February 8, 2024 • 13 mins
Ever wondered what the journey from dry to wet macular degeneration looks like, or why it doesn't lead to complete blindness? Tune in as Dr. Laura Falco and Jeremy Wolf, joined by the insightful Dr. Nguyen, unravel the complexities of this eye condition, offering clarity on its progression and the hope that remains for those diagnosed. Our discussion promises to reveal the subtle yet significant differences between dry and wet forms, and why understanding these can be a game-changer for patients and their families.
This episode is a beacon of light for anyone navigating the murky waters of macular degeneration. We confront the common myths and fears surrounding legal blindness and illustrate how peripheral vision remains a saving grace, ensuring that life's visual story continues beyond a central vision loss. Through our conversation, we not only provide education but also illuminate the supportive resources available, like the benefits at the Lighthouse for the Visually Impaired of Broward County. Let's embark on this enlightening journey together, discovering not just treatments, but a community of support and reassurance.
For more information visit: JazzyEyes.com
or contact: (954) 473-0100
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:02):
Welcome to the Jazzy Eyes podcast.
Taking care of your vision withexpert precision.
Here's your host, dr LauraFalco.
Jeremy (00:14):
Hello, hello everyone, Welcome back to the Jazzy Eyes
podcast.
Co-host Jeremy Wolfe here withyour host, Dr Falco.
Dr Falco, fancy meeting youhere again.
We were just talking aboutmacular degeneration.
I learned a lot of interestingstuff going on.
I know you talked about what itis, how it comes about.
(00:38):
I know now you wanted to talk alittle bit about the treatment,
the various treatment forms formacular degeneration, the dry
variety.
I know we're going to get intothe dry variety, yeah.
Dr. Falco (00:49):
Dr Nguyen is going to cover the wet macular
degeneration At some point.
Anyone who has dry has a riskof converting to wet.
Some people will convert in oneeye, some people will convert
in both and some people willnever convert.
So she'll go through that.
Jeremy (01:06):
Oh, I think, before you go into treatment for this type
of ailment, maybe you could Idon't know if you did this in
the previous segment could youmaybe distinguish between the
dry and the wet version forlisteners, just so?
Dr. Falco (01:19):
they understand what the differences are.
I'll talk about this in moredetail.
But blood, the presence ofblood in the back of the eye,
makes macular degeneration wetwet basically.
So yes, we have blood supply,but there's an abnormal blood
supply, and when you have thatcome into the back of the eye
(01:40):
with the drusen, then it has nowconverted from dry no abnormal
blood to wet.
So the presence of bleeding inthe back of the eye is what
makes it wet.
Jeremy (01:50):
In the macula and the phobia.
Dr. Falco (01:53):
That whole?
Yeah, it has a parallel.
Did I get the terms right?
Jeremy (01:55):
Am I just my memory right?
Dr. Falco (01:56):
now?
Yes, look at us.
Jeremy (01:59):
I'm learning.
I'm learning, yes, yes, allright.
So treatment options what cansomebody do?
They have macular degeneration.
They've been diagnosed.
What are some of the treatmentoptions to do with it?
Dr. Falco (02:08):
Right, or you have a family member or a parent and
they're struggling with it and alot of times the retinal
specialists can diagnose butthey don't treat the dry so much
because there's really not alot of special the retinal
specialists can do for for dry I.
I do want to clarify thatpeople think they're going to go
(02:29):
quote-unquote blind frommacular degeneration.
Now, legal blindness Means thatwith glasses you can't get a
patient to see better than 2200or it can be a very, very
restricted field of view.
You can have a patient who is2020, who has a five degree
Peripheral visual field and theyare considered legally blind
(02:50):
from field versus acuity maculardegeneration.
Even if it's Terrible, you willnever go completely blind,
because I think people get veryscared when they hear this term
and you're gonna go blind Likeyou close your eyes, you see
black and that's it.
That's never what maculardegeneration is going to result
(03:10):
in.
You might have somebody withthe best glasses you can get
them.
The best they can see atdistance is 2400, that big E
that qualifies them asquote-unquote legally blind, but
they can see somebody coming inthe periphery.
