Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

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.

Provider photo for Eun-Ha Park

Eun-Ha Park, MD

Ophthalmology

Welcome to My Doctor Online, a website my colleagues and I developed to make it easier for you to take care of your healthcare needs. On this site you will find answers to many of your questions about my clinical practice. Also included are several online features that will allow you to e-mail me, check your laboratory results and refill prescriptions. If you are a patient who sees me regularly, you can reach my office directly at 650-301-5807

My Offices

Daly City Medical Offices
Appt/Advice: 650-301-5800

See all office information »

subContentURL_nobackslash = resources/dc/condition

firstActiveTabUrlFragment = resources/dc/conditionlist

subContentURL_nobackslash = resources/dc/condition

JSP2Include = /mdo/presentation/conditions/condition.jsp?nocache=true

Overview

Age-related macular degeneration (AMD) is caused by damage to an area of the retina called the macula. The macula helps the eye to focus clearly, particularly when looking straight ahead. A healthy macula is important for activities like driving and reading.

AMD can lead to loss of central vision. If you have the “dry” type of AMD this happens gradually. The less common” wet” type can cause vision loss very quickly.

AMD is the leading cause of blindness in people aged 55 and older in the United States. It affects more than 10 million Americans. It is important to be aware of symptoms of this disease, especially if you are older than 55 years. Early detection and treatment can help protect your vision.

Additional References:

Dry AMD

The dry form of AMD occurs when the macular deteriorates with age. Small yellow waste deposits collect underneath the retina. These deposits are called drusen. At the same time, the pigmented layer under the retina begins to break down. The loss of pigment and the buildup of drusen damage your central vision.

Vision changes caused by dry AMD:

  • Will vary depending on how much drusen builds up and how much pigment has been lost.
  • Tend to progress slowly over a number of years. Most people retain functional vision.
  • Can be severe. Dry AMD can also change into the wet variety without warning.

Wet AMD

People with the wet type of AMD always develop the dry type first. Only around 10 percent of cases of dry AMD progress to the wet type.

Wet AMD damages the eye much more quickly. It can cause serious vision loss within months or weeks. Here’s how vision loss occurs:

  • The eye grows abnormal blood vessels that bleed and leak fluid into the macula.
  • Fluid buildup distorts the macula so it can’t function properly.
  • Straight edges or objects may look wavy, because the macula is no longer smooth.
  • Everything may be blurred. You may develop blind spots.
  • Without treatment scar tissue can develop and permanently damage your central vision.

Treatments for wet AMD have improved over the past several years. Previously untreatable disease can now be treated.

Symptoms

The symptoms are similar for both types of AMD. However, symptoms are more serious and develop much more quickly with wet macular degeneration. 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:

  • Dim or blurry central vision.
  • Flat or level objects may look wavy or crooked or smaller than they really are.
  • Blurred or blind spots in the center of your visual field. This may be combined with a drop in the sharpness of your central vision. In the dry form this happens very gradually. In the wet form it happens quickly.
  • Vision loss that prevents reading or driving. This is more common with advanced disease.

Screening and Diagnosis

If you have sudden vision changes make an urgent appointment in the Ophthalmology department. This is especially important if you have family history of macular degeneration.

A screening exam for AMD may include:

  • Ophthalmoscopy. We use a strong light and magnifying lens to examine your retina. This allows us to see signs of AMD such as drusen and scarring.
  • Visual Acuity Test. We test the strength of your central vision by asking you to read letters on a screen some distance away.
  • Amsler Grid. An Amsler Grid consists of straight lines with a dot at the center. The lines near the center dot appear wavy or curved if you have wet macular degeneration. You can use a grid to use at home to watch for vision changes.
  • Optical Coherence Tomography (OCT). If we suspect wet AMD we may perform a computerized eye scan called optical coherence tomography. We may also need to do a photographic test called a Fluorescein Angiogram.

