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In my practice, I see patients everyday that are at risk for Macular Degeneration.  Eye doctors historically have used the Beckman classification scale to determine when someone has Macular Degeneration.  This classification scale is based on the eye doctor visually identifying small changes in the macula.  These small changes are called drusen and appear as little white spots.  Drusen are often difficult to identify in their earliest stages and in one study eye doctors missed them in 25% of patients, some of those even had larger (or Intermediate) sized drusen.  In my practice, we do our best to identify these drusen at their earliest stage using retinal imaging and scans of the macula, but we also use Dark Adaptation testing.  Dark Adaptation testing allows to get an assessment of how well the macula is functioning.  The test flashes a small square of light 5 degrees from the center of the macula.  This causes a bleaching effect in that area.  By testing the ability of the Rod photoreceptors near the macula to recover from this light, we can determine whether the macula is performing normally or if it is starting to show early degeneration.  This allows our doctors to identify macular degeneration at the earliest possible stage.  In the ALSTAR study they found that delayed dark adaptation can identify macular degeneration up to 3 years before macular drusen are found.  When we find this in one of our patients, we initiate a strategy using supplements and eye protection to give the patient the best potential for a successful outcome.  It is my opinion, that when we can initiate a carotenoid supplement plan earlier, we increase the potential for the quality adjusted life years of the patient.  This means that we can push back the progression to more severe and vision threatening macular degeneration by earlier intervention.  I encourage anyone over 50 years old to find an eye doctor that is performing dark adaptation testing so that you can assess your risk.  You can reach me at drpowell@vseyecare.com or visit our Kansas City area practice at vseyecare.com.  Thank you for learning more at TheEyeDoctorShop.com