AFFILIATED EYE SURGEONS | RETINA CARE
Retina & Macular Degeneration Care in Northern New Jersey
Macular degeneration is the leading cause of vision loss in adults over 60 — but early detection and timely treatment protect central vision. Our
board-certified ophthalmologists provide comprehensive retinal care at three convenient Northern New Jersey
locations.
Your Central Vision Deserves Expert Protection
The retina is the light-sensitive tissue lining the back of the eye — the biological equivalent of a camera's film. The macula, a small specialized region at the center of the retina, is responsible for the sharp, detailed vision we use for reading, driving, recognizing faces, and seeing fine detail. When the retina or macula is damaged — by age, disease, injury, or vascular changes — the consequences for vision can be profound and permanent.
At
Affiliated Eye Surgeons, our ophthalmologists diagnose and manage a broad range of retinal conditions — from early macular degeneration detected on routine dilated exam to urgent evaluation of sudden floaters, flashes, and visual field changes that may signal a retinal tear or detachment. If something is happening in your retina, we want to know about it early — when treatment is most effective and vision is most preservable.
Age-Related Macular Degeneration (AMD)
What Is Macular Degeneration?
Dry AMD (Atrophic AMD)
Wet AMD (Neovascular AMD)
Age-related macular degeneration (AMD) is a progressive disease of the macula — the central region of the retina — that is the leading cause of severe, irreversible central vision loss in Americans over age 60. As the macula degenerates, the sharp central vision needed for reading, driving, and recognizing faces gradually deteriorates. Peripheral vision is typically preserved.
AMD exists in two distinct forms with different mechanisms, progression rates, and treatment approaches.
Dry AMD is the more common form, accounting for approximately 85 to 90% of cases. It progresses slowly as the macular tissue gradually thins (atrophies) and small yellowish deposits called drusen accumulate beneath the retina. Early and intermediate dry AMD often has no noticeable symptoms. Advanced dry AMD — including geographic atrophy — causes progressive central vision loss as large areas of macular tissue are lost.
There is no cure for dry AMD. However, AREDS2 nutritional supplementation has been shown to reduce the risk of progression to advanced AMD by approximately 25% in patients with intermediate or advanced disease. Lifestyle modifications — smoking cessation, cardiovascular risk management, UV protection, and a diet rich in leafy green vegetables and omega-3 fatty acids — also support macular health.
Wet AMD accounts for only 10 to 15% of AMD cases but is responsible for approximately 90% of severe vision loss from the disease. It occurs when abnormal blood vessels (choroidal neovascularization or CNV) grow beneath and into the macula, leaking fluid and blood that distort and damage the macular tissue. Without treatment, wet AMD can cause rapid, severe central vision loss within weeks to months.
Wet AMD is treated with anti-VEGF (anti-vascular endothelial growth factor) intravitreal injections, which block the growth factor driving abnormal vessel formation. When initiated promptly, anti-VEGF therapy can halt or reverse vision loss in the majority of patients — and some patients experience meaningful visual improvement. Regular monitoring and consistent injection schedules are critical for maintaining outcomes.
AMD Risk Factors and Prevention
Understanding your risk for AMD allows for targeted monitoring and lifestyle intervention:
- Age — the primary risk factor. Risk increases dramatically after age 60 and continues to rise each decade.
- Family history — first-degree relatives of AMD patients have significantly elevated risk. Genetic variants in the complement pathway and ARMS2 gene are strongly associated with AMD.
- Smoking — the most important modifiable risk factor. Smokers have 2 to 4 times the AMD risk of nonsmokers. Quitting smoking at any age reduces risk.
- Cardiovascular disease and hypertension — vascular health directly affects the choroidal circulation that nourishes the macula.
- Light eye color and fair skin — associated with slightly higher risk, possibly due to reduced macular pigment density.
- Obesity and sedentary lifestyle — associated with higher AMD risk in multiple population studies.
- Diet low in antioxidants and carotenoids — a diet rich in lutein, zeaxanthin (leafy greens, eggs), and omega-3 fatty acids is associated with lower AMD risk.
- Prolonged UV exposure without protection — wear sunglasses with UV protection outdoors.
