EP #23: The Amsler Grid Alert: Defending Against Wet Macular Degeneration with Early Detection

Could a simple grid be the key to safeguarding your sight against wet macular degeneration? That's what Dr. Thuy Nguyen and I, Jeremy Wolf, explore in the latest episode of Jazzy Eyes podcast. We dive into the significance of the Amsler grid for early detection and why it might be the most important piece of paper on your fridge. As we navigate through the eye's version of a stealthy intruder, we lay out the signs that should prompt a march to your ophthalmologist and the treatments that await.

Ever heard of Aria, Eylea, or Lucentis? They're not the latest pop stars, but they could be headlining the chart of your eye health. We pull back the curtain on the mystique of intraocular injections, these groundbreaking treatments that sound like they've leaped out of a sorcerer's spell book. With a touch of humor and a heap of expertise, Dr. Nguyen and I discuss the experience of receiving these treatments, debunk myths about the discomfort, and provide comforting insights about the journey through ophthalmological care that might just change the way you see the world—quite literally.

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or contact: (954) 473-0100

Transcript

Speaker 1: 0:03

Welcome to the Jazzy Eyes podcast. Taking care of your vision with expert precision. Here's your host, dr Tui Nguyen.

Jeremy: 0:14

Hello, hello everyone. Welcome back to the Jazzy Eyes podcast. I'm your co-host, Jeremy Wolfe, joined by your host, Dr Tui Nguyen Dr Nguyen, so nice to see you again so soon. We've been on a deep dive exploration of macular degeneration. I've already learned quite a bit about the dry version as well as the wet version. I know you were just talking about the differences and distinctions between the two and what wet macular degeneration is. Now I know you wanted to get into kind of management treatment options once somebody is diagnosed with wet macular degeneration. Yeah, yeah, In lightness let's go.

Dr. Nguyen: 0:54

When we see you for your annual eye exam and we dial you and everything like that and we are suspicious that you might have early signs of just macular degeneration in general, what we do is we give you a little grid. This grid is kind of like those math paper grids that you get with the lines. I give my patients these grids and I tell them to kind of put it on their fridge, because you go to your fridge every single day Right before you open the fridge just check one eye at a time, looking at that grid, to see if all the lines on that grid is straight and there's no missing lines or there's no wavy lines or stuff like that. When there is wavy lines or missing spots at the line, it could indicate leakage or the conversion from your dry to your wet macular degeneration. And then, once you see us, once you notice that change in vision, what we're mostly going to do is refer you to an ophthalmologist and they can do a couple treatments.

Dr. Nguyen: 1:54

One of the most common treatments that they do in your favorite they inject the eye. They inject a medication in the eye. No, thank you, very pleasant Check, please. The medications they inject inside the eyes is called anti-Vegia. Now I talked about Anti-Vegia, anti-catch up, what?

Jeremy: 2:16

V-E-G-F.

Dr. Nguyen: 2:16

V-E-G-F. V-e-g-f.

Jeremy: 2:22

I think you mentioned that earlier. What is anti-Vegia?

Dr. Nguyen: 2:25

The anti-Vegia is what we talked about previously, where it's promoting the new blood vessel growth that are leaky. That's the chemical that the damage cells release, and so the counterpart for that is injecting an anti-Vegia to discourage the blood vessel growth, and so that's what they do. There are three, actually four, types of brand names of anti-Vegia, and they all sound like they came from like a Harry Potter book, so it's called Aria Houston Lucentis, and a newer one came out. It's called Vibismo, and so they're very magical.

Jeremy: 3:03

I was just going to say it sounds very magical.

Dr. Nguyen: 3:06

Yes, and these injections are actually given every four to six weeks. Yes, yes, they're given.

Jeremy: 3:11

They're given Depending on is it painful to get an injection in your eye, Like when you numb the area? How does that work?

Dr. Nguyen: 3:17

You numb the area. You actually numb the area with tetra cane drops, so you will be numb. However, like the, they have to sanitize the eyes with betadine, like betadine before it, which is that yellow iodine thing.

Jeremy: 3:30

OK.

Dr. Nguyen: 3:30

And that's what's going to sting later. Once you start to, once the anesthesia starts to wear off, then you start to feel that stinging pain, but, like initially, you don't.

Jeremy: 3:38

Can you just put me to sleep before you do that? I don't want to look at a needle coming. You can't look away, right, you open your eye, you see the needle coming.

Dr. Nguyen: 3:46

No you're right awake. You just look down and then they come from the top.

Jeremy: 3:51

Oh, I'm pretty sure, guys, we talk about it.

