During your recent eye exam your optometrist may have mentioned that they can see a few drusen at the back of your eye. This article will help you understand what drusen are and why it is important to closely monitor your eyesight from now on.
What are Drusen?
Drusen are the most common early signs of macular degeneration. They are like tiny yellow or white pebbles that form under the retina and can be seen by an eye doctor during an eye exam.
The retina is the light-sensitive layer of cells at the back of the eye that is responsible for most of our vision. Drusen generally develop in your eyes as you age. They are common in people over age 60, especially women.
The majority of people with drusen have no symptoms. A regular eye exam will frequently detect their presence by chance. Having a few tiny drusen is not a sign of eye illness. Rather, the existence of these deposits represent a risk for some degree of vision loss in the future.
Given the symptomless nature of drusen, the only way that you can know for sure if you have drusen is from a thorough eye examination. Hence the importance of having an eye exam every single year.
Types of Drusen
There are three different types of drusen, hard, soft and optic nerve drusen.
- Hard drusen are small, distinct and more spaced apart. It’s natural to get a few hard drusen as you become older. The majority of adults have at least one hard drusen. This sort of drusen is usually harmless and may not cause vision problems.
- Soft drusen are larger and cluster closer together. They are not distinct and can increase the risk of age-related macular degeneration (AMD). Soft drusen can cause bleeding and scarring in the macula cells as they grow larger.
- Optic nerve drusen, unlike drusen in the retina, can cause a modest loss of peripheral (side) vision. Optic nerve drusen has little to do with becoming older. Children are more likely to have them.
What Causes Drusen?
Drusen are a result of cellular waste and proteins that are not disposed of or recycled by the body. Retinal cells dump unwanted material, and immune cells normally clean up most of it. However, if too much is dumped, or the immune cells don’t function efficiently, it can pile up causing these little deposits.
Soft drusen are associated with Age-related Macular Degeneration (AMD). Risk factors for AMD include:
- family history of AMD
- cardiovascular disease
- abnormal cholesterol levels
- being over the age of 65
Why the Size and Number of Drusen is so Important
The risk of future vision loss is related to the number and size of the drusen. People with more drusen, and larger drusen, are at higher risk than those with fewer, smaller drusen.
The presence of numerous large soft drusen is an early indicator of age-related macular degeneration meaning you are at a higher risk for some vision loss in the future.
To put it into perspective, the chance of a person with a few small drusen losing some central vision from AMD in a five-year timeframe is only a few percent, whereas the chance may be as high as 50 percent over the same timeframe for certain people with many intermediate and large size drusen.
Treatment of Drusen and Monitoring for Age-Related Macular Degeneration
There is no treatment for drusen.
If you have hard drusen, your optometrist or ophthalmologist will want to closely monitor your eyes to keep track of how many drusen you have and their size, as well as, any changes in your vision. They may give you an Amsler Grid test to take home so that you can keep a close eye on any changes in your own vision.
If you have soft drusen your eye doctor will likely want to run additional tests for age-related macular degeneration. The ophthalmologist may also ask you questions about any other symptoms you might be experiencing.
Symptoms of AMD include:
- distortion of straight lines in your field of vision
- difficulty adapting from bright lights to low lights
- hazy or blurry vision
- blank spot in your central vision
Clinical research at US National Eye Institute (called AREDS2) conducted on patients with numerous large drusen and AMD found that a nutritional supplement formulation (containing Lutein, Zeaxanthin, Vitamin C, Vitamin E, Copper, and Zinc) may help ward off the advanced stages of AMD.
Furthermore, clinical research at Waterford Institute of Technology (called the CREST Studies) reinforced these findings, demonstrating an improvement in AMD patients’ visual function (improved contrast sensitivity and reduction of glare disability) with a modified AREDS2 formulation.
This modified AREDS2 formulation is available in Ireland and is called MacuPrime PLUS. In addition to the AREDS 2 formulation, it contains the third critical macular carotenoid Meso-Zeaxanthin with safer levels of Zinc.