Macular degeneration: how big is the problem?

Almost every report on macular degeneration begins with a somber reminder that macular degeneration is the single most common cause of blindness in the elderly in the United States and Europe. Almost every report also confirms that there is no known successful approach to slowing, stopping, reversing, or preventing this syndrome. In the light of these devastating statements, it is difficult to explain the paucity of information about the disease process in general and its epidemiologic implications in particular. What little is known deals with prevalence rates; no figures are available regarding the incidence. Additionally, almost without exception, the prevalence numbers are based on the assumption that macular degeneration is a binomial (black and white) problem. However, macular degeneration, like all chronic diseases, exists in a potentially infinite number of shades of gray. Hence, when viewed as an achromatic continuum, macular degeneration is more prevalent than generally believed. Recognizing this disorder earlier invites the greater possibility of a cure or primary prevention.