Dr. Nguyen: 3:54

They use kind of like a tool that helps you open your eyes.

Jeremy: 3:58

OK, so you can't play OK.

Dr. Nguyen: 4:00

Right. So it sounds very pleasant all of this, but that's actually the main. Most common treatment is the eye infections. And again, you get it four to six weeks and they space it out more and more like the interval which you get the shots once there's improvement or stabilization, so you can be getting it once or twice a month. You could be getting it once forever, one or two months.

Jeremy: 4:23

It's interesting. I had asked Dr Falco if there was any kind of surgical treatments for macular degeneration. She said not for the dry, but there is something kind of akin to that for the wet that you would talk about it. And it's not really a surgery per se, I guess, but it's inter-invasive, somewhat Invasive. It's kind of somewhere in between right A surgery.

Dr. Nguyen: 4:43

The needle is very thin. It's thinner than a hair. It's very, very thin.

Jeremy: 4:48

Every time you say needle and eye, I get like oh, imagine seeing it.

Dr. Nguyen: 4:53

You haven't even seen it yet.

Jeremy: 4:55

And you do that right in your office back in the chair?

Dr. Nguyen: 4:57

No, in our ophthalmologist. Ok, you said you have to go to the ophthalmologist.

Jeremy: 5:00

Ok, yeah, so you don't you?

Dr. Nguyen: 5:01

say, I'm sure that the dried isn't converted to the wet, but when it does, converted to the wet can be.

Jeremy: 5:06

Yeah, you go to the ophthalmologist.

Dr. Nguyen: 5:07

And then like other less common ways that they do it, they can do a laser, they can zap the leaky blood vessels.

Jeremy: 5:14

I want that one.

Dr. Nguyen: 5:16

The only bad thing there is not used as common, because the macula is your centermost part of your vision, so you really don't want to be using a laser that zaps your central vision, so it's not used as common. Another one which is not as common as well, but it's pretty cool it's called photodynamic therapy. What they do is they actually inject a light activating medication into your veins, like just your arm or your vein, and then they wait a couple minutes. That medication travels through your bloodstream and eventually to the blood vessels in your eyes, and then they use a special type of light or laser to activate the medication.

Jeremy: 5:54

Oh, how cool In your eyes. Yeah, I like that. Yeah, I like that better than the needle in the eye too. Sign me up for that one.

Dr. Nguyen: 6:01

That medication, once activated by the light, actually destroys the leaky blood vessels in the eye.

Jeremy: 6:06

That's pretty cool.

Dr. Nguyen: 6:07

I like that yeah isn't it cool, I thought that was cool too. And then once you're stable, from once you're getting all these treatments and you're stable, you can see your optometrist back annually or as needed so that we can update your prescription, because as the condition improves, your prescription can improve as well. And in the sad case that you're due to the condition, the nature of your condition you're now a low vision patient. We can actually optometrist can do low vision refractions or low vision exams, where it's more catered towards giving you the best prescription so that you can regain, like certain independence of your life, like you can see it, to at least read your mail or sign checks or stuff like that.

Jeremy: 6:49

Interesting. Is there any particular reason why somebody would elect to get, or why an ophthalmologist would recommend the needle in the eye versus the injection to the bloodstream with the light? The photo is?

Dr. Nguyen: 7:01

there it's more effective, efficient and there's more research showing a decrease in progression with the shot. So overall more effective. Not the most pleasant, but the most effective OK fair enough.

Jeremy: 7:15

I'll take that into consideration as I move forward. Thankfully, my vision is near perfect.

Dr. Nguyen: 7:23

Yes, yes that's great. A lot of things in training within the next couple of years. So just make sure you get your eyes just on that.

Jeremy: 7:31

Dr Falco said even though I don't see perfect 2020, there's no need for any glasses. I don't need to increase the font size in my phone. I got a few more years before I upgrade the font size. So goodness, ok, cool. Is there anything else you wanted to share about the kind of management or treatment options other than, obviously, getting your eyes checked regularly and taking care of yourself, even if you're trying to go on me? No smoking, eat lots of leafy green vegetables. All the good stuff, all the good stuff.

Dr. Nguyen: 8:04

You want to do that right. That's pretty much the basics of it. The most common forms of management.

Jeremy: 8:10

All right, very cool, dr Neumann, always a pleasure. You're a wealth of knowledge and I've learned a lot today, so I've gotten my education in for the day. Good good good, all right everyone. Thank you for tuning in and we will catch everyone next time. Take care, have a great day.

Speaker 1: 8:31

Thank you for listening to the Jazzy Eyes podcast. For more information, visit jazzyeyescom or contact 954-473-0100.