What is Macular Degeneration? | Knock Knock Eye 

So glad you covered this Dr. G. Both my parents have/had Macular Degeneration. Dad went completely blind. I am thinking he must have had severe dry because he was only offered the vitamins as treatment. Mom has wet. She has been getting the injections. She is now down to once every 6 weeks. Initially, it was only in one eye. However, during treatment they were able to catch it starting in her other eye and she began treatment immediately. I am 63. I will make sure I have eye exams regularly since I am both of the right age and genetics for it to start.

My dad has dry in one eye and wet in the other. He's lost his vision, but retained his sense of humour about it. Bless his heart, he keeps calling it "immaculate degeneration", which sounds like a great name for a band.

A detailed eye model would be great on these videos or insert a diagram , would be helpful!

My eye doctor found my first hole from MD when I was 25. He used it to show students as he said it was abnormally for my age.

Would love to see you tackle Stargardts or other juvenile macular degeneration. When I was first diagnosed the drs got excited as they had never seen it in person. Every new dr wants to take a look. Its annoying but I understand that its not something you typically see but still.

Thank you so much for covering this topic. I was diagnosed with MD within the last year. My retinologist must see over a hundred patients in a day. He has no time to talk or do much education. I learned a lot from you. On Monday, when I went in for my eyeball shot, he found a small pocket of blood in my right eye, so I got two injections. It was found much earlier than the wet MD in my left eye, so hopefully I’ll get even better results. Let me reassure people, the needle in the eye isn’t bad. A couple rounds of numbing drops, then local anesthesia shot, then medicine shot. And my guy is really quick giving the shots, I imagine most are. No pain if he’s waited long enough between drops and after the local. When I have felt anything, it was no worse than getting an eyelash in my eye. As far as generic drug names, one of my favorite memes is “I tried pronouncing the generic names of my meds and accidentally summoned a demon.”

We used to have laws and actual enforcement against vertical integration. It's why a lot of old movie theater buildings are named "Fox", "Paramount", etc. The film studios used to own theaters as well and were forced to divest of them. Sadly, the trend since the '80s in the US has been to undermine enforcement and then simply to repeal laws that were protecting the average USian against the rapacious wealthy, including wealthy corporations.

I'd love to see a video on MS and how it can effect the eye.

Thank-you so much for this. I learned that I have dry macular degeneration at last year's annual eye exam. I feel much more hope having listened to this. I am taking AREDS-2.

6:00 that's why I believe healthcare should be almost all exclusively government funded and not private... Turning life into a commodity should be illegal.

Ok Doc, ya gonna love this. I live in Houston. Kelsey Seybold Clinic is a HUGE clinic here with 20+ locations…and growing. Been around since the 60’s. UHC acquired them roughly 2 years ago. There’s been no name change - yet. Most docs there have to stay for 3 years in order to get a full payout. So in roughly 1 more year, they could see a large outflow of docs. I have been going there for the last 5 years (excellent Advantage program….i have been quite happy with the healthcare). I am holding my breath that the good docs don’t move on.

Just out of hospital because I have intracranial hypertension. The first neurologist I saw missed it, but then when my eyes stopped focusing correctly I went to an ophthalmologist and she saw there was something wrong with my optic nerve and referred me to a general hospital. I ended up being kept in for 11 days and I'm not fully better yet but I'm definitely improving. I'm glad I watch your videos and I knew there was something wrong with my brain, I wouldn't have thought to go to an ophthalmologist if it weren't for you

Thank you for this one! My grandmother had macular degeneration and my mom made me promise to wear sunglasses whenever I'm outside during the day in order to prevent it.

Thank you for this episode. I was researching macular degeneration because a close family friend was diagnosed with it. I learned so much. I really enjoy your podcast. Who knew the eyeball could be so interesting?!

My Dr gave me drops and it seems to have lowered the pressure by a lot. Eventually I’ll have to increase the number of drops and hopefully I’ll keep my eyesight for a long time. I’m 70 an hope and pray I don’t go blind. Your videos are not only entertaining but very much needed education. I personally appreciate all your efforts. Nice job young man.