Other Retinal Conditions We Monitor and Treat
Retinal Tears and Detachment
A retinal tear occurs when the vitreous gel, which fills the center of the eye, pulls away from the retina during posterior vitreous detachment — a normal age-related process — and creates a small break in the retinal tissue. Most retinal tears can be sealed with in-office laser photocoagulation to prevent fluid from seeping beneath the retina and causing detachment.
A retinal detachment occurs when fluid accumulates beneath the retina through a tear, causing the retina to separate from the underlying tissue. Retinal detachment is a medical emergency. Symptoms include a sudden significant increase in floaters, bright flashes of light, and a dark shadow or curtain spreading across part of the visual field. Without prompt surgical treatment — pneumatic retinopexy, scleral buckling, or vitrectomy — permanent vision loss results.
Floaters and Flashes — When to Worry
Most floaters — the drifting spots, threads, or cobwebs in the visual field — are benign and result from normal age-related changes in the vitreous gel. As the vitreous liquefies and separates from the retina (posterior vitreous detachment), the tugging sensation produces brief flashes of light, and fragments of the detached vitreous create new floaters. These typically diminish over weeks to months as the brain adapts.
However, sudden onset of a significant new floater shower, persistent or worsening flashes, or any shadow across part of the visual field warrants same-day evaluation to rule out a retinal tear or detachment. When in doubt — call us. A brief exam is far preferable to the alternative.
Epiretinal Membrane
An epiretinal membrane (ERM) — also called a macular pucker — is a thin layer of fibrous tissue that grows on the surface of the macula and can cause it to wrinkle or pucker. Symptoms include mild to moderate blurring and distortion of central vision. Many epiretinal membranes are mild and require only monitoring. When the membrane causes significant visual disturbance, vitrectomy surgery to remove it can restore vision in many cases.
Macular Hole
A macular hole is a small break in the center of the macula that causes a blind spot or distortion in central vision. Most macular holes develop from traction by the vitreous as it separates. Small macular holes may close spontaneously. Larger or full-thickness holes are treated with vitrectomy surgery and a gas bubble that holds the edges of the hole together while it heals.
Central Serous Chorioretinopathy
Central serous chorioretinopathy (CSC) is a condition in which fluid accumulates beneath the macula, causing blurry or distorted central vision. It is most common in younger to middle-aged men and is associated with stress and steroid use. Most cases resolve on their own within 3 to 4 months. Persistent or recurrent cases may be treated with laser or photodynamic therapy.
Retinal Diagnostics at Affiliated Eye Surgeons
We use advanced retinal imaging technology to detect, characterize, and monitor retinal conditions with precision:
- OCT (optical coherence tomography) of the macula — high-resolution cross-sectional imaging that visualizes retinal layers in micron-level detail. Essential for staging AMD, detecting and quantifying macular edema, and monitoring treatment response over time.
- Wide-field fundus photography — high-resolution color photographs of the retina document baseline status and detect changes over time. Wide-field imaging captures the peripheral retina where tears and lattice degeneration are most common.
- Fluorescein angiography — a fluorescent dye injected intravenously reveals blood flow patterns in the retinal and choroidal vessels, identifying areas of leakage and neovascularization in wet AMD and other vascular conditions.
- Dilated fundus examination — the foundation of all retinal evaluation. No imaging technology replaces the ophthalmologist's direct view of the retina through a dilated pupil.
- Amsler grid monitoring — a simple home monitoring tool provided to all AMD patients to detect new distortion between office visits.
Why Choose Affiliated Eye Surgeons for Retinal Care?
Experienced Retinal Evaluation and Management
Our
board-certified ophthalmologists have extensive experience evaluating and managing retinal conditions across Northern New Jersey. We detect early AMD, retinal tears, and other conditions routinely during
comprehensive dilated exams — which means many of our patients are diagnosed and treated before they experience any symptoms.
Advanced Imaging Technology On-Site
OCT macula imaging and fundus photography are available at our offices, allowing us to image, document, and monitor retinal findings at the point of care — without sending patients elsewhere for diagnostic studies.
Same-Day Urgent Evaluation
For patients with sudden-onset floaters, flashes, or visual field changes, we provide same-day urgent evaluation. Retinal tears and early detachments caught before the macula is involved have an excellent prognosis with timely treatment. We take these calls seriously and see urgent patients the same day whenever possible.
