient after injections excuse me the fluid has resolved and their Vision has um returned to 2025 so pretty good um so you know dry macular degeneration slowly gets worse wet macular degeneration yes it's like running out of gas but it's not like you fill up with gas once and you're done um we very specifically use the word treatment and not cure and the reason we say that is because the shots work great as long as we administer them Unfortunately they have to be given
at regular intervals just like filling your car up with gas um and so just like your blood pressure medication or your diabetes medication they work great when you're taking them but what happens if you stop your blood pressure goes back up your sugars go back up and so same sort of thing with wet macular degeneration you stop the injections um it's just a matter of time before you will have another bleed and potentially lose vision permanently um in really Advanced stages like the one on the bo
ttom right here um that patient has a very very large Hemorrhage and so there's been um treatments aimed at trying to figure out how to drain that blood to get patients to see better um surgically um and unfortunately nothing has panned out um to be too helpful as of yet um so we kind of talked about living with severe macular degeneration um a lot of that can be facilitated by um co-managing with your optometrist so as of as of last year we would basically talk about therapies with wet macular
degeneration and that was it we didn't really have any treatments for wet or dry macular degeneration we don't really have a treatment for dry macular degeneration but um Geographic atrophy which is those areas of loss of the rpe where you um are slowly getting into the more advanced stages of the dry macular degeneration um just um usually starts right off to the to the side of the macula and with time will involve the phobia and once it involves the center or the phobia that's when you lose um
permanent Vision so Geographic atrophy affects about 20% of patients with macular degeneration and it can cause severe vision loss so this is kind of a um a diagram of what that looks like so on the on the very first picture you can see that yellow area is that area where you're starting to lose the RP cells and then you can see that lesion progress until in the in the far right it's completely involved the center and and vision has been lost so before last year there was really nothing we coul
d do we would just watch those lesions grow and watch patients lose their central vision right in front of our eyes last year there were two drugs that were um approved by the FDA called cyob and iserve um and both of those drugs are um work on the complement Cascade which we know makes um those Geographic atrophy lesions grow so these are also injections that are administered between every four to eight weeks and they don't improve the vision but they slow down how fast those Geographic atrophy
lesions grow by about 30% so if we see um someone who healthy that we know is you know going to be around for a while um and they have that Geographic atrophy lesion that's approaching the center um then we'll have a discussion with them about um potentially giving them a few more months to years of vision with starting treatment with either of these medications what's next um we are constantly constantly looking for um new Therapies in both wet and dry macular degeneration um Harvard Eye Assoc
iates is um part of a phase three clinical trial for rat macular degeneration we're actually um we're still currently enrolling but I don't think for too much longer but um but what we're looking at in this drug in this um study is a new um drug that will help our current medications last a little bit longer so really the biggest burden with wet macular degeneration treatment is how often we have to administer it so we have so many different options of different drugs we can use but the average
for all people across the country is about every six weeks they need injection so that's still pretty often so all of our research is look is looking at how do we get those drugs to work better and longer so patients don't have to come in as often to get injections um and so for this study um we are only enrolling patients who've never had injections before for wet macular degeneration and they get lucentis which is a medication that we already inject for wet macul degeneration with potentially
a um an adant of this new molecule to see if it's going to work a little bit better and longer so um I I'm tired of hearing myself talk um and these are a picture of my three little kids um just a couple months ago here um but I want to pause to see if anyone has any more questions um to see if we can open this up to talk more about specific things that you guys are interested in or have questions about yeah thank you so much Dr D and like Dr D said please go ahead and feel free to utilize the q
uestion and answer function down below and also the chat let's stay away from the hand raising because that hand raising function tends to bring up a lot of technical difficulties so please go ahead and utilize the Q&A or chat function down below um also if you're anything like me and you there oh you know there's something uh I would love to rewatch this again or you know what I have a family member who would love to see this we do actually send a recording of this video to everybody who regist
ered for tonight's webinar um not only that but you can actually access it through our YouTube channel as well where there's also a lot of great uh and wonderful presentations just like tonight um so you can feel free to visit that page as well um and we do have a great question how is AMD discovered oh that's a good question yeah um I think a lot of a lot of people will tell me that they don't know if they have a family history or they don't think they did and I think that's just because we did
