Macular degeneration is the leading cause of impaired vision and legal blindness in people aged 50 years and over. It involves progressive loss of central vision and impacts the ability to read, drive, recognise faces and distinguish contrasts and colours. While the direct causes of macular degeneration aren’t well understood, we know that it is caused by damage to the nerves of the eye – the small central part of the retina, called the macular, begins to wear down. The retina lies at the back of the eye and senses light. The condition is often called age-related macular degeneration (‘AMD’). There is no cure, however, there are measures you can take to prevent it and, if you are diagnosed, to reduce or delay its spread. Although the middle of your sight will be affected, your peripheral vision will remain intact.
There are two main types of age-related macular degeneration:
- Dry (Geographic atrophy): This is the most common type, occurring in 90% of cases. It develop slowly. Yellow deposits of the protein drusen form in people over the age of 50, but do not necessarily case AMD. If they grow in number and size however, and become soft, large and located over the macular, they will distort your central vision. The drusen prevent oxygen from reaching the eye. As it worsens, the cells in the macular get thinner and die.
- Wet (Neovascular): This is the more rapid and serious version, that occurs in 10% of cases. Abnormal blood vessels grow from under the macular, leaking blood and fluid into the retina. Straight lines appear wavy and vision is distorted. Scaring occurs, leading to loss of central vision. The dry version can evolve into the wet version. Up to 5% of people with dry AMD in both eyes will progress to wet AMD in one year.
AMD is more common in females and can also occur in genetic groups. Your risk is greater if you have a parent, sibling or child with it. More people have AMD than have cataracts and glaucoma combined.
Signs of macular degeneration
For people aged 45 years and above, it is recommended to have a complete eye examination with an optometrist or ophthalmologist, and a follow-up every two to four years. It’s important to diagnose macular degeneration as you can take action to prevent or slow the spread. It is often not diagnosed until it worsens or both eyes get it, so it’s important to check regularly. For early detection, check weekly with an Amsler Grid, to see if any of the grid lines are wavy or missing. One in every 20 people over 50 years will show signs of early stage AMD.
- Blurred vision
- Blind spots or empty spaces, similar to when having viewed a camera flash
- Difficulty reading smaller print, which isn’t improved with new glasses
- Trouble focussing on close subjects
- Require a bright light to read or do close work
- Delays in adapting to the dark
- Straight lines such as door frames, trees or poles appear wavy
- Presence of drusen in the eyes
- Difficulty in judging distances
- Colours appear less bright
- Difficulty recognising faces.
There is no pain or discomfort.
Prevention and treatment of symptoms
- Do not smoke or give up smoking
- Keep your blood pressure and cholesterol at normal levels
- Eat fruit and green leafy vegetables
- Eat fish and other sources of omega, such as flaxseeds
- Avoid eye exposure to ultra-violet rays with sunglasses and a hat
- Supplements such as anti-oxidants (eg: lutein, zeaxanthin) and vitamins (eg: C and E) recommended by a doctor
- Maintain a healthy weight
Activities
- Dancing
- Tennis
- Golf
- Bird-watching
- Meditation and mindfulness
- Swimming
- Walking
- Yoga and pilates
Useful Links
- http://www.amdsupport.ca/
- https://www.visionaustralia.org
- https://www.macularsociety.org/
- https://www.fightforsight.org.uk/about-the-eye/a-z-eye-conditions/age-related-macular-degeneration/
- https://www.fightingblindness.ca/eye-diseases-pathways/age-related-macular-degeneration/
- https://www.nhs.uk/conditions/age-related-macular-degeneration-amd/