Macular Degeneration is the number one cause of blindness in the developed world – yet surprisingly little has been written to help family and friends of those who have lost vision to the disease.

Until now.

Dorchester-based optometrist and low sight specialist Paul Wallis has written a book to help cope with the condition, a severe, irreversible loss of vision.

He has been working with blind and partially sighted people since starting his career at the Moorfields eye hospital in London and his practice in Dorset has twice won the optician’s equivalent of an Oscar.

Paul says in his introduction that the aim of the book is to explain how help can be offered for those with sight loss to regain their independence. It is, as he says, a straightforward learning process.

“It has taken me 30 years to work out how to give that help and to understand what is happening when an individual has sight loss,” he said – pointing out that many either “mope or cope” and it’s the latter that his book aims to promote.

“This book,” he says, “is not about the disease process of MD. It is about the person who has MD and how he/she is affected by the disease.”

Most will know of two types of Macular Degeneration, wet or dry (90 per cent have dry), but Paul Wallis argues that, in reality, it matters little which you have... learning how to cope is the same process.

Mr Wallis says in the introduction to his book that Macular Degeneration has been the leading cause of blindness in this country for the past one hundred years. It was an unknown disease for most of the 20th century, people just accepting that vision faded as you got older.

He says that it was only in recent years that it began to get attention. “It has always been the Cinderella of the eye-disease world, which is tragic considering it is the largest cause of blindness in the UK,” said Mr Wallis.

Mr Wallis says that times have moved on from the days when everyone with MD was prompted to buy a magnifying glass and improve their lighting.

He offers a series of suggestions explaining why some messages seem hard to get across – until you understand that the effect of loss of vision is to reduce the brain’s ability to make sense of the world, similar to stroke.

“It’s like moving from full Technicolour to a black and white movie as the disease progresses. Some feel the loss quite markedly while others are not so concerned by it,” he writes.

And that is another message of the book – people will feel the effects of MD in different ways, but few will be left without some sight which means working with them to find solutions which work for them.

Many learn to cope with the dramatic changes in their vision but for many the psychological effects are the most troubling. MD for most represents a loss of lifestyle which Mr Wallis describes as a period of grieving which can be overcome, with help and support.

His book offers help to do that and warns those who embark on the journey that they could find their previously cheerful family member of friend becoming grumpy and, at times, acting like a toddler. They are also likely to often feel exhausted because the brain is working hard to comprehend the world without one of the major senses.

The author offers advice on how to deal with these situation and says many of the difficulties can be overcome by what he describes as “coaching”. It is, he says, a question of taking your time and dealing with one thing at a time, as if the brain has gone from finding fast solutions to being downgraded to slow thinking.

You might be forgiven for thinking this a gloomy subject but the book manages to be uplifting and encouraging and, perhaps most important of all, to offer the hope of a positive future.

Not surprisingly the book, Macular Degeneration – A Guide to Help Someone You Love is also available in audio form.

The book version costs £12.99 and can be found via good booksellers and online. It is also available for Kindle and similar readers and can be downloaded in audio form.

The macula itself is only 1.5mm across in the middle of the retina, but handles about 80 per cent of the information from the eyes.

The retina itself consists of two types of light receptor: rods and cones. The majority of the retina is made up of rods giving detailed vision.

The centre of the macula is made up only of cones and, as you move away from the centre of it, there is a mixed area of rods and cones which become just rods the further away from the centre.

Rods give black and white vision and movement detection, while cones give colour and detail.

When the cones are destroyed the colour drains away from vision giving a world of greys.

How far you read down the chart at the opticians is a good indication of how well your macula is working.

As Mr Wallis says: “Unsurprisingly the system can break down after 75 years of 24/7 use. It is amazing that it manages that well for so long for the majority of us. Not many 75-year-old cameras are in constant use nowadays.”

When macula degeneration starts in the retina it destroys the cones with the damaged area getting bigger.

90 per cent have dry MD where waste tissues are not flushed away and build up just beneath the retina. The macula has the highest nutritional needs and breaks down first. The underlying structure of the macula withers away but it is not possible to treat it, as there is no tissue left to repair.

In wet MD a build up of fluid lifts the macula away from the underlying blood supply which can be tackled if caught it time. As long as the retina has not been detached for too long, vision may return.