When they wake up, they know ifit's sunny or if it's dark.
You know like it's a very bigdistinction.
(03:31):
We have a complete loss ofvision versus having visual
impairment centrally frommacular degeneration.
So, like we said earlier, ithas a predilection for the
macular area.
It's not going to destroy theperipheral retina.
The rest of your retina, I mean, you can have another disease.
That's a whole differentsituation.
But if you only end up withmacular degeneration, it
(03:54):
degenerates exactly that part,the macula.
The peripheral retina staysintact, which is a big deal when
you're talking about Completeblindness and someone who's, you
know, losing all vision andcan't see if it's light or dark
outside.
So so it's not completeblindness but it's quote-unquote
(04:14):
legal blindness.
If you can't with glasses getthis patient better than 2200
and I mentioned that because oneof the treatments or I should
like therapies or hope for thesepatients they then qualify for
benefits at the lighthouse forthe visually impaired of Broward
County.
For me we, as Dave County, thelighthouse international is is
(04:38):
in New York City.
I spent months there when I wasan intern.
But there are tricks and tipsand Ways to teach someone how to
navigate the world who isvisually impaired.
It doesn't mean you have tostop so once you hit that legal
blindness.
One of the things I recommendto my patients is to pay a visit
(04:59):
to the lighthouse.
You now qualify for benefitswhen you have that diagnosis of
legal blindness and there's somany different things they have
there that can teach you how toContinue to do some activities
of daily living that maybe youthought you had to depend on
other people for.
That will give you a little bitof sense of your life back and
(05:21):
then and I can do this Going offof that, I do a special
Refraction exam for patients whohave been diagnosed.
It's a low vision refraction.
It's different, and I'll putthem behind the big foropter.
That's useless to them.
We have to make much biggerjumps to see if I can get them
to see as best I can at distance.
(05:42):
Oftentimes distance is harderfor me to correct.
But if somebody has a largemonitor, if somebody wants to
write their checks, if somebodywants to be able to read their
bills and they don't have towait for their daughter to come
over two weeks later to write abill for the utility, something
like that, we can work onhigh-powered Magnification
(06:02):
glasses that can really helpsomebody.
Especially with this technologywe have, you can make your font
size gigantic on your phone orgigantic on your iPad.
You can now actually Say makeuber eats, have an Uber pick you
up, you know, put an order inso it can actually help you
function in life where youthought I will never be able to
(06:25):
read my bills again, you can.
It's.
It's more time consuming.
I block a bigger space out forpatients, but it's important to
know that that's out there so Ican do that for patients that
that need that kind ofrefraction.
I was talking about doing aspecial eye exam where I can try
(06:45):
to get a patient, usingMagnification, to take a little
bit of their life back and seeup close.
It's a different type of exam.
It's a different kind of.
It's a lot of working with apatient and really kind of
honing in on prioritizing theirvisual needs and trying to get a
Paraglass as a hand magnifier,stand magnifier something that
will help them with theiractivities of daily living so
(07:07):
they can feel more Independentand less relying on others.
So that's a really, reallyimportant part of what I do At
Jazzy eyes.
That is a specialty.
It's a low vision specialty.
There's there's a vitamins thatpeople recommend For people who
have already started to developmacular degeneration.
(07:29):
If you go down the aisles,you'll see all these eye health
vitamins.
Vitamins are always a littlebit controversial For as far as
macular degeneration goes.
They're really not recommendedFor patients who have no signs
of macular degeneration becausethere is absolutely no proof
that they're going to prevent itfrom happening.
Jeremy (07:49):
So that was going to be a question I had, so there's
really no right.
Dr. Falco (07:52):
So there's really nothing for that.
Jeremy (07:54):
No, yes, yes just get eye exams regularly and make
sure you're correct.
Dr. Falco (07:58):
Yeah, take care of yourself one of the reasons why,
as we mature, we need to haveannual eye exams, as we want.
If you start developing thepresence of drusen, then there
is some data to show that somepeople will have a.
It'll be less severe.
It won't reverse but perhapsslow down the progression of
(08:21):
macular degeneration.
