EP #23: The Amsler Grid Alert: Defending Against Wet Macular Degeneration with Early Detection

Could a simple grid be the key to safeguarding your sight against wet macular degeneration? That's what Dr. Thuy Nguyen and I, Jeremy Wolf, explore in the latest episode of Jazzy Eyes podcast. We dive into the significance of the Amsler grid for early detection and why it might be the most important piece of paper on your fridge. As we navigate through the eye's version of a stealthy intruder, we lay out the signs that should prompt a march to your ophthalmologist and the treatments that await.

Ever heard of Aria, Eylea, or Lucentis? They're not the latest pop stars, but they could be headlining the chart of your eye health. We pull back the curtain on the mystique of intraocular injections, these groundbreaking treatments that sound like they've leaped out of a sorcerer's spell book. With a touch of humor and a heap of expertise, Dr. Nguyen and I discuss the experience of receiving these treatments, debunk myths about the discomfort, and provide comforting insights about the journey through ophthalmological care that might just change the way you see the world—quite literally.

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Episode Transcript

Speaker 1 (00:03):
Welcome to the Jazzy Eyes podcast.
Taking care of your vision withexpert precision.
Here's your host, dr Tui Nguyen.

Jeremy (00:14):
Hello, hello everyone.
Welcome back to the Jazzy Eyespodcast.
I'm your co-host, Jeremy Wolfe,joined by your host, Dr Tui
Nguyen Dr Nguyen, so nice to seeyou again so soon.
We've been on a deep diveexploration of macular
degeneration.
I've already learned quite abit about the dry version as
well as the wet version.
I know you were just talkingabout the differences and

(00:36):
distinctions between the two andwhat wet macular degeneration
is.
Now I know you wanted to getinto kind of management
treatment options once somebodyis diagnosed with wet macular
degeneration.
Yeah, yeah, In lightness let'sgo.

Dr. Nguyen (00:54):
When we see you for your annual eye exam and we dial
you and everything like thatand we are suspicious that you
might have early signs of justmacular degeneration in general,
what we do is we give you alittle grid.
This grid is kind of like thosemath paper grids that you get
with the lines.
I give my patients these gridsand I tell them to kind of put

(01:17):
it on their fridge, because yougo to your fridge every single
day Right before you open thefridge just check one eye at a
time, looking at that grid, tosee if all the lines on that
grid is straight and there's nomissing lines or there's no wavy
lines or stuff like that.
When there is wavy lines ormissing spots at the line, it
could indicate leakage or theconversion from your dry to your

(01:40):
wet macular degeneration.
And then, once you see us, onceyou notice that change in
vision, what we're mostly goingto do is refer you to an
ophthalmologist and they can doa couple treatments.
One of the most commontreatments that they do in your
favorite they inject the eye.
They inject a medication in theeye.

(02:02):
No, thank you, very pleasantCheck, please.
The medications they injectinside the eyes is called
anti-Vegia.
Now I talked about Anti-Vegia,anti-catch up, what?

Jeremy (02:16):
V-E-G-F.

Dr. Nguyen (02:16):
V-E-G-F.
V-e-g-f.

Jeremy (02:22):
I think you mentioned that earlier.
What is anti-Vegia?

Dr. Nguyen (02:25):
The anti-Vegia is what we talked about previously,
where it's promoting the newblood vessel growth that are
leaky.
That's the chemical that thedamage cells release, and so the
counterpart for that isinjecting an anti-Vegia to
discourage the blood vesselgrowth, and so that's what they
do.
There are three, actually four,types of brand names of

(02:49):
anti-Vegia, and they all soundlike they came from like a Harry
Potter book, so it's calledAria Houston Lucentis, and a
newer one came out.
It's called Vibismo, and sothey're very magical.

Jeremy (03:03):
I was just going to say it sounds very magical.

Dr. Nguyen (03:06):
Yes, and these injections are actually given
every four to six weeks.
Yes, yes, they're given.

Jeremy (03:11):
They're given Depending on is it painful to get an
injection in your eye, Like whenyou numb the area?
How does that work?

Dr. Nguyen (03:17):
You numb the area.
You actually numb the area withtetra cane drops, so you will
be numb.
However, like the, they have tosanitize the eyes with betadine
, like betadine before it, whichis that yellow iodine thing.

Jeremy (03:30):
OK.

Dr. Nguyen (03:30):
And that's what's going to sting later.
Once you start to, once theanesthesia starts to wear off,
then you start to feel thatstinging pain, but, like
initially, you don't.

Jeremy (03:38):
Can you just put me to sleep before you do that?
I don't want to look at aneedle coming.
You can't look away, right, youopen your eye, you see the
needle coming.

Dr. Nguyen (03:46):
No you're right awake.
You just look down and thenthey come from the top.

Jeremy (03:51):
Oh, I'm pretty sure, guys, we talk about it.

Dr. Nguyen (03:54):
They use kind of like a tool that helps you open
your eyes.

