Age-related Macular Degeneration
What is AMD?
AMD is a common eye condition and a 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.AMD by itself does not lead to complete blindness, with no ability 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.
The macula is made up of millions of light-sensing cells that provide sharp, central vision. It is the most sensitive part of the retina, which is located at the back of the eye. The retina turns light into electrical signals and then sends these electrical signals through the optic nerve to the brain, where they are translated into the images we see. When the macula is damaged, the center of your field of view may appear blurry, distorted, or dark.
Who is at risk?
Age is a major risk factor for AMD. The disease is most likely to occur after age 60, but it can occur earlier.
Other risk factors for AMD 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. People with a family history of AMD are at higher risk.Does lifestyle make a difference?
Types of AMD
Dry type - is a gradual thinning of the central retina which usually takes many years to develop
Wet or Disciform type - here the body tries to heal the ageing retina by making new blood vessels grow into the retina. Unfortunately, these are very fragile and often bleed. This can lead to a sudden deterioration of vision. The vision may become distorted and straight lines, like window panes, may appear bent.
Researchers have found links between AMD and some lifestyle choices, such as smoking. You might be able to reduce your risk of AMD or slow its progression by making these healthy choices:
1. Avoid smoking
2. Exercise regularly
3. Maintain normal blood pressure and cholesterol levels
4. Eat a healthy diet rich in green, leafy vegetables and fish
If you are at risk of AMD, you should check your eyesight for distortion using an Amsler Grid
Click on the button for a downloadable Amsler Grid that you can print out
Research has shown found that daily intake of certain high-dose vitamins and minerals can slow progression of the disease in people who have dry AMD.
If you have dry AMD, you might benefit from taking such supplements. Many of the supplements have different ingredients, or different doses, from those tested in the research trials. Mr. David will advise you about which supplement, if any, is right for you. For example, if you smoke regularly, or used to, Mr. David may recommend that you avoid supplements containing beta-carotene.
Even if you take a daily multivitamin, you should consider taking a supplement if you are at risk for late AMD. The formulations tested in the research trials contain much higher doses of vitamins and minerals than what is found in multivitamins.
Finally, remember that these supplements are not a cure. They are meant to slow the progression of AMD.
Fortunately treatment is now available in the form of anti growth factor injections (Lucentis, Eylea). In most cases these offer around a 30% chance of visual improvement and a 95% chance of stabilistaion. Therefore, urgent diagnosis and treatment gives a better visual outcome.
If you get this treatment, you may need monthly injections. Before each injection, your eye will be numbed and cleaned with antiseptics. To further reduce the risk of infection, you may be prescribed antibiotic drops. A few different anti-VEGF drugs are available. They vary in how often they need to be injected, so you may wish to discuss these issues with Mr. David.
Implantable Miniature Telescope
This new device offers the potential for improved vision in patients with advanced dry or wet disease affecting both eyes. Please see separate info page for further details.
Partial Sighted and Blind Registration - For those whose vision is badly affected registration brings many benefits. The support team will visit you in your own home and assess whether you need any additional help or appliances. They can arrange the talking book and other support services which you may find very helpful.
Mr. David can organise a Low Vision Clinic Appointment to help with rehabilitation.
The Royal National Institute for the Blind has an online shop with gadgets that may be helpful. It is best if one purchased such gadgets or devices with the help of your local visual rehabilitation team.
The Macular Disease Society
Darwin House, 13a Bridge Street,
Andover, Hampshire, SP10 1BE
Tel. 0845 2412041
Talking Newspaper Association of the United Kingdom
90 High Street Heathfield,
East Sussex TN21 8JD
Tel. 01435 866102
Royal National Institute for the Blind
224 Great Portland Street
London W1N 6AA
Tel. 020 7388 1266
South Yorkshire DN2 6AA
Tel. 0844 477 4966