Thank you! Both my parents had it, and my ophthalmologist knows about my family history, so she’s on the lookout for it in my annual exam. She also has been very optimistic and reassuring about treatments and preserving my sight, but you help a lot too.

Thank you for this video! 🥹 My Mother suffered from macular degeneration, and eventually was nearly blind with some peripheral vision. Miraculously, she was able to see my redheaded 👩🏻‍🦰 3yo who was dancing in a white dress to the side of her grandmother. She was thrilled! That’s how much vision means, never take it for granted. Regarding Insurance and profit, at Kaiser Permanente, you need to actually KNOW GOD😳 to have an in person appointment with a Dermatologist. Not exaggerating, it’s the most gate keeping 🙅🏻‍♀️ department.

My grandmother suffered from Macular Degeneration, and my mom has it real bad. The injection timeline sounds about right because my mom started injections about 20 years ago. There was some holding it off for a while but the last 3 or 4 years it's gotten really bad for my mom. Specifically the last year and a half. She can no longer identify faces and has minimal sight remaining on the edges of her right eye. Added to that she's quite hard of hearing. It can be kind of depressing getting older. At least my wife and I are in a position to be able to care for her, so there's that. Thanks for the videos they're quite enjoyable. 99% of the time I accidently get educated. Stay safe out there, and take it easy.

Ya, I take the vitamins. I took them when I had to take the individual vitamins before the speciality pills. I was told my Bruch's membrane was intact, so I needed the vitamins. Luv the show Doc.

I’m in my mid 40’s and have developed some ptosis in my left eye. It doesn’t affect my vision but does make me self conscious. The ophthalmologist I saw said it’s related to long term contact lens use. I would love it if you could explain how wearing contacts can lead to ptosis. I had no idea that could happen. Yes, I rub my eyes some but I never thought I did so excessively (though I didn’t know rubbing one’s eyes could be harmful until I watching your videos!). Thanks for your enjoyable and informative videos!

Thanks so much! I asked for this topic (although I don't know whether you saw it) and I an very happy to have learned more about the pathologies of MD! A family member now has the wet form on top of three other eye conditions, having to make a difficult surgery decision. So understanding really helps me talk about it with her :)

6:47 OMG Yikes! I'm a Canadian healthcare worker and this is rather horrifying!

I have (dry) macular degeneration and was very interested in your video. I found your information calming. Thank you so much. By the way, I live in Tualatin and I'm guessing I'm not far from you.

Heyyyy you should do a video on how Ehlers-Danhlos Syndrome affects your vision, it’s more common than we think!

This series is super informative. Thank you!

Thanks for covering this topic. My aunt (now long since deceased) had macular degeneration. Glad to hear that there are now treatments for it that will prevent others going through what she went through.

Retinitis pigmentosa is a very similar condition that runs in my in law’s family and has begun to express in my husband already. I’d love to hear what you know about that one and perhaps any studies you’ve come across that are working towards some sort of treatment.

This was very good!

Thank you so much for the video about macular degeneration. I enjoyed every second of it. I do have a question: does diabetes affect macular degeneration?

Great information, as always, Doc Glauc, and your presentation can't be beat! Thank you for doing these!

Great insights, thank you!

I wish I have these a year ago in PA school. Well done!

I'm going to share this with my coworkers (we work in retina)- it's helpful to get things explained in layman's terms!

I love your im-maculate presentation on this topic.

Thank you Optho bro 😎 love your mini rant and I so agree - healthcare is going down a scary road - it should not be a business!!

Thanks for sharing your experience with anxiety post cardiac arrest. I was diagnosed with a heart condition years ago but I still occasionally feel a tinge of anxiety if I'm trail running near the peak of a mountain these days.

