Macular Degeneration Care in Titusville Keeping the Center of Your Sight.

Do straight lines look wavy, or is there a smudge in the middle of your sight?

You heard the word drusen at your last exam, or the words "early macular degeneration," and left with more worry than answers. Or print looks faded, you need the lamp closer than you used to, and the door frame is not quite straight anymore. Or your mother had it, and you want to know where you stand.

Most macular degeneration is the dry kind, and it moves slowly. Our job is to tell which kind you have, watch it carefully, move fast if it changes, and keep your sight working for the things that matter to you. Come see us. You will leave knowing what we found.

What is macular degeneration?

Macular degeneration is wear on the macula, the small spot at the center of the retina that gives you sharp, detailed vision. Age-related macular degeneration, AMD for short, is the form that comes with age and often with family history. It blurs or dims the center of what you see and leaves side vision alone, so people with AMD do not go dark, but reading, driving, and faces get harder.

There are two kinds. Dry AMD is far more common. Small yellow deposits called drusen collect under the macula and the tissue thins slowly over years. Wet AMD is less common and more urgent. New, fragile blood vessels grow under the macula and leak fluid or blood, and vision can change within days. Dry can turn wet at any point, which is why we keep watching even when nothing seems to be changing.

Age is the biggest factor, then family history. Smoking and years of Florida sun add to the odds. If AMD runs in your family, tell us, and we will start looking closely at the macula earlier than we otherwise would.

How do we check for macular degeneration?

We look at the macula at every comprehensive eye exam, with a dilated view of the retina and an Optomap wide-field photo. When we see early changes, or when a parent had AMD, we add an OCT scan that shows the layers of the macula in cross-section. The three together tell us whether you have AMD, which kind, and whether it is holding steady.

The OCT is the scan that changes the picture. It uses light to read the retina layer by layer in a few seconds, with nothing touching your eye. Drusen and thinning show on it long before you notice a change in your reading, and fluid from wet AMD stands out as a bump in the layers that is hard to miss. Every scan stays in your file, so the next one has something to be measured against.

The Optomap photo does the same for the wider retina, and it is up on the screen before you are out of the chair, so you see what we see. Year to year, it is your baseline.

At a macular degeneration visit we look at:

• How well you read the chart, and whether that has slipped since last time
• The macula itself, through dilated pupils
• An Optomap photo of the retina, kept as your baseline
• An OCT scan of the macula, set beside your earlier scans
• The rest of your eye health, pressure and lens included

How is macular degeneration treated?

Dry AMD has no drop or pill that reverses it, so care means careful monitoring, protecting the retina, and for some stages a specific eye vitamin formula that has been studied for slowing it down. We tell you whether your stage is one that benefits, because it is not for everyone. Not smoking and wearing sunglasses outdoors are the two things you can do at home that count.

Wet AMD is treated with injections of a medicine into the eye that stops the leaking vessels. A retina specialist gives them on a schedule, and timing matters, so we do not wait. We do not give the injections here. When an OCT shows fluid, we refer you to a retina specialist, send our scans along, and keep seeing you for everything else your eyes need between those visits.

Whichever kind you have, the scans decide when we see you next, not the calendar, and you leave knowing the changes that should bring you back sooner.

What if I already have trouble reading?

When glasses can no longer bring print back, the next step is our Low Vision Clinic at Playalinda. Dr. Sarah Koehnemann started it in 2012, the year she joined us, and she still runs it. A low vision visit begins with one thing you want back, the mail, the price tags, the TV, faces across a room, and works through magnifiers, telescopes, lighting, and glare filters until we find what does the job.

It is a longer visit than an eye exam, and a different kind. Medical insurance usually covers the evaluation and the follow-ups. The devices are paid separately, and most cost about what a pair of glasses does. Once your appointment is booked, a welcome packet from us tells you what to bring and what to expect.

Who follows macular degeneration at Aker Eye, and where?

Dr. Sarah Koehnemann is the doctor to ask for when AMD is changing how you live. She grew up in Titusville, five generations deep, and shadowed Dr. Aker in high school before optometry school. Her residency at the SUNY State College of Optometry was in ocular disease and low vision, she did an externship in ocular disease at Bascom Palmer Eye Institute, and she walks in the Foundation Fighting Blindness Vision Walk every year. She practices at Playalinda, 1114 S Washington Ave, on one floor with parking at the door.

Dr. Greg Aker, a member of the Optometric Retina Society, and Dr. Amanda Aker, whose residency was in ocular disease, follow AMD patients at our Downtown office, 338 S Washington Ave, second floor with an elevator. Dr. Jennifer Bradley sees patients at Playalinda. All four of us look at the macula at every exam, and any of us can send you down the road to Dr. Koehnemann when glasses stop being enough.

Does insurance cover macular degeneration care?

As a rule, yes. Once we are following macular degeneration, the visits, the dilated exams, and the OCT scans are medical care, so they go to your medical insurance, including Medicare, with your usual copay. A vision plan pays for glasses, not for this. Give us your plan name when you call (321) 269-2021 and we will check your benefits before you come in, so there is nothing to sort out afterward.