As the body ages it deteriorates, whether it’s your joints, your spine, or your eyes.  There are normal changes associated with aging eyes such as inability to focus, occasional floaters, and the need for more light.  But then there are more aggressive forms of deterioration that result in abnormal loss of vision.

The macula is prime real estate in the back of the eye about the size of a grain of rice.  It is amazing how important this tiny spot is for our vision. Without it, we couldn’t see color, a person’s face or print in books.

The retinal pigment epithelium (RPE) is a layer of cells that sit right underneath the layer of rods and cones.  They are responsible for nourishing these photoreceptor cells by providing nutrients and by removing debris.  You might say these cells are the eyes “garbage men.”   Adult RPE cells cannot regenerate so we must do what we can to keep the existing ones healthy.   If the RPE degenerates so do the rods and cones. Atrophy  or the death of the RPE cells leads to geographic atrophy, late stage age related macular degeneration, which results in a more severe loss of one’s straight ahead vision.

Needless to say, we want to do whatever we can to keep the RPE cells working.  There are two physiological processes that help maintain a healthy RPE:

1.   Nourish it with oxygen and nutrients

2.   Remove toxins, waste products and “garbage”

“…normally functioning RPE cells are necessary to sustain rods and cones and in turn, to help preserve normal visual acuity.”

Gerald Allen Fishman, M.D. Ophthalmologist, Chicago, IL

As the RPE ages some of the changes that can occur are accumulation of lipofuscin (LF) and the formation of drusen.  Lipofuscin is actually debris that comes from the normal shedding of an outer portion of rods and cones.  A healthy RPE can digest this waste and remove it.  But when the lipofuscin gets trapped or stuck in the RPE it can contribute to AMD.

“Growing evidence indicates that these large quantities of LF in the RPE may have a negative impact on retinal health, and possibly contribute to pathogenesis of age-related macular degeneration (AMD).”

François Delori, Ph.D.

RPE Lipofuscin in Aging and Age-Related Macular Degeneration

Schepens Eye Research Institute

Another form of waste products called drusen may also be associated with the development of AMD – depending on the size, number and type of drusen.  Macular drusen form from lipids that again result from the RPE not being able to remove them.  Some types of drusen cause more vision loss than others while another type is an early sign of AMD.

Find out more about the role of macular drusen here;

Macular Drusen

Leslie Degner, RN, BSN

www.WebRN-MacularDegeneration.com