Charles Bittel, O.D., Inc.

Charles Bittel, O.D., Inc., Newsletter 

The Macular Degeneration Issue

May, 2011


Charles Bittel, O.D., Inc.

Thank you as always for your support of our practice and for the wonderful responses to the newsletters. Just like last month's newsletter on LASIK, this month's topic comes from a patient request. Actually, a few patients have wanted to hear more about Macular Degeneration, so below is a summary of this disease that is unfortunately becoming more prominent as the population of our country ages. We hope you find the information useful, and thank you as always for your time.


Charles Bittel, O.D.

Charles Bittel III, O.D.


In This Issue
Featured Article
FAQs about ARMD
Macular Degeneration - Dry and Wet
Age-related macular degeneration (or ARMD) can basically be separated into 2 categories: Dry and Wet.
The early phase of ARMD is the dry form. This is the result of a deterioration of the macula, the tissue responsible for central vision. Patients with dry ARMD experience difficulty with detailed objects, such as small letters or recognizing facial features. The management for dry ARMD includes vitamin therapy with specific doses of antioxidants and minerals as determined by the AREDS study. (This link is very helpful in summarizing the results and recommendations of the study, please thoroughly review the information if you or a family member have dry ARMD).
In some cases the dry form of ARMD will progress to wet ARMD which is the more advanced classification of the disease. Wet ARMD is characterized by leaky blood vessels at the macula. When these vessels leak, they can cause the macula to swell and to ultimately scar, resulting in severe vision impairment. Retinal specialists are presently using an injectable drug known as Avastin to stop the growth of the leaky blood vessels.





 FAQS about ARMD



One of my parents/grandparents has macular degeneration, does that mean I am going to get it?


No, but it does put you in a higher risk category. If a close relative has ARMD than you must take extra precautions to ensure that you are not exposing yourself to other risk factors.


What are some other risk factors besides family history?


1. UV exposure. If you are 40 and spent the first 39 years of your life without wearing sunglasses outdoors, start now. If you are a parent and can get your child, no matter how young, to wear sunglasses outside, please do so. Think of them as sunscreen for your eyes.


* Please make sure your lenses have a good quality UV coat. Most will say 100% UVA / UVB protection. A $5 pair off the rack at the drug store may actually do more harm than good.


2. Smoking. Yes, this is yet another reason to stop smoking. Studies have indicated that smoking makes an individual 3 times more likely to develop ARMD and that the onset can be about 10 years sooner in individuals that smoke.


3. Diet. Yes, yet another good reason to have a healthy diet. While the vitamin therapy from the AREDS study has not shown to have any preventative effects, a healthy diet with plenty of green leafy veggies has been shown to have some beneficial effects.


So should I take a supplement designed for macular degeneration patients if I don't have ARMD?


No, but you should take a multivitamin. A multivitamin, along with a healthy diet can give you plenty of the vitamins and minerals you need to lead a healthy lifestyle.


I have dry ARMD, what is the likelihood that it will convert to the wet form?


Only about 10% of patients with ARMD have the wet form.


What changes in my vision should I look out for?


Many of the early symptoms of ARMD can be attributed to a few different diagnosis. Difficulty seeing fine detail, difficulty with color perception, or just a reduction in overall vision can be early signs of ARMD, BUT they can also be signs of cataracts or something as simple as a prescription change. One of the more telling signs that something may be going on at the macula is the appearance of straight lines looking wavy, but again, this is not necessarily diagnostic of ARMD. The best rule of thumb is to play it safe...if you feel like your vision is changing for the worse, schedule an appointment as soon as possible.


What if Dr. Bittel sees early signs of ARMD during my exam?


There are very early warning signs that we look for at the back of the eye. If these are detected, it does not necessarily mean that you will develop ARMD, but we will urge you to control the risk factors that are controllable. If dry ARMD is detected, we will likely start you on the AREDS vitamins, and depending on the level of vision loss at the time may refer you to see a retina specialist for further evaluation.


What are my options if I do ultimately suffer vision loss from ARMD?


If the vision loss is minor, you will likely be able to function very well with normal glasses. We might slightly increase the magnification in your reading prescription to help with smaller details. Lighting will also make a HUGE difference for patients with any level of vision loss. The closer you can get the light source to the reading material, the more beneficial the lighting will be (also look for full-spectrum light bulbs, these most closely imitate natural sunlight).


Patients with a moderate degree of vision loss will likely benefit from more magnification in their reading prescription or even a separate pair of high magnification reading glasses.


If you or someone you know suffer from severe vision impairment from ARMD (or any other ocular disease) please seek assistance from low vision centers such as the Braille Institute or the Southern California College of Optometry Low Vision department. There are a number of low vision aides to help with distance and near vision, computer programs, and even government programs that provide books on tape and large button telephones.

Medical Insurance: Dr. Bittel now accepts most PPO plans as well as Medicare for medical office visits. If you have a red eye, allergies, or any other eye related medical concerns we are happy to help. If you have a PPO or Medicare, we will ask to make a copy of your card for our records.
Contact Lens Rebates: Many contact lens companies are offering rebates with the purchase of an annual supply of contact lenses. This can significantly reduce the price paid per box of contacts, especially when used in conjunction with vision insurance. Please ask if your contact lens manufacturer is presently offering any rebates.
Glasses: Some vision insurance plans offer 20-30% off a second pair of glasses. If you need to update your primary care glasses but are interested in a second pair such as sunglasses or computer glasses, please ask if your insurance offers these discounts.
Transitions: Many of you may have seen recent commercials for Transitions lenses (the lenses that are clear indoors and turn dark outdoors). For patients with certain vision plans we are able to offer a no-risk trial of Transitions lenses. If you ultimately don't like your Transitions the insurance company will refund the cost of the Transitions and remake your lenses.
About Us

Dr. Chuck Bittel (Senior) has been practicing in Yorba Linda for over 25 years. His son, Dr. Charlie Bittel (Junior) has been practicing in Yorba Linda and Fullerton for the last 5 years and has just joined his father's practice full-time.


Learn more about Dr. Bittel Senior and Junior and about their practice on their website and Facebook page. Also visit the blog for Computer Vision Services to learn more about Computer Vision Syndrome.


For appointments call 714-779-8521


Charles Bittel, O.D., Inc.
20399 Yorba Linda Blvd.
Yorba Linda, California 92886