Looking Forward To Better Vision

Comfortable eye injections treat wet age-related macular degeneration.

Gail Wadsworth retired on January 3, 2017, just before her 71st birthday. She had been serving as Flagler County’s comptroller and clerk of the circuit court, which is an elected position. Gail believes the experience she garnered from previous positions prepared her for the role.

Gail Wadsworth walking down the beach.

By keeping to her injection schedule, Gail has maintained sufficient vision
to safely take her daily walks

“I’ve done a lot of things during my lifetime,” Gail recounts. “Before becoming clerk of the court, I was a corporate secretary and comptroller for a manufacturing company in DeLand that makes amazing skydiving equipment. I also taught school and raised three children.

“Everything I did took me to something else. I taught kindergarten for a while, but then realized I had three children of my own and wanted to spend more time with them, so I went to work at their father’s CPA firm. Understanding accounting led me to the position as comptroller at the manufacturing company, and from there I became clerk and comptroller for Flagler County.”
Gail enjoyed teaching and working at the CPA firm and manufacturing company, but she was especially fond of her government job.

“Being clerk of the court meant I was the country recorder,” she clarifies. “I went to every court session and kept all the court records. I also attended every board of county commissioners’ meeting and kept their records. Government-related jobs fascinate me, and my position with Flagler County kept me on my toes so I was never bored. And I love people.”

Gail was nearly forced to retire in 2010, when small black spots, also known as floaters, suddenly appeared in her left eye. The floaters affected the vision in that eye and even altered the way she carried out some basic daily tasks.

“At first, I didn’t notice any changes,” Gail recalls. “I still had 20/25 or 20/30 vision in my right eye when corrected for astigmatism, so I wore glasses to read. Then, I noticed I was moving my book from the front of my face to the right. I finally realized I was reading with only my right eye.

“When the floaters appeared, I called my eye doctor right away and told her something was wrong. She discovered fluid in my left eye. The next morning, I was in Dr. Jeroudi’s office at Florida Retina Institute in Palm Coast.”

Abdallah M. Jeroudi, MD, is a board-certified, fellowship-trained retina specialist. He diagnosed Gail with age-related macular degeneration, or ARMD, in both eyes.

“ARMD is a condition in which wear and tear damage occurs on the supporting layer underneath the retina, the retinal pigment epithelium, or RPE,” Dr. Jeroudi describes. “ARMD affects RPE cells in the central part of the retina, impacting central vision, which is used to see faces, watch television, read and drive.

“There are two forms of ARMD. Dry ARMD is like the wear and tear on the knees of your favorite pair of jeans. Over time, that wear and tear becomes so severe that a bare spot forms. Dry ARMD affects vision very slowly.

“With the more advanced form, wet ARMD, bad blood vessels and something called a choroid neovascular membrane, or CNVM, grow and leak fluid and blood under the retina. This drastically and quickly affects central vision.”

Every patient can be affected by ARMD differently.

“If you look at pictures of my type of macular degeneration (wet ARMD), there’s a kind of cloud covering the vision,” Gail explains. “I didn’t see very well straight ahead, but I still had pretty good peripheral vision. And I couldn’t see to walk, and I usually walk five kilometers every day.”

Hallmark Sign

As in Gail’s case, ARMD is diagnosed using a dilated eye exam. Once the pupil is dilated, Dr. Jeroudi examines the retina looking for yellow granules called drusen, the hallmark of ARMD.

“While searching for drusen, we can visualize areas of atrophy on the retina. That is how dry ARMD is diagnosed,” Dr. Jeroudi observes. “Atrophy is present with wet ARMD as well, but in addition, there is also evidence of CNVM growing underneath the retina. That can be detected using a special scan called optical coherence tomography, or OCT.

There is no specific treatment for dry ARMD. For wet ARMD, treatment is directed at shrinking the CNVM, primarily through an injection into the affected eye.

“I’m very lucky to have Dr. Jeroudi’s amazing care, because now I can see!” – Gail

“The medication we use is an anti-vascular endothelial growth factor or anti-VEGF,” Dr. Jeroudi informs. “Anti-VEGF medications shrink bad blood vessels, so the injection of these medications stops fluid leakage. These injections can control wet ARMD, but it does not cure it, so the injections must be repeated over time.

“Fortunately, anti-VEGF medications are quite effective. More than 90 percent of wet ARMD patients achieve a favorable response with the injections.”

Many people facing ARMD injection therapy for the first time are fearful that the injections will be painful. Dr. Jeroudi assures that he and his staff take multiple steps to ensure patients are not in pain during treatment.

“The injection experience is actually quite comfortable for our patients,” he notes. “We start by numbing the eye very carefully with drops. We then provide a numbing injection into the area we are going to inject with the medication. We allow the eye to settle for several minutes and become completely numb before we perform the actual injection.

“Most patients are quite pleased because they do not feel the medication injection as it is being performed.”

“Amazing Care”

Gail was a bit nervous when she started injection therapy. She credits Dr. Jeroudi for putting her mind at ease about the eye condition and treatment. She’s thrilled with the improvement in her vision that resulted.

“I’m fortunate that my eye doctor was so quick to get me an appointment at Florida Retina Institute,” Gail maintains. “And I’m very lucky to have Dr. Jeroudi’s amazing care, because now I can see! I can go for walks and go through the grocery store and generally find all the items I need.

“Now, my left eye is the better eye. It’s the one that allows me to read my cellphone and the back of a cake box with magnification. And I look forward to seeing even better.

“Dr. Jeroudi is awesome,” she reports. “He answers all of my questions and always makes me feel better about where I’m going with my treatment. He’s the first person to tell me I will never be totally blind, that I will always have some peripheral vision, for which I’m thankful. He reassures me that as long as I maintain my treatment schedule, and God is willing, I’ll remain right where I am.

“And he’s been right. My eyes haven’t changed for two years.”

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    • Florida Retina Institute

      Founded by James A. Staman, MD in 1979, Florida Retina Institute has 19 locations throughout Central Florida, North Florida, and Southeast Georgia. They have proudly delivered Excellence in Vitreo-Retinal Diseases and Surgery for 40 years. T... Read More

    • Abdallah M. Jeroudi, MD

      Abdallah M. Jeroudi, MD, is board certified by the American Board of Ophthalmology. He earned his bachelor’s degree in Biochemistry from The University of Texas at Austin and his Doctorate of Medicine degree from Baylor College of Medicine in H... Read More