AMD - Macular Degeneration

Age Related Eye Problems


age-well.org > eye care > AMD, Age-Related Macular Degeneration


by Michelle Botes

AMD - The saying “prevention is better than cure” has never been more true than in the case of Age-related Macular Degeneration (AMD or ARMD).

What is AMD?

In layman’s terms, Age-Related Mascular Degeneration is the painless distortion or loss of sight in a person’s visual field and is caused by damage or degeneration to the macula, mainly due to rupture of the blood vessels around the macula. The macula is the part of the retina that is responsible for clear, sharp vision and acts as the body’s natural sunglasses, absorbing any excess light that enters.

This is a cross section of the human eye showing the macular, retina, pupil and iris

Medici differentiates between two types of Age-Related Mascular Degeneration. Dry ARMD is the most common and signifies the early stages of Age-Related Mascular Degeneration. Wet ARMD is a more advanced disease. To date, no cure has been developed for the condition, but treatment to slow the progression and stabilise the patient's view does exist. As with most diseases, the sooner the condition is diagnosed, the sooner it can be treated, minimizing the negative effect the disease has on the patient.

What is it like to have ARMD?

On the left you can see a street scene as perceived with normal vision, on the right, the same street as seen by someone with ARMD

Who is most at risk?

ARMD is an age-related disease and also the leading cause for blindness in people older than 60 years of age. Studies have shown that Age-Related Mascular Degeneration is hereditary and occurs more often in Caucasian females than any other population group.

Other, more manageable, factors include:

Nutrition: Some vitamins and minerals have proven to aid in prevention of Age-Related Mascular Degeneration. A study done by the National Eye Institute in 2001 have found that a diet rich in vitamins C and E, beta-carotene and zinc reduced the progression of ARMD in some patients. A balanced diet plays an important role in preventing numerous diseases, with ARMD being no exception. Regular consumption of fish and leafy green vegetables has proven to be beneficial to AMD patients.

Exposure to sunlight: Although there are conflicting reports as to the effect of sunlight and AMD, it is better to be safe than sorry. By wearing 100% UV protective sunglasses, you are shielding you eyes from harmful UVA and UVB rays.

Smoking: Smokers are more likely to be affected by AMD.

Maintaining a healthy weight: A healthy body has a healthy weight. Your body’s defenses and ability to heal itself is higher when you maintain a healthy weight.

Regular eye exams: By having regular eye exams, you can detect and treat Age-Related Mascular Degeneration as soon as it occurs, limiting progression. As AMD is hereditary, it is even more important for regular eye examination if you think you might be genetically predisposed.

Blood pressure and cholesterol: Healthy cholesterol levels will ensure that the blood in the vessels does not have fat build up that restricts the blood flow to the eyes. Regular visits to the doctor or clinic for tests and checkups will ensure that you maintain the desired levels.

What are the signs and symptoms?

A quick and easy test for Age-Related Mascular Degeneration is by using the Amsler Grid (below). With normal vision, all lines on the grid will look straight and evenly spaced.

How to do the test:

  • Hold the grid normal reading distance from your eyes, while wearing your normal reading glasses (if applicable).

  • Focus on the dot in the centre of the grid and cover one eye at a time.

    If any of the lines appear distorted or curved or you see black spots on the grid, visit your optometrist as soon as possible

    These pictures show how a street scene looks with normal vision and how it looks for someone with AMD or Macular Degeneration

    What Treatment Is Available?

    Although there is no cure for ARMD, the current treatments and drugs on the market aids greatly in preserving vision for ARMD patients.

    Photodynamic Therapy (PDT) – This is a treatment that destroys the abnormal blood vessels in the eye. The drug is injected into your arm and by shining a non-thermal laser light with a specific wavelength into your eye, the drug is activated.

    Laser treatment – Laser treatment was used in the past to seal abnormal blood vessels to prevent leaking, but is no longer a popular treatment for Age-Related Macular Degeneration due to the scarring that is left on the eye during laser treatment. These scars are perceived as ‘blind spots’ by the patients and laser treatment has greatly been replaced by PDT therapy.

    Injections – Drugs are injected directly into the eye on a regular basis. The drug attacks the protein in the eye that causes abnormal blood vessel growth. The most side-effects of this drug is mainly related to the injection itself, ranging from increased eye pressure to infections in the eye.

    Other practical aids are available to increase quality of life for sufferers of Age-Related Mascular Degeneration. Magnifying glasses, special lenses and audio books all contribute to easing the discomfort for ARMD patients.

    JAWS (Job Access with Speech) is a computer screen reader designed specifically for visually impaired people. It integrates with frequently used software programs, including Microsoft Windows and allows the user full function of their computer by converting displayed information into speech or braille.

    More information on living with AMD can be found by cutting and pasting the links in the resources section at the bottom of this page into your browser

    Get Your Priorities Right

    As we age, we seem to be more concerned about the lines around our eyes than we are about our eyes itself. Although not life threatening, Age-Related Macular Degeneration is a serious disease, but if detected early enough it can be managed and the negative effect it may have on your daily life can be limited.

    By making a few small changes to your diet, quitting smoking and wearing your sunglasses on your daily run or walk, you are taking positive steps towards guarding your eyes against AMD.


    Sources:
    http://www.ahaf.org/macular/resources/publications.html#
    http://www.nei.nih.gov/health/maculardegen
    http://www.ahaf.org/macular
    http://www.allaboutvision.com
    http://www.eyechat.co.za
    http://www.freedomscientific.com
    (the above are not links and are there for the benefit of researchers who need to consult a variety of information on the same topic; you will need to cut and paste the addresses into your browser).


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