*T.

SITAGLIPTIN
50mg /METFORMIN
1000MG OD

*T.AMLODIPINE 5MG
OD
tt
*T.BRILLINTA 90MG
BD

*T.CARDIPRIN 1/1 0D

*T.SIMVASTATIN
10MG ON

*MONITORING DXT 2 HOURLY

*DXT EVERY 15 MINUTES BEFORE OPERATION

*TO DILATE AFFECTED EYE

*FOR OP 1/1/18

*T.SITAGLIPTIN 50mg /METFORMIN 1000MG OD

*T.AMLODIPINE 5MG OD
3. White race

4. Smoking

5. Cumulative light exposure

6. Hypertension

7. Higher summer sun exposure

8. Excessive alcohol intake

9. Genetic/familial predisposition

10. Obesity

#Patient_Presentation :

1) Loss of visual acuity

2) Poor color vision

3) Central scotoma

4) blind/blurry spot in field of view

5) Metamorphopsia (wavy lines)

#Diagnostic_Tests :

1) Color fundus photography

2) Fluorescein angiographic imaging

3) Optical coherence tomography

#Treatment :

1. AREDS formula (Age-Related Eye Disease Study )

* Vitamin C 500 mg ( increase the risk of nephrolithiasis )

* Vitamin E 400 I.U. ( contraindicated in patients with cardiovascular diseases)

* Beta-carotene 15 mg or Vitamin A 25,000 I.U ( contraindicated for smokers because of the

increased risk of lung cancer)

* Zinc 80 mg

2. Intravitreal drug therapy (inside the eye)

a. Bevacizumab (Avastin®)

b. Pegaptanib (Macugen®)

c. Ranibizumab (Lucentis®)

d. Aflibercept (Eylea®)

3. Other considerations:

a. Photodynamic therapy: Verteporfin infusion followed by laser therapy

b. Laser photocoagulation

c. Surgery

The vision decrease with time and age factor due to main part of retina (Macular) degeneration.
Macula is made up of millions of light sensitive cells cone. It provide us sharp and central vision and
accurate knowledge about shape, size and distance of any object. Macula is most sensitive part of
the retina that turns light into electric signal and sense to brain through optic nerve.

There are two types of ARMD-

1. Dry (Atrophic)

2. Wet (Neovascularization or Exudative) most ARMD starts as a dry and progresses to wet type.

Reason of ARMD –

Exact cause of ARMD is still unknown and correlates with senile generative process but family
history, racism (ethnicity), smoking, alcohols, sunlight, obesity, HT, DM, IHD etc.

Systoms of ARMD –

Loss ability to see fine, contrast and sharpness affected central vision, problem in driving, identity
face, seen black spotting, difficulties in reading, writing, things appears shacking, unable to assume
distance.

Diagnosis –

1. Visual Acuity Test

2. Visual Field Analysis

3. AMSLER Grid Test

4. Retinal Imaging

5. Fundus Photography

6. Fluorescein Angiography / ICG

7. OCT

Ayurvedic Treatment of Age Related Macular Degeneration (ARMD) –

The two main treatment in Allopathy :

1. Anti VEGF Medicine

2. Laser to prevent growth of abnormal blood vessels. Vitamin & Nutrient supplement i.e. Lutein,
Xeaxanthin, Omega 3 Fatty Acid, Beta Carotine, Vitamin C & E is also given in ARMD.

A stage of diabetic eye disease "NPDR (non-proliferative diabetic retinopathy)"

This is the early stage of diabetic eye disease. Many people with diabetes have it.

With NPDR, tiny blood vessels leak, making the retina swell. When the macula swells, it is called
#MacularEdema. This is the most common reason why people with diabetes lose their vision.
Also with NPDR, blood vessels in the retina can close off. This is called #MacularIschemia. When that
happens, blood cannot reach the macula. Sometimes tiny particles called "exudates" can form in the
retina. These can affect your vision too.

If you have NPDR, your vision will be blurry.