Macular Degeneration
Bulk-billed or no gap injections for eligible patients.
Local Toowoomba management.
Age-related macular degeneration (AMD) is the leading cause of blindness in Australians over 50. Dr Holcombe’s goal for his macula degeneration patients is to control the disease with the least number of injections possible.
What is macular degeneration?
The macula is the central part of the retina responsible for sharp, central vision needed for reading, driving, and recognising faces. Macular degeneration occurs when this area deteriorates, impairing central vision while peripheral (side) vision remains intact. The condition never causes complete blindness, but it significantly affects quality of life.
Key facts about macular degeneration:
- Most common in people over 50
- 1 in 7 Australians over 50 show some evidence of the disease
- Direct family history increases your risk to 50%
- Early signs can be present without symptoms which make regular eye checks essential
What is the diffference between wet and dry macular degeneration?
There are two main types of age-related macular degeneration, distinguished by the presence or absence of fluid and bleeding beneath the macula.
| Dry Macular Degeneration (85-90% of cases) | Wet Macular Degeneration (10-15% of cases) |
|---|---|
| Develops gradually over time | Abnormal blood vessels grow beneath the retina |
| Does not cause sudden vision loss or distortion | Vessels leak fluid or bleed, causing scarring |
| Areas of the macula slowly die, leading to blind spots in central vision | Vision loss can be rapid and severe |
| Can convert to the wet form at any stage | Requires urgent treatment to preserve vision |
How can I recognise early macular degeneration?
Macular degeneration can be present without symptoms, which is why regular eye examinations are critical. Common symptoms include:
- Difficulty reading or performing tasks requiring fine vision
- Straight lines appearing wavy, bent, or distorted
- Trouble recognising faces
- Dark patches, blurry spots, or empty spaces in central vision
Amsler Grid
You can monitor your vision at home using an Amsler grid.
Download the chart and follow the instructions to check for early changes.
MD Foundation Amsler Grid
Download PDF
How does an eye specialist assess macular degeneration?
At Toowoomba Ophthalmic Consultants, we use state-of-the-art diagnostic technology to detect and monitor macular degeneration with precision.
Optical Coherence Tomography (OCT) is a non-invasive imaging technique that shows the macula in cross-section, revealing fluid, bleeding, or structural changes in exquisite detail. We use the Heidelberg Spectralis OCT, which combines scanning laser fundus imaging with simultaneously acquired OCT for unmatched accuracy in detecting early disease and monitoring treatment response.
A careful dilated fundus examination complements this imaging to provide a complete assessment of your eye health.
Heidelberg OCT scan showing drusen in early-stage dry macular degeneration (top) and geographic atrophy in late-stage dry macular degeneration (bottom).
What are the treatment options for dry macular degeneration?
Currently, there is no cure for dry AMD, but diet and lifestyle can slow progression and help preserve vision. Recommendations include:
- Eating a healthy, well-balanced diet
- Dark green leafy vegetables and fresh fruit daily
- Fish 2–3 times per week
- Choosing low-GI carbohydrates
- A handful of nuts each week
Supplements: The AREDS2 Formula
For people with intermediate AMD in one or both eyes, or late AMD in one eye, the AREDS2 supplement formula may help.
Dr Holcombe can advise on your stage of disease and whether supplements are appropriate for you. Important notes:
- Supplements do not cure the disease
- They do not reverse existing damage
- They are not beneficial for those with no AMD or early-stage disease
What are the treatment options for wet macular degeneration?
The mainstay of treatment is intravitreal injections which are injected directly into the back of the eye. Injections typically begin monthly, with the interval progressively increasing based on disease response, aiming for the fewest injections necessary to maintain vision.
For eligible patients, these injections are either bulk-billed or no gap.
While these injections cannot cure wet AMD, they aim to stabilise vision, preserve sight, and in some cases, improve it.
Dr Holcombe's goal is to control the disease with the least number of injections possible. This personalised approach is possible thanks to the precision of Heidelberg Spectralis OCT imaging and Dr Holcombe's advanced expertise in macular disease treatment.
Why choose Toowoomba Ophthalmic Consultants for AMD treatment?
- Expertise: Dr David Holcombe is an experienced ophthalmologist in the management of macula degeneration, and holds a PhD in the field of ophthalmology
- Advanced Technology: Heidelberg Spectralis OCT for precise diagnosis and monitoring
- Affordable: Bulk-billed or no gap intravitreal injections for eligible patients
- Personalised Care: Treatment plans tailored to your individual condition
- Local Access: Expert retinal care in Toowoomba without the need to travel to Brisbane
Frequently Asked Questions
Do eye injections for macular degeneration hurt?
Most patients feel little to no pain during the procedure. Before the injection, your eye is numbed with anaesthetic drops or gel, so you shouldn't feel the needle itself though you may experience some pressure or a slight scratch. After the procedure, some people also feel a mild burning sensation from the antiseptic used to clean the eye, which is normal.
How many injections will I need, and how often?
Most patients start with a loading phase of monthly injections for the first 3 to 4 months to get the condition under control. After that, if your eye responds well, your specialist may move you to a treat and extend schedule, gradually increasing the time between injections. With the later generation drugs administered by the injection, some patients may only need injections every 16 weeks or sometimes greater to control their disease. Most patients need ongoing injections to control their macular disease.
What are the risks or side effects of eye injections?
Common, mild side effects include a gritty feeling, slight redness, temporary floaters, or a black spot (which is usually just an air bubble that resolves within 24 hours). Serious complications are rare. These include eye infection, retinal detachment, or increased eye pressure. Contact us immediately if you experience severe pain, worsening redness, sensitivity to light, or sudden changes in vision, especially in the first few days after treatment.
What should I do to prepare for an injection appointment, and what happens afterward?
On the day, you can eat and drink normally. It's helpful to bring sunglasses, as your eyes may be sensitive to light afterwards. Arrange for someone to drive you home, as your vision may be blurry for a few hours. The appointment typically takes 1–2 hours, but the injection itself is very quick. Afterward, try to rest your eyes and avoid rubbing them. After the procedure if there is discomfort from the sterilizing solution, flushing your eyes with preservative free tears and simple oral analgesia is often helpful.
How successful is this treatment, and what is the goal?
Anti-VEGF injections are the most effective treatment for wet AMD. The primary goal is to prevent further vision loss and keep your vision stable. Delaying or missing injections can lead to irreversible vision decline, so it's important to attend all appointments.
Book Your Macular Eye Check in Toowoomba
Macular degeneration can develop without symptoms, which is why regular eye examinations are important.
State-of-the-art Heidelberg OCT imaging allows Dr Holcombe to detect and monitor macular degeneration with exceptional precision, and to design a personalised injection schedule if treatment is required.
For all appointments and enquiries, please phone 07 4670 9666
Monday to Thursday: 8:30 am - 4:00 pm
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