Macular Degeneration

What is Macular Degeneration?

AMD stands for age-related macular degeneration and is responsible for causing loss of central vision. Although it could end up causing blindness, that is extremely rare and most people end up having a more mild form of this condition. Early detection and prevention is the key to ensuring that AMD does not lead to permanent loss of vision. If you notice any subtle changes in your central vision or if you know that you’re at risk for developing AMD then make sure to book an appointment to see your eye doctor. If you experience any sudden and severe changes to your central vision then the appointment should be booked immediately.

How Common is AMD?

As the name states, it is a condition common in senior citizens and is a progressive disease in the part of the retina, called the macula. However the earlier stages of the disease is common even among the middle aged, with a recent groundbreaking study by JAMA Ophthalmology showing that 12.6% or almost 20 million Americans over the age of 40 have AMD. AMD is the leading cause of vision loss in Americans over the age of 65. 

Preventing the Progression of AMD

Although this condition is considered a leading cause of blindness, the majority of people who develop AMD do not become blind. Since it’s a degenerative disease, early detection prior to severe visual loss is crucial because precautions can be taken to prevent damage (Macular Degeneration Prevention). Additionally, lifestyle changes such as quitting smoking and incorporating well-researched supplements into your diet can help reduce the risk of AMD progression.

Recognizing the Signs of AMD: Dry versus Wet

Macular degeneration starts out in a less severe form called dry AMD. In this type of early stage of the disease, the person might not notice any symptoms for the first while. However, there are certain signs of this condition which the eye doctor will see when the retina is checked. The most characteristic sign of this condition is called drusen which are yellow deposits under the retina.

Dry AMD symptoms often include:

  • Your glasses no longer providing the same clarity of vision
  • A loss of sharpness in your central vision
  • Straight lines appearing wavy

If you experience these symptoms, you may be witnessing the progression of dry AMD. Regular checkups can help catch these changes early on.

Wet AMD, a more aggressive form of the disease, has its own unique symptoms, often indicating a more serious progression:

  • Sudden, severe changes in central vision
  • Rapid loss of central vision
  • Visual distortions, such as straight lines appearing wavy or bent
  • A dark or empty area in the center of vision

These symptoms often indicate the growth of new, unstable blood vessels in the retina - a characteristic sign of wet AMD. Schedule an eye exam with your eye doctor if you experience these symptoms.

Effective Treatments for Macular Degeneration

One of the most effective treatments for wet AMD is injections of medications known as anti-VEGF (Vascular Endothelial Growth Factor) drugs. These drugs, including Ranibizumab (Lucentis), Aflibercept (Eylea), and Bevacizumab (Avastin), work by blocking a protein that stimulates the growth of new blood vessels. Regular injections can prevent further blood vessel growth and leakage, thereby maintaining vision.

Laser Surgery

This method involves directing a high-energy laser beam into the eye to destroy actively growing abnormal blood vessels. However, this technique is now less commonly used due to the risk of damaging surrounding healthy tissue and the superior results of anti-VEGF therapy.

Nutritional Supplements

Besides these treatment methods, certain nutritional supplements, including the AREDS2 formulation, may help slow the progression of AMD. The AREDS2 supplement includes vitamins C and E, zinc, copper, lutein, and zeaxanthin. It's been found to reduce the risk of progression from intermediate to advanced AMD, which can help preserve vision over time. It's important to discuss with your healthcare provider before starting a new supplement regimen, to ensure it's safe and beneficial for you.

AMD and Low Vision

Age-related macular degeneration, whether in its dry or wet form, can lead to low vision, a term used to describe significant visual impairment that can't be fully corrected with glasses, contact lenses, medication, or surgery.

Low vision due to AMD typically affects central vision, causing a blurry or blind spot in the middle of one's field of view. This can make it difficult to perform everyday activities such as reading, driving, recognizing faces, or seeing fine details. Peripheral vision is usually preserved, so total blindness is rare, but the impact on central vision can be a major challenge.

Thankfully, various tools and aids are available to help those with low vision navigate their daily lives more easily. These low vision aids can be categorized into optical aids and non-optical aids.

As with any aspect of AMD management, the use of low vision aids should be discussed with a low vision optometrist. Low vision optometrists have extensive knowledge and training in the field of low vision and are an important resource for someone with macular degeneration. They can provide recommendations for the most suitable devices for you based on your specific needs and the nature of your vision loss. They are also able to share resources, help you and your family understand the changes related to loss in vision, and help you navigate during this trying and often overwhelming time.