n't know much about it at the time and people weren't living as long so people may have had it in their genes but people were either passing away sooner than they would have been diagnosed or there was just no way to diagnose it um I think once we were able to actually start visualizing the retina um we were able to start you know realizing this was a problem I don't have a really great answer of like it was discovered one day in a dark lab or anything like that but I I think it was just like as
people got older and were experiencing this and we were able to visualize the retina became something we were able to look at and treat yeah just more consistent screening and I would imagine as well as a way to kind of tell the advancements of AMD um and this is a great question can cataract surgery um or any other surgery for that matter make dry AMD worse that's a great question um so dry AMD no um but patients with wet macular degeneration we want to be stabilized and have the fluid gone be
cause certainly having surgery can um activate it again and so um you know we have a lot of patients that sometimes have to wait months before we can get their fluid to go away before we can finally send them to the Cataract surgeon um so that they can have their cataract out so um so ideally we like the wet to be stabilized but the dry it does not increase your risk of conversion to wet no would there be and this is kind of an altered followup to that question but is there potentially a preferr
ed lens to a patient with wet macular degeneration yeah good question um so you know there's lots of different lenses and there's always new ones coming on the market every couple of months um I feel like I can't even keep up with any with all of them anymore but um but basically we know any of the premium lenses um which are kind of the fancier lenses that are aimed at trying to get your distance and your reading um Vision all fixed with cataract surgery those are not ideal for patients with ma
cular degeneration and that's just because different parts of the lens are aimed at different um different focal points so for example they'll have rings on them for maybe the outer ring being for distance and the central ring being for reading and if you're if you're not able to utilize your central ring then you're not really going to be able to appreciate the full capacity of what that lens has to offer um so patients with macular degeneration we typically recommend them just getting the stan
dard monofocal lens whether we they get corrected for just distance or just for reading um and then you know often times reading glasses are needed as well how about something like the L would that be come into effect given yeah that's something that um we have um discussed quite a bit because the L um is a for those of you that don't know is a light adjustable lens and so it's pretty neat um it's a lens that corrects you for one distance but you know it it's aimed at getting your vision precise
just for you if you go out and buy shoes you can buy a size 10 and you can buy a 10 and a half and maybe the 10 is slightly too small and the 10 and a half is slightly too big and it's very similar when you're looking at Cataract lenses and so what the L does is it basically tailor that lens just to you and the way that they do that is after they put the lens in afterwards in the office they use a laser to adjust it based on your prescription and so there was some thought that maybe using that
laser could potentially be damaging the retina but so far all of our Studies have shown that it's safe and so if you have really Advanced macular degeneration probably still not a good option for you but I think for the very very early stages I think it's a good option um what's the effect of dry eyes on a patient with AMD um no dry eyes are very very common as we get older hormones um you know heaters just normal environmental factors can make eyes dry out um certain medications can do it so it
's very very common in the Aging population um and so certainly dry eyes can affect your vision um it's like driving with a cracked windshield right so you want your tear film to be nice and smooth and if it's not smooth you know your your vision is going to be impaired um so it's important to treat the dry eye for the sake of comfort because it can be very very uncomfortable and to optimize Vision but it actually has no effect on macular degener generation itself um patients who get injections
um in general their dry eye does tend to get worse so we just have to make sure we're staying on top of that treatment treating their dry eyes as well um and then another good question but and I do uh do you need to have macular degeneration to take aeds to or eye Caps or can they be taken preventively so you can take it without having macular degeneration um it's not going to do anything um like harmful to you um they aren't cheap so I tell patients if you know if you want to spend the money on
them it's not going to harm anything but all of the Studies have shown it's not going to reduce your chance of developing macular degeneration so I usually tell people if they have a strong family history to just take like a silver daily multivitamin instead um and then this is a we have kind of two separate questions that are in the same the same category and we we might be a little biased about this one um but are you familiar with the new uh ayrex goggle and headsets and or have you heard of