And there's a vitamin over thecounter, like you know there's,
there's a few.
Basically, you're looking forvitamins that say AREDS2,
formula A-R-E-D-S2, which is astudy that showed that there was
a the presence of Lutein.
Ziaxanthine are important forretinal health.
Jeremy (08:45):
Now there you go with those fancy words again I know,
I know.
Dr. Falco (08:48):
Now, the other thing I could tell you that's easier
is if you don't like to takevitamins green leafy vegetables
kale has a ton of it.
If you like cruciferousvegetables like broccoli, you're
going to get a ton of it.
So there are ways to getZiaxanthine and Lutein in your
diet Essentially, anything thatis good for your body diet-wise,
like fried food, bad saturatedfat, bad green leafies,
(09:12):
plant-based, everything likethat.
And there's a Mediterranean,you know, like the omegas,
that's great.
So your walnuts, your salmon,it's basically what's good for
your body is good for your eyes.
And then the last thing I wantto touch on is that there are
some devices.
One is a simple looks likegraph paper, we call it an
(09:32):
Amzler grid, and when somebodyhas the presence of Druzen, this
graph paper, this grid, canhave distortions and missing
parts on it, and this isimportant to establish a
baseline.
What is your normal right?
And then, every a couple ofdays, a week, is the goal for a
patient to look at this grid.
If one day they look at thegrid and there's a whole
(09:55):
different part of distortionthat there wasn't there last
week, or a new part of the gridis missing, we need to come in
and see the doctor and seewhat's changed in the back.
There's a new technology thathas come out that is electronic.
That I'm having some successbecause sometimes insurance pays
(10:16):
I can't even get into insurancewith you.
That's a whole.
You can solve that problem.
You can solve something.
Jeremy (10:20):
Topic for another day.
Dr. Falco (10:22):
Yeah, that's a.
This is the Nobel Prize, butit's a technology where you look
into a device and after 14times of you doing the test
which is about a two-minute testand it asks you questions to
see if you can find a dot that'snot in line with the rest of
these dots, it creates abaseline for you and then after
(10:44):
that, you do that device and itcan detect before the grid,
actually showing that they candetect change before I can
clinically see a change indrusen, specifically if we're
maybe converting from dry to wet, because then there are
treatments and Dr Nguyen isgoing to talk about that that
are important to startimmediately.
(11:04):
You don't wait on those.
So I think it's important forpeople to know.
Number one if you just have dry,there are things that can be
done to help you navigate theworld and, more importantly, if
you have dry, you have to reallystay on it, because nobody has
a crystal ball to tell you ifyou will or will not convert to
wet.
So the only way is you knowyou're doing your grids, you're
(11:26):
doing everything at home andthen you also coming in for your
eye exam.
So these are important thingsbecause, as I've said before,
about everything we talk abouthere.
Early detection is key inbetter outcome visually, so it's
important to get your eyeschecked.
Jeremy (11:43):
Last question for you before we close up here.
I'm assuming, as you didn'tmention it, there's no surgical
options for this when somebodyhas too much drusen and they're
kind of later stages.
There's no way, there's notechnology.
Dr. Falco (11:54):
Not for the dry.
Yeah, not for the dry.
There are options for the wetand it involves going to a
retinal specialist, but not thedry.
We're not there and, to behonest, I don't know.
I don't know if they're goingto come up with something that
identifies it and geneticallytreats it before, so you don't
(12:15):
develop that, that problem.
It's interesting.
You know, there's a lot ofthings.
I don't know if our friend Elonis going to come out with a
microchip.
Jeremy (12:24):
Well, it's coming.
You know it's coming no 100%,100%.
Dr. Falco (12:28):
It's already out but it's not get.
It's like taking patients whoare totally blind to see shadows
.
It's not.
It's not what people want it tobe, but not for nothing.
I mean these VR headsets, alsowith magnification.
It's interesting, I feel like.
I feel like we're on theprecipice of, maybe, in the next
20 years, a lot of thingscoming, coming out, but right
(12:48):
now, no All right, fair enough,we'll.
Jeremy (12:53):
We'll keep our hopes high for the future.
Yes, all right.
