Are you having back pain with any of the following?
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Age-related macular degeneration (AMD) is a disease of the retina that can lead to loss of central vision. This can happen either very gradually over many years or very quickly, depending on the type of macular degeneration. AMD is the leading cause of blindness in people aged 55 and older in the United States. It affects more than 10 million Americans. Significant improvement in treatments over the past several years have made living with AMD and keeping functional vision more possible. It is important to be aware of symptoms of this disease as you pass age 55 so you can seek medical attention if it develops. Early detection and treatment can help you keep your central vision.
There are two basic types of macular degeneration: dry and wet. Approximately 90 percent of the cases we see are the dry type.
The dry form of AMD occurs when the central retina deteriorates with age. As it deteriorates, small yellow waste deposits, called drusen, accumulate underneath the retina. At the same time, the pigmented layer under the retina begins to break down. The loss of pigment and the build up of drusen damage your central vision.
The wet type of AMD is always preceded by the dry type. It causes damage to the eye much more quickly and can cause serious vision loss within months or weeks. Approximately 10 percent of cases of dry macular degeneration progress to the wet type. In wet macular degeneration, the eye grows abnormal blood vessels that bleed and leak fluid into the macula. The fluid builds up, causing the macula to become distorted, which prevents the retina from functioning properly.
The symptoms are similar for both types of AMD. However, symptoms are more serious and develop much more quickly with wet macular degeneration. Dry macular degeneration progresses more slowly. If you think you have wet macular degeneration, contact us right away. Early detection and treatment can help you keep your central vision. Symptoms of AMD include:
We can schedule a general eye exam for you in either our Optometry or Ophthalmology departments. However, if you have sudden vision changes, especially if you have a family history of macular degeneration, contact us to schedule an urgent appointment in Ophthalmology.
A screening exam for AMD will include some or all of the following:
AMD is caused by deterioration of the central portion of the retina, called the macula. The retina is the nerve layer that lines the back of the eye and converts light into electrical signals that are sent to the brain. These signals are interpreted by the brain as images. The macula ensures that we can focus clearly, particularly when looking straight ahead. A healthy macula is important for activities like driving and reading.
AMD is associated with family history of the disease and the natural aging process. Smoking, chronic sun exposure and poor nutrition can also increase your risk of developing macular degeneration. To reduce your risk of developing AMD:
There is no cure or treatment for dry macular degeneration at the moment. We recommend that you follow lifestyle and nutrition advice including wearing sunglasses, eating dark leafy vegetables and fruit, and quitting smoking.
There are a number of effective treatments for wet macular degeneration, although there is no cure yet.
We will usually refer you to one of our retina vitreous specialists who can recommend the best approach to treating your wet AMD. This may include a combination of treatments or one specific treatment. Sometimes treatment can't restore good central vision, but can slow the vision loss. Response to treatment varies from patient to patient and can even vary between each of your eyes. We will consider treatments such as:
If you have already lost vision, it's important to adjust your lifestyle to maximize the eyesight that you have:
Scientists are still debating whether taking vitamin and/or mineral supplements could help prevent, treat or cure certain eye conditions. Some early scientific studies seemed to show that supplements had the potential to prevent or slow the progression of cataract and AMD. One such study is The Age-Related Eye Disease Study (AREDS), sponsored by the National Eye Institute (NEI), one of the Federal government's National Institutes of Health. If you are interested in considering multivitamin supplements:
The Amsler grid is a screening test that is used to assess your macula (the center of your retina). You should print a copy of the Amsler grid and administer the test at home.
The grid has horizontal and vertical lines, with a dot in the center, printed on black or white paper. While staring at the dot, you should look for wavy lines and missing areas of the grid. We are interested in tracking the following:
If the lines of the grid do not appear straight and parallel or there are missing areas, we will examine the back of your eye (macula) very closely. If you notice any sudden vision change, such as flashing lights or floaters, you should come in for a dilated eye exam, even if the Amsler grid looks normal.
If your optometrist sees signs of macular degeneration during your regular eye exam, he or she will make an appointment for you to see me or one of my colleagues in the Ophthalmology department. If you are not scheduled for a regular eye exam, and you notice symptoms of macular degeneration such as dim or blurry central vision or a blind spot, your first contact will typically be with your personal physician, who will evaluate your health and symptoms.
If specialty care is needed, your personal physician will facilitate the process of scheduling an appointment in my department. If appropriate, she or he might call me or one of my colleagues while you are in the office so we can all discuss your care together. If we decide you need an appointment with me after that discussion, we can often schedule it the same day or soon thereafter.
Your first appointment is likely to take at least 1 hour and possibly longer. During your office visit, we will discuss your medical and family history and I will perform a comprehensive eye exam and some diagnostic tests.
I may administer eyedrops to dilate your pupils so that I can clearly see the structures of your eyes. Your pupils will remain dilated for several hours, so you may wish to bring someone who can drive you home after your exam.
I will explain the findings of your exam and answer any questions or concerns you may have. I will also give you an Amsler grid to use at home to monitor your symptoms. If you notice any new changes, please let me know.
If we decide that you need further evaluation, or further treatment or surgery, I will discuss the treatment options that are available, and together we will create a treatment plan that is right for you.
If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.
If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line, available 24 hours a day, 7 days a week. You will be connected with a nurse who can give you immediate advice.
If you are experiencing a serious problem or an emergency, call 911 or go to the nearest Emergency Room when the clinic is not open.
Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
We will work together to monitor and assess how your medications are working and make adjustments over time. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.If refills are needed in the future, you can:
For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the Radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.
If we decide together that your condition would also benefit from the care of other types of specialists, our staff will help arrange the appointment(s) with one or more of my specialty colleagues.
I will recommend you review educational information and tools to help you prepare for your procedure or surgery. The information will often help you decide whether surgery is right for you. If you decide to have a surgery or procedure, the information will provide details about how to prepare and what to expect.
If we proceed with surgery, I will have my Surgery Scheduler contact you to determine a surgery date and provide you with additional instructions regarding your procedure. Once your surgery is scheduled, a medical colleague of mine will contact you to conduct a preoperative medical evaluation that will assure that you are properly prepared for your surgery.
As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available at any time that is most convenient for you. From my home page you can:
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.