The most difficult eye disease to deal with, for both a doctor and a patient, is macular degeneration. It affects one’s vision right in the center. Whatever you try to look at directly ends up distorted, blurry or darkened.

The hardest part for us as eye care providers is that there are not great treatments for some of the variants of macular degeneration. There are a lot of current research studies on new drugs for this condition, and we hope there will be some very good treatments in the coming year.

Here’s the good news now, though. A new study published in the Journal of the American Medical Association Ophthalmology showed rates of macular degeneration to be declining with each generation.

The rates and risk of macular degeneration increase with age, but this study adjusted for age, gender and other factors to show that there was as high as a 60 percent decline in incidence in macular degeneration for the baby boomers as compared to the “Greatest Generation,” those born between 1901 and 1924.

Early findings that included Generation X also showed a further decrease in prevalence as compared to the baby boomers.

My initial thoughts were that the decline must be related to the decrease in rates of smoking. Smoking is one of the most well known modifiable risk factors for macular degeneration. However, the study suggests that the lower rate of smoking was of little consequence in these findings.

Epidemiologists think that the decline in incidence might be related to multiple environmental factors as well as advances in overall healthcare. Better sanitation, less childhood infection, lower rates of cardiovascular disease and dementia could all contribute.

Conditions such as macular degeneration, cardiovascular disease and dementia are all linked to inflammation within the body. While scientists have no definite explanation for the drop, the decrease is too steep to be secondary to only genetic factors.

The study began three decades ago at University of Wisconsin-Madison in Beaver Dam, and has included follow-ups for the research participants every five years. They also began to include the offspring of the study’s participants to compare along generations, noting that Generation X is still fairly young to be seeing signs of macular degeneration.

While the results are promising, we are still seeing plenty of macular degeneration daily in our offices. Ultimately, we hope to continue to understand more and more of the cause of this disease and reach new treatment alternatives.

Who knows what 2018 will bring?

Caroline Bundrick, O.D. is an optometrist practicing at Darling Eye Center, with offices in Bluffton and on Hilton Head Island.