I, Dr. Nguyen, will always be the first to admit that sometimes, I misses stuff (like the tense of miss). While looking into this patient’s eyes UNDILATED, everything looked unremarkable. But upon performing confocal scanning photography, tiny patches of pigment loss in the macular is revealed. Depending on if you can blow up the photograph, there are four whitish dots in the very dark center of this eye (the parafoveal region). Above the parafoveal region at 12, 11, and 10 o’clock are further spots in the macular of pigment loss. Although very minor at the moment, the future is hard to predict and it is possible this patient is at the very early beginnings of macular degeneration.

This patient received an eye exam five years ago and was never told anything regarding his eyes. The plan for this patient is to receive an annual fundus photo to monitor the progression of these white spots (called drusen) and a change in diet and sun and UV protection. If time reveals an increase in the number or the size or location of drusen, a more aggressive plan may be put into place. But for now, this patient is happy eating more green leafy vegetables (which he admits he avoids) and more blueberries (which he already loves). He also says he will be purchasing sunglasses.

Also, this is an aside… but have you ever noticed why there are so many macular degeneration vitamins commercials shown during football sunday? The answer is simple. The demographic for Age-Related Macular Degeneration (called ARMD or AMD) is the same demographic for viewers of American football: Caucasian males, in their 60s-80s. A large portion of this demographic also smoked cigarettes when it was popular during the 1970s and 1980s and smoking is also a risk behavior associated with AMD.