Time Is Of The Essence

Early detection of macular degeneration key to preserving vision.

For many years, Olivia* and her husband owned an automotive radiator and air-conditioning business in Miami. When business there began to decline in 2002, the couple took their entrepreneurial spirit and moved 200 miles north to Titusville.

“We had friends who lived in the Titusville area that we visited frequently, and we really liked the area,” Olivia shares. “Our children were all grown up and had moved out, and we thought Titusville would be a nice place to relocate and eventually retire.

“Some people we know own a self-service car wash in Port St. Lucie. We figured that would be a good business to have to keep us busy, so we opened a self-service car wash in Titusville. We’ve had it for about 18 years.”

Olivia, 62, says there are benefits and drawbacks to being self-employed.

“It’s nice not having to answer to a boss, but your business becomes your boss,” she reflects. “It dictates when you work, and it doesn’t care what the hours are. Because our car wash is self-service, people come at all hours of the day and night.

“It’s our job to make sure the equipment works properly and the place is clean, so we have to empty the garbage cans and things like that. It’s actually a 24/7 job. Still, we’re OK with it. It keeps us busy, and we’re making enough money to survive.”

Ten years ago, Olivia started experiencing a serious threat to her security. She developed an issue with her eyes that affected her ability to perform many everyday tasks.

“I was having problems with my vision; it was blurry,” Olivia discloses. “The problem started in my left eye. Then five years later, my right eye was affected as well. I didn’t have any other symptoms, such as headaches or black spots, just the blurry vision.

“I went to my regular ophthalmologist, who ran some tests and discovered that I had macular degeneration. He advised me to go to Dr. Barnard.”

Thomas A. Barnard, MD, is a board-certified, fellowship-trained retina specialist at Florida Retina Institute. After thoroughly evaluating Olivia’s left eye, Dr. Barnard confirmed the diagnosis of macular degeneration, a progressive breakdown of the macula, or center portion of the retina responsible for central vision. The retina is the light-sensitive layer (or wallpaper) of nerve tissue that lines the back of the eye.

“Just like the rest of the body, the retina undergoes changes over time that can eventually affect vision,” Dr. Barnard describes. “These changes generally occur in people over 40 years old, so the condition is also called age-related macular degeneration, or AMD. 

“The changes associated with AMD are primarily genetic. People who have family members with AMD have a much higher risk for developing it. Genetics accounts for at least half of all cases of AMD, although certain lifestyle factors affect risk as well. These factors include sun exposure, diet, activity level, cholesterol and blood pressure.” 

Wavy Lines  

There are two types of AMD: dry and wet. Dry AMD occurs due to natural degenerative changes to the retina. The most common symptom of dry AMD is blurry or distorted vision; straight lines may appear wavy, for example.

“With wet AMD, the body tries to grow new blood vessels to help nourish the degenerating tissue in the back of the eye,” Dr. Barnard explains. “However, these blood vessels are abnormal and leak into the retina, destroying central vision. In addition to blurry or distorted vision, wet AMD can also cause dark spots to form in the field of vision.

“The majority of people with AMD have the dry type. Only about 15 percent develop wet AMD. We do not know why some people develop dry AMD and some develop wet AMD. Generally speaking, dry AMD does not progress to wet.”

There are no treatments for dry AMD, other than taking a special formulation of eye vitamins called AREDS2.  If wet AMD is caught early, there are treatments that are effective at halting progression and further vision loss.

“For the most part, treatment for wet AMD involves medications that block vascular endothelial growth factor, or VEGF,” Dr. Barnard educates. “VEGF is a protein made by the body that causes new blood vessels to grow. Anti-VEGF medications suppress the formation of blood vessels that become abnormal with wet AMD.

“These medications only stay inside the eye for a certain amount of time before the body flushes them out. Therefore, anti-VEGF injections must be given continually at certain intervals. Each patient is different, so the interval between injections is specific to the patient.”

There are three FDA-approved anti-VEGF medications used by the specialists at Florida Retina Institute: bevacizumab (brand name AVASTIN®), ranibizumab (LUCENTIS®) and aflibercept (EYLEA®).

“Olivia first came to us 10 years ago with symptoms of wet AMD in her left eye,” Dr. Barnard recalls. “We treated that eye, but unfortunately, we caught the AMD too late and she lost significant central vision in that eye.

“Fortunately, we caught the wet AMD in her right eye very early, and we are treating it with injections of AVASTIN every eight weeks. She is doing very well with the treatment. She has been able to stay independent and do everything she wants to do.”

“I Love Them”

“The injections aren’t painful at all because Dr. Barnard numbs my eye first,” Olivia describes. “And within a matter of minutes it is done. And thanks to those injections, my vision now is very good. Depending on the day that I visit Florida Retina Institute, sometimes my vision is 20/20 and sometimes it’s 20/30. God bless Dr. Barnard. He’s done a fabulous job of helping me keep my vision.”

Olivia is thrilled with the outcome of her treatment at Florida Retina Institute. She’s also pleased with the retina specialist providing that treatment.

“Dr. Barnard is a very nice man,” she describes. “He’s very polite and has a very good bedside manner. He’s good at explaining things to me, and I feel very comfortable going to him for my eye care.”

She appreciates the institute’s staff as well.

“I love them,” Olivia raves. “There’s not one person that works there that I don’t love. They’re very nice people and very friendly and compassionate. Dr. Barnard has a great staff.

“I recommend Dr. Barnard and Florida Retina Institute to anyone who has any kind of macular degeneration.”

© FHCN article by Patti DiPanfilo. js
*Patient’s name changed at her request.
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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

    • Thomas A. Barnard, MD

      Thomas A. Barnard, MD, is certified by the American Board of Ophthalmology. He earned a Bachelor of Science degree from Stetson University in DeLand and a Doctor of Medicine degree from the University of South Florida in Tampa. After g... Read More