Thank the computational chemists who extrapolate what organic chemists synthesize to predict the docking mechanisms of potential drug candidates "in silico" and come up with novel pharmaceuticals that may confer better efficacy and fewer side effects designed in software. That is my background from before I went to medical school and I have been fully admiring of the genius that thinks about these possibilities. Was so pleased to hear your talk today on (advanced) dry and on wet macular degeneration. It is an exciting time to be an ophthalmologist - and an ophthalmology patient!

I'm coming up on 20 years since I finished pediatric residency. Man, I'm old.

I love this content! ❤

Good morning, Dr. G! Question: do macular wrinkles or cysts make one more likely to get AMD? Also, fave drug names: pegaptanib (Macugen), voretigene neparvovec (Luxturna), all of the -mumabs, tebentafusp (really? fusp?), mitomycin C (just like how it trips off the tongue), I could go on and on.

Horner's syndrome has haunted me ever since I found out about it and that it can happen in humans (I learned about it because of cats). Would love to hear your talk about it!

Hey, I love this series! I have a possibly dumb question - how important is the warning label on eye drops that says “don’t let the tip of the dropper touch anything”? I have hand tremors and poor visual spatial skills, and I occasionally hit the inside of the lid or my eyelashes.

Loving the Knock Knock Eyes! I'm trying to get into grad school for organic chemistry but maybe I haven't grown the required gyrus yet lol. I would love to see an episode on genetic diseases with eye signs, like Wilson's disease or Tay-Sachs.

I do like to watch and I would love some slides on the eye when you describe the parts.

Thanks!

Love your work. I am a clinical coordinator for a Specsavers in New Zealand so I find your content fascinating. My favorite name of a medication we have here in NZ is efudix cream.

Thank you for this rather optimistic and demystifying topic. Family history of AMD so I'm hoping for science to progress before I might need treatment. Sounds like it is! 🇨🇦

Hello Dr.Glaucomflecken can you please tell about retinal detachment.Because my grandmother had retinal detachment as a complication of Diabetic retinopathy.

You give me hope.

can you do a video about opthamology research if you know anything about it? just from the drugs and treatment you were talking about in this video it sounds really fascinating

My mom has wet MD and the shots worked so well that she has to only go once every three months now. My dad had both retinas detach - so I have bad eyes on both sides of the family.

I have a family history of MD (grandmother and an uncle)and have been taking AREDS vitamins daily for about 25 years. I’ve mentioned my familial history and use of these vitamins to my eye doctor and he has never said to stop. I thought I was doing what I could to decrease the risk of MD now I feel maybe I’ve just flushed a lot of money down the toilet over the past quarter century🤔

This was a very good video. I especially liked the anatomy description of the eye because it was more detailed than any doctor has ever given me. I have a formation of druzin and both my retinologist and optometrist have said that it’s very mild, and to not worry about it too much. I was recommended to take the vitamins. My question to you is does good cardiovascular care have an effect on the formation of druzin ?

Well done and thanks. Education of patients is such a huge part of medicine. [Perhaps exception is ortho- ugh, see problem-fix it:-) ]. Being serious with good humor is dynamite combo. BTW not so sure re organic chem but kudos for recent advances through immunology (monoclonal segments) and perhaps genetic (aptamers) or simply biologics based.

Hey doc, idk if you will see this, but recently as a 21m i have been experiencing my right eye uncontrollable looking up while i look to my left. From what I have seen online it would appear to be strabismus, specifically hypertropia. I was wondering if you could do a video on strabismus in general, and what risk there are and how it happens in early adult hood.

I moved in with my brother 3 years ago. In that time he went from driving and doing his thing, to almost totally blind except for peripheral vision. His healthcare is through the VA, which offers shot but he refused them.

I love this content! Really very interesting! You’ve gotten me interested in ophthalmology! Looking forward to learning more in med school! Thank you!

