Macular Degeneration

Age-related macular degeneration (AMD) is a common eye condition and the leading cause of vision loss among people age 50 and older.  It causes damage to the macula, a small spot near the center of the retina and the part of the eye needed for sharp, central vision, which lets us see objects that are straight ahead.  In some people, AMD advances so slowly that vision loss does not occur for a long time.  In others, the disease progresses faster and may lead to a loss of vision in one or both eyes.  As AMD progresses, a blurred area near the center of vision is a common symptom.  Over time, the blurred area may grow larger or you may develop blank spots in your central vision.  Objects also may not appear to be as bright as they used to be.  The center of your field of view may appear blurry, distorted, or dark.  AMD by itself does not lead to complete blindness, with no abililty to see.  However, the loss of central vision in AMD can interfere with simple everyday activities, such as the ability to see faces, drive, read, write, or do close work, such as cooking or fixing things around the house. 

Other risk factors in addition to age include:

• Smoking.  Research shows that smoking doubles the risk of AMD.
• Race.  AMD is more common among Caucasians than among African-Americans or Hispanics/Latinos.
• Family History and Genetics.  People with a family history of AMD are at higher risk.

You may be able to reduce your risk of AMD or slow its progression by making these healthy lifestyle choices:

• Avoid Smoking.
• Exercise Regularly.
• Maintain Normal Blood Pressure and Cholesterol Levels.
• Eat Nutritious Foods including a diet rich in green, leafy vegetables and fish.   

To detect AMD, it is important to have a comprehensive dilated eye exam since the early and intermediate stages of AMD usually start without symptoms.  The eye exam may include the following:

• Visual Acuity Test.  This measures how well you see at distances.
• Dilated Eye Exam.  Drops are placed in your eye to widen or dilate your pupils.  This enables the doctor using a special magnifying lens to look at your retina and optic nerve for signs of AMD and other eye problems.
• Amsler Grid.  This is used to see if you see the lines correctly as printed on the grid or if some of the lines disappear or appear wavy, a sign of AMD.
• Optical Coherency Tomography (OCT).  OCT uses light waves to achieve very high resolution images to help detect AMD.  OCT is painless.

The stages of AMD are:

• Early AMD.  People with early AMD typically do not have vision loss.
• Intermediate AMD.  Intermediate AMD may cause some vision loss, but most people will not experience any symptoms.
• Late AMD.  People with late AMD have vision loss from damage to the macula.

Two types of late AMD:

• Dry AMD:  This type results in a gradual breakdown of the light-sensitive cells in the macula, and of the supporting tissue beneath the macula.  These changes result in vision loss.
• Neovascular or Wet AMD:  Abnormal blood vessels grow underneath the retina.  These vessels can leak fluid and blood,which may lead to swelling and damage of the macula.  The damage may be rapid and severe.

 Treatment for AMD:

•  Early AMD:  Currently, no treatment exists for early AMD, which in many people shows no symptoms or loss of vision.  A comprehensive dilated eye exam at least once a year will help determine if your condition is advancing.  As for prevention, AMD occurs less often in people who exercise regularly, avoid smoking, and eat nutritious foods including green leafy vegetables and fish.
• Intermediate and Late AMD:  Research has found that nutritional supplements containing vitamin C, vitamin E, zinc, copper, lutein, and zeaxanthin may slow the progression of AMD.  Nutritional supplements are not a cure and will not restore vision already lost from AMD, but they may delay the onset of late AMD.  Consult your doctor.
• Advanced Neovascular or Wet AMD:  Injections of anti-VEGF drugs, laser treatments and laser surgery are procedures our ophthalmologists use to slow the progression of vision loss and in some cases improve the vision of patients with neovascular AMD.

If you are having symptoms of AMD or are of an age or in a higher risk group for developing AMD and would like to schedule an appointment, please call our office.  We look forward to serving you.     

Educational Resource

National Eye Institute of the National Institute of Health. A government service to advise information about eyes and eye health subjects. Click Here