Jeremy (03:58):
OK, so you can't play OK .

Dr. Nguyen (04:00):
Right.
So it sounds very pleasant allof this, but that's actually the
main.
Most common treatment is theeye infections.
And again, you get it four tosix weeks and they space it out
more and more like the intervalwhich you get the shots once
there's improvement orstabilization, so you can be
getting it once or twice a month.
You could be getting it onceforever, one or two months.

Jeremy (04:23):
It's interesting.
I had asked Dr Falco if therewas any kind of surgical
treatments for maculardegeneration.
She said not for the dry, butthere is something kind of akin
to that for the wet that youwould talk about it.
And it's not really a surgeryper se, I guess, but it's
inter-invasive, somewhatInvasive.
It's kind of somewhere inbetween right A surgery.

Dr. Nguyen (04:43):
The needle is very thin.
It's thinner than a hair.
It's very, very thin.

Jeremy (04:48):
Every time you say needle and eye, I get like oh,
imagine seeing it.

Dr. Nguyen (04:53):
You haven't even seen it yet.

Jeremy (04:55):
And you do that right in your office back in the chair?

Dr. Nguyen (04:57):
No, in our ophthalmologist.
Ok, you said you have to go tothe ophthalmologist.

Jeremy (05:00):
Ok, yeah, so you don't you?

Dr. Nguyen (05:01):
say, I'm sure that the dried isn't converted to the
wet, but when it does,converted to the wet can be.

Jeremy (05:06):
Yeah, you go to the ophthalmologist.

Dr. Nguyen (05:07):
And then like other less common ways that they do it
, they can do a laser, they canzap the leaky blood vessels.

Jeremy (05:14):
I want that one.

Dr. Nguyen (05:16):
The only bad thing there is not used as common,
because the macula is yourcentermost part of your vision,
so you really don't want to beusing a laser that zaps your
central vision, so it's not usedas common.
Another one which is not ascommon as well, but it's pretty
cool it's called photodynamictherapy.
What they do is they actuallyinject a light activating

(05:37):
medication into your veins, likejust your arm or your vein, and
then they wait a couple minutes.
That medication travels throughyour bloodstream and eventually
to the blood vessels in youreyes, and then they use a
special type of light or laserto activate the medication.

Jeremy (05:54):
Oh, how cool In your eyes.
Yeah, I like that.
Yeah, I like that better thanthe needle in the eye too.
Sign me up for that one.

Dr. Nguyen (06:01):
That medication, once activated by the light,
actually destroys the leakyblood vessels in the eye.

Jeremy (06:06):
That's pretty cool.

Dr. Nguyen (06:07):
I like that yeah isn't it cool, I thought that
was cool too.
And then once you're stable,from once you're getting all
these treatments and you'restable, you can see your
optometrist back annually or asneeded so that we can update
your prescription, because asthe condition improves, your
prescription can improve as well.
And in the sad case that you'redue to the condition, the

(06:30):
nature of your condition you'renow a low vision patient.
We can actually optometrist cando low vision refractions or
low vision exams, where it'smore catered towards giving you
the best prescription so thatyou can regain, like certain
independence of your life, likeyou can see it, to at least read
your mail or sign checks orstuff like that.

Jeremy (06:49):
Interesting.
Is there any particular reasonwhy somebody would elect to get,
or why an ophthalmologist wouldrecommend the needle in the eye
versus the injection to thebloodstream with the light?
The photo is?

Dr. Nguyen (07:01):
there it's more effective, efficient and there's
more research showing adecrease in progression with the
shot.
So overall more effective.
Not the most pleasant, but themost effective OK fair enough.

Jeremy (07:15):
I'll take that into consideration as I move forward.
Thankfully, my vision is nearperfect.

Dr. Nguyen (07:23):
Yes, yes that's great.
A lot of things in trainingwithin the next couple of years.
So just make sure you get youreyes just on that.

Jeremy (07:31):
Dr Falco said even though I don't see perfect 2020,
there's no need for any glasses.
I don't need to increase thefont size in my phone.
I got a few more years before Iupgrade the font size.
So goodness, ok, cool.
Is there anything else youwanted to share about the kind
of management or treatmentoptions other than, obviously,

(07:54):
getting your eyes checkedregularly and taking care of
yourself, even if you're tryingto go on me?
No smoking, eat lots of leafygreen vegetables.
All the good stuff, all thegood stuff.

Dr. Nguyen (08:04):
You want to do that right.
That's pretty much the basicsof it.
The most common forms ofmanagement.

Jeremy (08:10):
All right, very cool, dr Neumann, always a pleasure.
You're a wealth of knowledgeand I've learned a lot today, so
I've gotten my education in forthe day.
Good good good, all righteveryone.
Thank you for tuning in and wewill catch everyone next time.
Take care, have a great day.

Speaker 1 (08:31):
Thank you for listening to the Jazzy Eyes
podcast.
For more information, visitjazzyeyescom or contact
954-473-0100.