Coordinated Care for Complex Cases
For conditions requiring vitreoretinal surgery beyond our scope — complex retinal detachments, vitrectomy for macular holes or membranes — we maintain close relationships with trusted vitreoretinal specialists and coordinate referrals promptly, ensuring continuity of care for our patients.
Three Convenient Locations
Retinal monitoring — particularly for AMD — requires regular follow-up imaging and examination. With offices in
Morristown,
West Orange, and
Denville, staying on schedule with your retinal care is straightforward and convenient.
Frequently Asked Questions
What is age-related macular degeneration?
Age-related macular degeneration (AMD) is a progressive disease that damages the macula — the central region of the retina responsible for sharp, detailed vision used for reading, driving, and recognizing faces. It is the leading cause of severe vision loss in Americans over age 60. Dry AMD progresses slowly as macular tissue thins and drusen accumulate. Wet AMD is less common but more aggressive, causing rapid central vision loss from abnormal blood vessel growth beneath the macula. Wet AMD responds well to anti-VEGF injection therapy when treated promptly.
What are the symptoms of macular degeneration?
Early dry AMD often has no symptoms. As the disease progresses, patients may notice blurring of central vision, difficulty reading fine print or recognizing faces, colors appearing less vivid, and straight lines appearing wavy or distorted (metamorphopsia). A dark or empty spot may develop in the center of vision in advanced stages. Wet AMD can cause sudden, dramatic central vision changes. The Amsler grid — a simple graph paper pattern — is a useful home monitoring tool for detecting new distortion between eye appointments.
What is the difference between dry and wet AMD?
Dry AMD accounts for 85 to 90% of cases and progresses slowly over years as macular tissue gradually atrophies. AREDS2 nutritional supplements reduce progression risk in intermediate and advanced dry AMD. Wet AMD accounts for 10 to 15% of cases but causes approximately 90% of severe AMD vision loss. It occurs when abnormal blood vessels grow beneath the macula and leak fluid or blood. Wet AMD can progress rapidly but responds well to anti-VEGF injection therapy when treated promptly — making regular monitoring and immediate response to new symptoms critical.
What are floaters and when are they serious?
Floaters are small shapes that drift through the visual field caused by clumps of collagen in the vitreous gel. Most floaters are benign and result from normal age-related vitreous changes. However, a sudden onset of new floaters — especially accompanied by flashes of light or a shadow or curtain across part of the visual field — may signal a retinal tear or detachment, which is a medical emergency requiring same-day evaluation. When in doubt, call us immediately.
What is a retinal detachment?
A retinal detachment occurs when the retina separates from its underlying tissue, losing its blood supply and causing permanent vision loss without prompt treatment. Symptoms include a sudden increase in floaters, flashes of light, and a shadow or curtain spreading across part of the visual field. Retinal detachment is a medical emergency — seek immediate eye care if you experience these symptoms. Treatment options include pneumatic retinopexy, scleral buckling, or vitrectomy surgery depending on the type and extent of detachment.
What are AREDS2 vitamins and should I take them?
AREDS2 vitamins are a specific formulation — vitamin C, vitamin E, lutein, zeaxanthin, zinc, and copper — shown in large clinical trials to reduce the risk of AMD progression by approximately 25% in patients with intermediate AMD or advanced AMD in one eye. They are not recommended for patients with early AMD or no AMD, as they have not been shown to benefit these groups. Your ophthalmologist will advise whether AREDS2 supplementation is appropriate for your specific stage of disease.
Can macular degeneration cause complete blindness?
Macular degeneration affects central vision but typically preserves peripheral vision, so complete blindness is rare. Most patients retain the ability to walk, see shapes, and navigate their environment, but lose the sharp central vision needed for reading, driving, and face recognition. Wet AMD can cause rapid, severe central vision loss if not treated promptly. With early detection and timely anti-VEGF treatment for wet AMD, significant vision loss can often be prevented or minimized.
Who is at risk for macular degeneration?
Risk factors for AMD include age over 60, family history of AMD, smoking (the most important modifiable risk factor — smokers have 2 to 4 times the risk), cardiovascular disease and hypertension, fair skin and light eye color, obesity, and prolonged sun exposure without UV protection. If you have a family history of AMD or multiple risk factors, regular dilated eye exams starting in your 50s are essential — AMD is most effectively managed when detected before significant vision loss occurs.
