What is Age-Related Macular Degeneration (AMD)?
The retina is a thin layer of nerve tissue that lines the back of the eye and gives you the ability to see, very much the same as the film of a camera. The macula is a specialised area of the retina that is responsible for seeing fine details clearly in the centre of your vision. The macula allows you to perform tasks like driving, recognising faces and reading small print.
Age related macular degeneration is a common condition that affects people in their 50s and older. In AMD, you develop weakness in and around the pigmented cells supporting the macula. The exact cause of AMD is unknown, but the most common risk factors are Caucasian race, smoking, being overweight, high blood pressure and a family history of AMD.
There are two types of AMD.
Dry AMD: Due to the weakness of the supporting cells, there is a buildup of waste material in the macular area. This waste material is called drusen. Most patient's vision remains stable. If the supporting pigmented cells become so weak that they die, the macular cells will die as well. These areas where the cells have died are called “geographic atrophy” and are patches where you have total and permanent vision loss. These areas of “geographic atrophy” may either stay the same size or slowly enlarge over a period of years.
Wet AMD: Weakness of the supporting cells in the macula lead to abnormal blood vessels growing underneath the retina. These abnormal blood vessels leak fluid, bleed and cause scars in the macula that lead to sudden and dramatic vision loss.
Symptoms of AMD
- Slow onset blurring of central vision making reading, driving and recognising faces difficult
- Distortion of images (straight lines are not straight anymore)
- Difficulty adjusting between dark and light conditions
- Sudden and dramatic loss of vision of central vision
- Sudden and dramatic distortion of images
When should you see a doctor urgently?
Dry AMD progresses slowly, but the use of vitamin supplementation and lifestyle modification can slow down vision loss if you catch the problem early. That is why regular eye exams matter. If you can’t see people clearly at a distance, have trouble adjusting between light and dark conditions or need increasingly brighter light to read, schedule an appointment with your eye doctor.
Wet AMD damages the macular much more rapidly. If you experience sudden decrease in vision or image distortion, then consult your eye doctor as soon as possible. The sooner you receive treatment, the better the chances that you will regain and keep your vision.
How is AMD treated?
With AMD, even different eyes in the same patient need a personalised treatment plan. After a thorough evaluation, your doctor will counsel you on the current state of each eye as well as guide and accompany you on the road ahead.
There is no treatment available that will recover vision loss from Dry ARMD. A specific combination of vitamin supplementation has been shown to decrease the chances that your AMD will progress to more severe forms of disease. Some studies have also shown that certain lifestyle modifications may also be beneficial, including stop smoking, a diet rich in Omega 3 fatty acids and colourful fruits and green leafy vegetables, controlling your blood pressure and cholesterol as well as being physically active several times a week. Visual aids and practical support such as magnifying lenses, brighter lighting and special software on your devices can minimise the impact on your day-to-day life.
The treatment of wet ARMD is aimed at treating the abnormal blood vessels. If the abnormal blood vessels are close to the fine vision area, they can be treated with intraocular injections that temporarily suppress blood vessel growth. If the abnormal blood vessels are further away from the fine vision area, they can be treated with laser or intraocular injections. At our practice, we strive to make these injections as comfortable and infrequent as possible while maintaining optimal visual outcomes.
“Vision is the true creative rhythm”
- Robert Delaunay