adaptic ei2 um and you know to help patients with AMD read and watch TV and kind of you know how do they how do they work yeah so adaptic um we actually sell in our office so I have some personal experience with that um and um for patients who are good candidates um it works great um and we know it works if you get it before your vision is too far gone because then you learn to use the glasses and then as your disease progresses they become more and more helpful for you so um so basically you k
now they're aiming at helping magnify helping move um an image out of the spot that you can't see and into a spot that you can see um typically patients that are seeing like 2060 or 2070 or worse in their better seeeing eye are patients that will um benefit from it and um ideally patients that don't have like severe glaucoma because if you have glaucoma on top of macular degeneration it you have other visual field problems it's harder to shift that image out of the area that you can't see into a
n area that you can see so patients that have glaucoma it's not going to be as helpful um but for the right patient it's been lifechanging so um so if you're interested at all we would have you come into our office to see any of our optometrists um they would do a good um prescription check for you and then um our we have one person in our optical department who just does um adaptic screenings and so she would spend some time with you figuring out whether it would be a good option for you um hel
ping you kind of try it on and see how it functions for you um and then um kind of go over the payment options yeah um and then this is kind of a two-part question as well but um what are the odds um or Are there specific odds um that one were to um have AMD if they have a family history of it and then is AMD um intensified or is there a higher chance of you getting it if you have a family history of of retinal detachments or tears or retinal issues what was the first part of that question is th
ere is there a certain odds that if um if you have family history of AMD is there a certain amount of odds or percentage that you you're the likelihood that you were to get it as well got it so um you know some diseases are like what we call autosomal dominant or autosomal recessive meaning you if you have one parent that has it there's a 50% chance you're going to get it or something like that and unfortunately macular degeneration is not that um it's it's multifactorial meaning there's lots of
things that play into it mainly you know the things that we watched out for or that we talked about um we know it is strongly hereditary but we don't have a percentage um and that's just because there's not just one mode of inheritance there's so much that goes into it um and so you know I tell patients who's who have children that are afraid of this you know just make sure you're really um emphasizing a healthy lifestyle not smoking um just taking care of yourself um but yeah unfortunately the
re's no um no specific number um and then in terms of retinal detachments um so yes retinal detachments can be hereditary to some degree as well but no relationship between having a hereditary retinal detachment and macular degeneration um different different diseases and it looks like those are all the questions that we have and then if any do populate and we have actually one more so we'll answer this one last one um if you have any intermed intermediate dry uh AMD what are the chances it beco
mes wet and after how long how longes that process usually take yeah so that's that's a hard question to answer um there's no you can go from like I said I've had patients that didn't even know they had macular degeneration they're like early in one eye and then they have a large bleed in the other eye so it doesn't necessarily go early intermediate Advanced wet it doesn't necessarily follow that path and so it makes it really challenging to to figure out what the timeline's going to be um I tel
l people you can live the rest of your life with intermediate dry macular degeneration you can die with it that way or you could wake up tomorrow and it'll be wet so there's really just no way to know um I know that's a little disconcerting and it's not meant to be it's just a matter of making sure you're keeping on top of your vision and if anything just doesn't seem right to call us right away um but yeah there's no like you know okay well in three years you're going to start needing injection
s there's just no way to predict that yeah and thank you so much everybody for your fantastic questions um if you're anything like me where it takes a minute to process the information and then you come up with questions later you can always call our patient support line um they are amazing and they will be able to point you in the right direction and answer any questions you may have um or have helped set up a consultation with with Dr dude or Dr Kim both of our our Retina Specialists um that n
umber is simply 949 951 2020 you can also find it on our website or Yelp or what have you or on Google um so they they are wonderful and they will absolutely be able to help you with any questions that might come up um later in the days to follow or weeks to follow um and yeah we just like I said we're so glad that everybody could join us this evening for another wonderful webinar uh thank you to Dr du so very much um again you can rewatch this on YouTube and it will be emailed to you as well um
but before we close Dr D any any last words no thank you all for spending evening with us and um hopefully we can get back to doing these in person soon it's nice to be able to like see our patients and their families and be able to interact with you guys in person but um if not we look forward to seeing you in the office um and feel free to reach out if you have any questions thank you all so much yeah thank you everyone have a great rest of your evening take care
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