Drusen in the eye: what are they and how do they affect vision?

The drusen in the eyes are waste deposits that build up because the body is unable to eliminate them. Depending on the area where these accumulations appear, they are called macular drusen OR druse of the optic nerve.

The truth is that they are a frequent phenomenon associated with age. The problem is that if they are large or numerous, vision can suffer. Especially the center. That is why in this article we explain everything you need to know about this situation.

What are drusen in the eye?

Drusen in the eyes, as explained by a article published in the Archives of the Spanish Society of Ophthalmology, They are accumulations of amino acids, iron, calcium and ribonucleic acids. The fact that they contain calcium makes them more opaque and prevents the passage of light to the retina.

They usually have a yellowish color. Its pathogenesis is not well known, but it is known that macular drusen are more frequent with advancing age. However, those of the optic nerve do not appear to be associated with this fact.

Also, Optic nerve drusen (ONDs) can appear in children. As explained by A study published in Anales de Pediatricain infants they usually cause no symptoms but sometimes cause decreased visual acuity.

Why are they generated?

As we mentioned, It is not well known why drusen occur in the eye. As explained by American Academy of Ophthalmologymost cases of macular drusen are age-related.

That is why they usually appear in people over the age of sixty. In these cases, when the deposits reach large sizes, they are associated with age-related macular degeneration.

In addition, some factors have been identified that can lead to the appearance of drusen in the eyes. It seems that they are more frequent in the Caucasian race. Alikehigh blood cholesterol levels or smoking may act as risk factors. Finally, having a family history also increases the likelihood.

Examination to detect drusen in the eye.
The accumulation of these waste substances can be localized in the macula or in the optic nerve.

Types of drusen in the eye

Druses in the eye can be classified into different types, depending on the age at which they appear, their evolution and the risks they pose. A study published in the Spanish Society of Retina and Vitreous put the hard drusen first. These are usually found between the retinal pigment epithelium and Bruch’s membrane. They are considered a normal sign of aging.

Soft drusen are found in the same place as hard ones. However, they are associated with an increased risk of developing eye problems. That is why follow-up is recommended every six months.

Drusen in cuticular-type eyes are smaller and more numerous. They tend to converge with each other, then group together, giving rise to larger ones. They appear in young people and are recommended to be observed every year.

The reticular drusen, unlike the rest, are located in the subretinal space. They contain a higher percentage of cholesterol. This type poses a risk for the formation of neovascular lesions and for the appearance of macular degeneration.

Symptoms and diagnosis of drusen in the eye

Drusen in the eye may or may not produce symptoms. This depends, above all, on how many there are and how big they get. When there are signs, central vision is often lost or flashing lights appear in the field of vision.

Some people experience blurry vision. There may also be dimming, black dots in the field of vision, or trouble switching from a bright to a darker environment.

To diagnose them, in addition to the clinic, an eye exam is essential. What you do is look at the fundus to be able to check the state of the area around the retina.

Other more specific tests are optical coherence tomography and fluorescein angiography. The first is a non-invasive technique that allows exploration of the macula and the optic nerve. Light waves are used to obtain cross-sectional images of the retina.

Fluorescein angiography involves injecting a dye (fluorescein) into a vein. This contrast spreads through the body and reaches the blood vessels of the eyes. A special camera photographs them. This is how you can see if there is any damage to them.

Another commonly used test is the Amsler grid test. This allows for assessment of central vision. When it is altered, it is oriented towards a possible macular problem.


As with the symptoms, the complications of eye drusen will mostly depend on the number and size of the drusen. That is to say, the more there are and the larger they are, the more frequent the vision changes are.

One of the earliest complications is atrophy of the retinal tissue. This impairs central vision. But the most important disorder is macular degeneration. It is a degenerative disease which, when it occurs in the macula, also alters the central visual field. Likewise, the ability to observe details is lost.

Drusen of the optic nerve, as explained by a study published in the Archives of the Spanish Society of Ophthalmologycan give rise to serious field metric defects.

Fundus of the eye to detect drusen.
The fundus is the initial test to look for drusen. Then it is integrated with other methods.

Can drusen in the eye be prevented or treated?

As we have seen, a large proportion of drusen in the eye is associated with aging. However, we also commented at the beginning that some factors, such as tobacco or cholesterol, can favor their appearance.

Therefore, it is vital to lead a healthy life, with a balanced diet and daily exercise. In this way it is possible to improve both cholesterol levels and blood glucose, which protects the retina. It is also recommended to wear sunglasses to prevent damage from ultraviolet radiation.

The treatment itself depends on the type of drusen and its progression. For example, in the case of soft ones, it is recommended to start a treatment to avoid macular degeneration. The most commonly used drugs are antiangiogenic drugs that prevent the formation of new vessels around the retina.

This is advantageous, as the vessels that usually form are weaker and more fragile. That’s why it’s normal for them to rupture or for fluid to pass through them, causing small bleeding or swelling around the macula.

Cuticular and reticular drusen should also be treated with antiangiogenic drugs.. Conversely, in the case of hard ones, the only thing that is recommended is a routine check-up, as no treatment seems to be effective.

Remember that you should go to the eye doctor

The most important thing to keep in mind about drusen in the eyes is that, to detect and treat them before they cause serious visual disturbances, it is essential to consult an ophthalmologist.

Many of them appear with age, but can be treated to stop them from progressing. Therefore, if drusen are found in the eye, it is essential to go through all the recommended checkups. In general, it is enough to go every six months or a year.

The post Drusen in the eyes: what they are and how they affect vision appeared earlier in research-school.



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