Well, dr Falco, always apleasure, always incredibly
informative, lots of good, goodbits of knowledge picked up
there.
So thanks everybody for joiningus and we will catch everyone
next time.
Have a great day and take care.
Dr. Falco (13:09):
Take care.
Speaker 1 (13:14):
Thank you for listening to the Jazzy Eyes
podcast.
For more information, visitjazzyeyescom or contact
954-473-0100.
Welcome to the Jazzy Eyes podcast.
Taking care of your vision withexpert precision.
Here's your host, dr LauraFalco.
Jeremy (00:14):
Hello, hello everyone, Welcome back to the Jazzy Eyes
podcast.
Co-host Jeremy Wolfe here withyour host, Dr Falco.
Dr Falco, fancy meeting youhere again.
We were just talking aboutmacular degeneration.
I learned a lot of interestingstuff going on.
I know you talked about what itis, how it comes about.
(00:38):
I know now you wanted to talk alittle bit about the treatment,
the various treatment forms formacular degeneration, the dry
variety.
I know we're going to get intothe dry variety, yeah.
Dr. Falco (00:49):
Dr Nguyen is going to cover the wet macular
degeneration At some point.
Anyone who has dry has a riskof converting to wet.
Some people will convert in oneeye, some people will convert
in both and some people willnever convert.
So she'll go through that.
Jeremy (01:06):
Oh, I think, before you go into treatment for this type
of ailment, maybe you could Idon't know if you did this in
the previous segment could youmaybe distinguish between the
dry and the wet version forlisteners, just so?
Dr. Falco (01:19):
they understand what the differences are.
I'll talk about this in moredetail.
But blood, the presence ofblood in the back of the eye,
makes macular degeneration wetwet basically.
So yes, we have blood supply,but there's an abnormal blood
supply, and when you have thatcome into the back of the eye
(01:40):
with the drusen, then it has nowconverted from dry no abnormal
blood to wet.
So the presence of bleeding inthe back of the eye is what
makes it wet.
Jeremy (01:50):
In the macula and the phobia.
Dr. Falco (01:53):
That whole?
Yeah, it has a parallel.
Did I get the terms right?
Jeremy (01:55):
Am I just my memory right?
Dr. Falco (01:56):
now?
Yes, look at us.
Jeremy (01:59):
I'm learning.
I'm learning, yes, yes, allright.
So treatment options what cansomebody do?
They have macular degeneration.
They've been diagnosed.
What are some of the treatmentoptions to do with it?
Dr. Falco (02:08):
Right, or you have a family member or a parent and
they're struggling with it and alot of times the retinal
specialists can diagnose butthey don't treat the dry so much
because there's really not alot of special the retinal
specialists can do for for dry I.
I do want to clarify thatpeople think they're going to go
(02:29):
quote-unquote blind frommacular degeneration.
Now, legal blindness Means thatwith glasses you can't get a
patient to see better than 2200or it can be a very, very
restricted field of view.
You can have a patient who is2020, who has a five degree
Peripheral visual field and theyare considered legally blind
(02:50):
from field versus acuity maculardegeneration.
Even if it's Terrible, you willnever go completely blind,
because I think people get veryscared when they hear this term
and you're gonna go blind Likeyou close your eyes, you see
black and that's it.
That's never what maculardegeneration is going to result
(03:10):
in.
You might have somebody withthe best glasses you can get
them.
The best they can see atdistance is 2400, that big E
that qualifies them asquote-unquote legally blind, but
they can see somebody coming inthe periphery.
When they wake up, they know ifit's sunny or if it's dark.
You know like it's a very bigdistinction.
(03:31):
We have a complete loss ofvision versus having visual
impairment centrally frommacular degeneration.
So, like we said earlier, ithas a predilection for the
macular area.
It's not going to destroy theperipheral retina.
The rest of your retina, I mean, you can have another disease.
That's a whole differentsituation.
But if you only end up withmacular degeneration, it
(03:54):
degenerates exactly that part,the macula.
The peripheral retina staysintact, which is a big deal when
you're talking about Completeblindness and someone who's, you
know, losing all vision andcan't see if it's light or dark
outside.