Risk Factors and Prevention

Risk Factors

AMD is associated with aging. You are also more likely to develop AMD if you:

  • Have close family members with AMD
  • Smoke. Smoking more than doubles your risk of developing AMD
  • Spend a lot of time in the sun especially if you don’t wear sunglasses
  • Don’t eat plenty of fresh fruit and dark green leafy vegetables
Prevention

You can reduce your risk of developing AMD or slow down the progress of existing disease:

  • Quit smoking
  • Wear sunglasses that block UVA and UVB rays
  • Eat fresh fruits and dark green leafy vegetables
  • Take an AREDS vitamin supplement. Multivitamins containing an AREDs formula may slow the progression of AMD. AREDs stands for Age-Related Eye Disease Study, sponsored by the National Eye Institute. Ask your doctor which formula is appropriate for you. Some formulas are not appropriate for smokers or for ex-smokers or people with certain urinary/kidney disorders.
  • Maintain healthy blood pressure and cholesterol levels

Treatments

Dry macular degeneration

There is no cure or treatment for dry macular degeneration at the moment.

Wet macular degeneration

Treatments for wet AMD have improved over the past several years. Many people who were previously untreatable can now be treated and returned to the ‘dry’ state of AMD.

Treatment options include:

  • Anti-VEGF injections. Vascular endothelial growth factor (VEGF) is a protein that supports the growth of the abnormal blood vessels that cause wet AMD. Injecting anti-VEGF injections into the eye can suppress VEGF and the growth of new abnormal blood vessels.
  • Photodynamic therapy (PDT) laser. We inject a light-activated medicine called verteporfin into your bloodstream. When it reaches the abnormal blood vessels, we activate the drug with the laser. Blood clots form and seal the leaky blood vessels.
  • Traditional argon laser. We seal the leaky blood vessels with a laser. The procedure is performed in a few minutes in our clinic, with local anesthetic.

Lifestyle Changes and Management

Enhance your vision

Follow these guidelines to make the most of the vision you have:

  • Choose large print books. Try a mobile device that allows you to adjust the font.
  • Use magnifiers or low vision aides.
  • Aim lighting at what you want to see and away from your eyes.
  • Light entry areas and stairs to avoid falls. Make them easy to see with contrasting paint or tape.
  • Label switches. Use bold lettering and high color contrast materials.
  • Consult a low vision specialist. We can refer you to someone who can help you adapt your home and lifestyle to support the vision you have.

Monitor Your Vision

The Amsler grid is a screening test you can use at home to assess your macula.

The grid has horizontal and vertical lines, with a dot in the center, printed on black or white paper. While staring at the dot, ask yourself if:

  • You are able to see the corners and sides of the square?
  • You see any wavy lines?
  • There any holes or missing areas?

If the lines of the grid do not appear straight and parallel or there are missing areas, tell us. We will examine the back of your eye very closely. If you notice any sudden vision change, such as flashing lights or floaters, come in for a dilated eye exam. Do this even if the Amsler grid looks normal.

Additional References:

Your Care with Me

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 an emergency, call 911 or go to the nearest Emergency Room.

Coordinating Your Care

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.

If you come to an office visit
  • At the beginning of your visit, you will receive information about when you are due for your next test, screening, or immunization. We can discuss and schedule any preventive tests that you need. 
  • At the end of your visit, you may receive a document called the "After Visit Summary" that will summarize the issues we discussed during your visit. You can refer to it if you forget what we discussed. You can also view it online under Past Visits.
  • To help you prepare for your visit, please see additional details under Office Visit. 
If I prescribe medications

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:
  • Order them online or by phone. Order future refills from my home page or by phone using the pharmacy refill number on your prescription label.
  • Have them delivered to you by mail at no extra cost. Or you can pick up your medications at the pharmacy. If no refills remain when you place your order, the pharmacy will contact me regarding your prescription.
If lab testing or imaging is needed

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 I refer you to another specialty colleague

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.

If surgery or a procedure is a treatment option

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.

Convenient Resources for You

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:

Manage your care securely
  • View and compose secure e-mail messages.
  • Manage your prescriptions.
  • View your past visits and test results.
  • View your preventive services to see whether you are due for a routine screening or updated immunization.
Learn more about your condition
  • Read about causes, symptoms, treatments and procedures.
  • Find interactive health tools, videos, and podcasts to help you manage your condition.
  • View programs to help you decide on or prepare for a surgery or procedure.
Stay healthy
  • Locate health education classes and support groups offered at every medical center.
  • Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
  • View your Preventive Services to see whether you are due for a routine screening or updated immunization.

Related Health Tools:

Videos

See more Health Tools »

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.

Content loading spinner