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Stargardt Maculopathy

Stargardt maculopathy is a familial eye condition with symptoms and clinical findings that can begin as early as the first decade of life. Stargardt disease affects the central vision, much like other degenerations of the macula and causes difficulty with detail vision such as reading overhead signs when driving or walking, reading small print and recognizing faces. Early in the disease, patients may notice significant vision changes even with an apparently healthy retina, or with subtle retinal changes. Progression of macular changes is typical, often leading to severe central visual impairment and the classification of legal blindness.

Stargardt maculopathy does not affect the peripheral retina; that is, the side vision remains intact. Stargardt's alone does not lead to total blindness and therefore vision enhancement strategies are often very successful.

In Vision Rehabilitation, much of the management is focused on enhancement of central visual function. We help patients maximize their visual function through the prescription of strong or specialized glasses, telescopes, hand-held or spectacle-mounted magnifiers, electronic/digital magnification and low vision occupational therapy. This can include eccentric viewing training, assistance with developing and teaching skills to manage activities of daily living and training with the recommended devices and assistive technology.

Because Stargardt maculopathy commonly affects younger individuals, adaptation to new visual strategies is often successful. The technology boom including tablet and computer use offers individuals the opportunity to be exposed to and learn text to speech software and screen-readers which are very effective strategies for efficient use of gathering information.

Many patients with Stargardt disease are still in school or working when they present to the Vision Rehabilitation Service. We work closely with employers, schools and disability services to ensure that patients are receiving the appropriate accommodations to maintain or gain employment. Learning to drive and maintaining driving privileges is a common concern in patients with Stargardt’s. Some patients with Stargart’s maculopathy continue to drive through specialized driving licensure programs available in many states. Our physicians work closely with patients, families and the motor vehicle administration to assess the potential to initiate and maintain driving.

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