I already have wet MD in one eye as a consequence of being a high myope; fortunately it has responded very well to just two intravitreal injections of aflibercept (eyelea). I would love a podcast on pathological myopia.

we have a family history of MD. so chances are i'll get it one day. the idea of the injections into my eyes is terrifying, because i have a phobia of 2 things: dolls and needles in my eyes (i had a foreign body in my eye when i was 5, and i'm pretty sure that traumatised me) my mum has been taking Lutein & zeaxanthin for many years, and our optician said that there's a big chance that because she's been taking them for so long, it's probably kept it at bay much longer. but who knows!

Thank YOU for being on the warpath to expose the woes of big medicine.

I had days and days of flashes. "Oh, it's pulling on your retina. No problem.". Then one morning, I closed one eye to put on eye shadow, and could not see my head! This was 20+ years ago, so had two sessions of photodynamic therapy. Couldn't go out in sun or have surgery because of the bright light for 3 days. Worked well, it hasn't come back.

A character in some of my favorite novels/one of my favorite underappreciated TV series has a condition called Retinitis Pigmentosa and I'm curious about that topic

I'll try to send you the nomenclature for the new biologics (as they're known at work) 33:13 I would like to know more about the disease that some of my patients have (I'm admin rather than clinical) where they are said to have 'trilateral'. (I don't want to specify my job but I think that you'll have a pretty good idea)

If the treatment for dry macular degeneration at an advanced level can help stop progression, why don't doctors use that when the first sign of yellow dots are present? My mother had macular degeneration.

this runs in my family :(

My aunt and recently deceased ex-FIL had it and it’s terrible. You should have Henry Winkler on to talk about his father in law 😂

I use a 32 gauge needle for a(non-eye) injection I'm on and guys it's like the size of 3-5 really fine strands of hair stuck together. I legit don't feel it most of the time, unless I accidentally inject into scar tissue.

Funny that you mention UHC as they are trying to purchase the clinic I m a patient of, Corvallis Clinic. The word locally is that it will be good for the the clinic as they have been struggling and actually cut the wages of doctors employed there. Personally, I don't care for it but have little recourse as I am deeply entrenched with them. We shall see. Also, one of the issues my dad had late in his life was MD but he passed at 103 over ten years ago.

Love to see Tabitha in the background!

I don't think there is a limit to my willingness to listen to you talk about eyeballs. A multi-hour video of you just going through this stuff would be fascinating to me.

As a clinical social worker/psychotherapist for 23 years, I find the vertical integration concept frightening, unethical and sickening.

Can you address the practice of moving practices to hospital outpatient departments? Practices can charge more for a cardiologist visit in a hospital outpatient department. They say that the patient sees very little of the increase in cost, but it's simply not true.

I am a Peds doc and have been told to take the vits. Read in one place that zinc in AREDS II is good and in another that it can make some people's MD worse. Can you weigh in on this please?

I want to learn about polycoria, we've all seen the pictures, i want to hear what the process on the ophthalmologist's side is when someone with this shows up

Hi Doc, I have a possible topic you might discuss; scarring within the retina. I've had a few optometrists and one retinal specialist mention that I have some scarring going on with my retina, but that it's not a big deal. I absolutely believe them, but I am curious about what can cause the scarring, and when it is a "big deal" or not. Is it just where the scarring occurred/occurs, what caused it, some combination of the two? I am highly myopic with some moderate astigmatism and some connective tissue issues just for flavor, so maybe those are responsible for the scarring? Anyway, love the content!

Have you covered keratoconus? I'd be interested in your thoughts on that

How about corneal abrasions and hard contact lens. I developed corneal ulcer after attack of shingles at age 40.

I got choroidal neovascularisations starting when I was just 25. Lost most of my central vision (in one eye) now at 43. Other eye is fine. But never any reasonable explanation! First they said it was my near-sightedness, but at the time I was only -4.0. Then they said it was tropical parasites when I'd never been further than Italy (I'm European). I very likely have an autoimmune disease, but ophthalmologists insist it can't be that, despite being much more likely than either of the two options they offered. Is this dithering because not enough is known about why this happens in the first place? Or some misplaced fear of stepping on the rheumatologist's toes? Or some combination of the two? I understand that as the patient this is happening to, I have a much greater interest in these things than the ophthalmologist themselves, but trying to work out what is going on in some doctors' minds is hugely frustrating. 'I don't know' is an answer. 'I don't know but maybe this person does' is an even better answer. I never get either of those.