So so it's not completeblindness but it's quote-unquote
(04:14):
legal blindness.
If you can't with glasses getthis patient better than 2200
and I mentioned that because oneof the treatments or I should
like therapies or hope for thesepatients they then qualify for
benefits at the lighthouse forthe visually impaired of Broward
County.
For me we, as Dave County, thelighthouse international is is
(04:38):
in New York City.
I spent months there when I wasan intern.
But there are tricks and tipsand Ways to teach someone how to
navigate the world who isvisually impaired.
It doesn't mean you have tostop so once you hit that legal
blindness.
One of the things I recommendto my patients is to pay a visit
(04:59):
to the lighthouse.
You now qualify for benefitswhen you have that diagnosis of
legal blindness and there's somany different things they have
there that can teach you how toContinue to do some activities
of daily living that maybe youthought you had to depend on
other people for.
That will give you a little bitof sense of your life back and
(05:21):
then and I can do this Going offof that, I do a special
Refraction exam for patients whohave been diagnosed.
It's a low vision refraction.
It's different, and I'll putthem behind the big foropter.
That's useless to them.
We have to make much biggerjumps to see if I can get them
to see as best I can at distance.
(05:42):
Oftentimes distance is harderfor me to correct.
But if somebody has a largemonitor, if somebody wants to
write their checks, if somebodywants to be able to read their
bills and they don't have towait for their daughter to come
over two weeks later to write abill for the utility, something
like that, we can work onhigh-powered Magnification
(06:02):
glasses that can really helpsomebody.
Especially with this technologywe have, you can make your font
size gigantic on your phone orgigantic on your iPad.
You can now actually Say makeuber eats, have an Uber pick you
up, you know, put an order inso it can actually help you
function in life where youthought I will never be able to
(06:25):
read my bills again, you can.
It's.
It's more time consuming.
I block a bigger space out forpatients, but it's important to
know that that's out there so Ican do that for patients that
that need that kind ofrefraction.
I was talking about doing aspecial eye exam where I can try
(06:45):
to get a patient, usingMagnification, to take a little
bit of their life back and seeup close.
It's a different type of exam.
It's a different kind of.
It's a lot of working with apatient and really kind of
honing in on prioritizing theirvisual needs and trying to get a
Paraglass as a hand magnifier,stand magnifier something that
will help them with theiractivities of daily living so
(07:07):
they can feel more Independentand less relying on others.
So that's a really, reallyimportant part of what I do At
Jazzy eyes.
That is a specialty.
It's a low vision specialty.
There's there's a vitamins thatpeople recommend For people who
have already started to developmacular degeneration.
(07:29):
If you go down the aisles,you'll see all these eye health
vitamins.
Vitamins are always a littlebit controversial For as far as
macular degeneration goes.
They're really not recommendedFor patients who have no signs
of macular degeneration becausethere is absolutely no proof
that they're going to prevent itfrom happening.
Jeremy (07:49):
So that was going to be a question I had, so there's
really no right.
Dr. Falco (07:52):
So there's really nothing for that.
Jeremy (07:54):
No, yes, yes just get eye exams regularly and make
sure you're correct.
Dr. Falco (07:58):
Yeah, take care of yourself one of the reasons why,
as we mature, we need to haveannual eye exams, as we want.
If you start developing thepresence of drusen, then there
is some data to show that somepeople will have a.
It'll be less severe.
It won't reverse but perhapsslow down the progression of
(08:21):
macular degeneration.
And there's a vitamin over thecounter, like you know there's,
there's a few.
Basically, you're looking forvitamins that say AREDS2,
formula A-R-E-D-S2, which is astudy that showed that there was
a the presence of Lutein.
Ziaxanthine are important forretinal health.
Jeremy (08:45):
Now there you go with those fancy words again I know,
I know.
Dr. Falco (08:48):
Now, the other thing I could tell you that's easier
is if you don't like to takevitamins green leafy vegetables
kale has a ton of it.
If you like cruciferousvegetables like broccoli, you're
going to get a ton of it.
So there are ways to getZiaxanthine and Lutein in your
diet Essentially, anything thatis good for your body diet-wise,
like fried food, bad saturatedfat, bad green leafies,
(09:12):
plant-based, everything likethat.
And there's a Mediterranean,you know, like the omegas,
that's great.
So your walnuts, your salmon,it's basically what's good for
your body is good for your eyes.
And then the last thing I wantto touch on is that there are
some devices.
One is a simple looks likegraph paper, we call it an
(09:32):
Amzler grid, and when somebodyhas the presence of Druzen, this
graph paper, this grid, canhave distortions and missing
parts on it, and this isimportant to establish a
baseline.
What is your normal right?
And then, every a couple ofdays, a week, is the goal for a
patient to look at this grid.
If one day they look at thegrid and there's a whole
(09:55):
different part of distortionthat there wasn't there last
week, or a new part of the gridis missing, we need to come in
and see the doctor and seewhat's changed in the back.
There's a new technology thathas come out that is electronic.
That I'm having some successbecause sometimes insurance pays
(10:16):
I can't even get into insurancewith you.
That's a whole.
You can solve that problem.
You can solve something.
Jeremy (10:20):
Topic for another day.
Dr. Falco (10:22):
Yeah, that's a.
This is the Nobel Prize, butit's a technology where you look
into a device and after 14times of you doing the test
which is about a two-minute testand it asks you questions to
see if you can find a dot that'snot in line with the rest of
these dots, it creates abaseline for you and then after
(10:44):
that, you do that device and itcan detect before the grid,
actually showing that they candetect change before I can
clinically see a change indrusen, specifically if we're
maybe converting from dry to wet, because then there are
treatments and Dr Nguyen isgoing to talk about that that
are important to startimmediately.
(11:04):
You don't wait on those.
So I think it's important forpeople to know.
Number one if you just have dry,there are things that can be
done to help you navigate theworld and, more importantly, if
you have dry, you have to reallystay on it, because nobody has
a crystal ball to tell you ifyou will or will not convert to
wet.
So the only way is you knowyou're doing your grids, you're
(11:26):
doing everything at home andthen you also coming in for your
eye exam.
So these are important thingsbecause, as I've said before,
about everything we talk abouthere.
Early detection is key inbetter outcome visually, so it's
important to get your eyeschecked.
Jeremy (11:43):
Last question for you before we close up here.
I'm assuming, as you didn'tmention it, there's no surgical
options for this when somebodyhas too much drusen and they're
kind of later stages.
There's no way, there's notechnology.
Dr. Falco (11:54):
Not for the dry.
Yeah, not for the dry.
There are options for the wetand it involves going to a
retinal specialist, but not thedry.
We're not there and, to behonest, I don't know.
I don't know if they're goingto come up with something that
identifies it and geneticallytreats it before, so you don't
(12:15):
develop that, that problem.
It's interesting.
You know, there's a lot ofthings.
I don't know if our friend Elonis going to come out with a
microchip.
Jeremy (12:24):
Well, it's coming.
You know it's coming no 100%,100%.
Dr. Falco (12:28):
It's already out but it's not get.
It's like taking patients whoare totally blind to see shadows
.
It's not.
It's not what people want it tobe, but not for nothing.
I mean these VR headsets, alsowith magnification.
It's interesting, I feel like.
I feel like we're on theprecipice of, maybe, in the next
20 years, a lot of thingscoming, coming out, but right
(12:48):
now, no All right, fair enough,we'll.
Jeremy (12:53):
We'll keep our hopes high for the future.
Yes, all right.
Well, dr Falco, always apleasure, always incredibly
informative, lots of good, goodbits of knowledge picked up
there.
So thanks everybody for joiningus and we will catch everyone
next time.
Have a great day and take care.
Dr. Falco (13:09):
Take care.
Speaker 1 (13:14):
Thank you for listening to the Jazzy Eyes
podcast.
For more information, visitjazzyeyescom or contact
954-473-0100.
Popular Podcasts
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Special Summer Offer: Exclusively on Apple Podcasts, try our Dateline Premium subscription completely free for one month! With Dateline Premium, you get every episode ad-free plus exclusive bonus content.
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.