I'm interested in the effects of connective tissue disorders on eyes because I have hEDS and resulting eye and vision issues.

Do you have the study article? My family is nuts about vitamins but I have a different view. We all hear from either side "there was a study" but where is it?

I saw it could be prevented with a low carb diet. A friend of mine's mother has md and only recently lost her drivers license and is in her 80's. Said friend smokes and won't stop even after getting a cancer scare in his mouth that was not cancer. At least he does not smoke in her house.

Re: nobody cares about corporate greed controlling US healthcare. They have purposely made it very, very confusing. I get the awfulness of insurance policies, but people’s eyes glaze over as soon as I start to mention the little malicious incompetencies that ALL insurance companies have built into their systems. This includes non-bad, not stupid people who work for the insurance companies, including the companies managing Medicaid and Medicare programs, AND whoever is coming up with limitations and policies that are part of the contracts between the states and insurance companies.

Could you do an episode with BlindSurfer Pete? He lost his vision due to an illness. I can't name it, but it's a degenerative disease since childhood where light slowly kills the cone receptors.

Have you heard anything about stemcell research on regrowing photoreceptors?

I have a question regarding a weird thing I noticed when playing with my dog. When a light source (let's say a lightbulb) gets reflected on my dog's eyeball, if I get reeeeeaaaally close and look into that light source reflection, I can see with my naked eye something akin to a microscopic image. I checked on some fellow humans later and got the same results, but I'd like to know what exactly am I seeing and why does this happen.

Will I find this info useful? Probably not. My family has no history and I dont smoke. Do I find this amazingly interesting for a 30 minute readers digest version? Yes, very much so!! Thank you!

1:30 'pertain to my organ... That I specialise in' good save

"aw hell yeah I just took care of someone with herpes in the eye" --words I never thought would be created by my mind when I was going to school

Here's a med for you - Azathioprine. I've seen many people in medicine who struggle with this one. Let's see how you do

I have ulcerative colitis. What eye problems should I watch out for?

My father’s side of family has macular degeneration, and all of them have them. I did a 23andMe gene test and the results were that my genes has high AMD risk. So now I know that I have to watch out for the degeneration to hit, and have planned to see an eye doctor each 3-5 years. But what else can I do to lessen the risks. The injections have not helped my aunt and my father’s cousins, even though they seem to have the wet version. They have been very varying age when AMD has effected, maybe the dry degeneration has already progressed so that the vision has been destroyed beyond help.

The thing separating organic chemists from normal people is a part of their brain that makes them feel warm and fuzzy whenever they see a curly arrow. Source: It came to me in a dream

I don't have MD in my family, but I have some curiosity about it, because I have some sort of mutation on the same gene as the one that gives people MD, but apparently it isn't associated with increased risk. I haven't a clue how that can be the case, but there it is. I do know though that whenever an ophthalmologist first looks at my retinas, they are always unsettled by them and reassured when they look again a few years later. So whatever my weird no-risk gene does, it's something but it just doesn't negatively impact my vision.

I switched away from United Health Care medicare this year thanks to the insurance education I got from this channel.

23 and me has a check for genetic mac degen.

One of my friends has requested POHS.

My eye doctor never told me I had AMD. Wasn't until I went to another person in his practice tell me oh did you know you have this. If infections don't work what's next

If someone (young, in their 20s) has multiple genetic variants associated with macular degeneration -> Would there be things they could do as a *preventative measure*? Or any specific medications you would recommend?

I have dry spots and take systane and ivizia drops throughout the day. Is this different from macular degeneration?

I got it at 44 probably due to being pathologically myopic. No smoking.