Age-related macular degeneration (AMD) is the leading cause of severe vision loss among older Australian's and New Zealanders. Although the disease is not yet curable, there are promising new therapies in the research
pipleline that may be available soon.
Roughly the size of a rubber on a pencil, your macula occupies the center of the retina in your eye. Despite its small size, it is responsible for the sharp, high-definition, central vision that allows you to read, drive, recognise faces and distinguish fine details. When you have macular degeneration, it means that the macula in one or both eyes has broken down irreverisbly over time. Your vision may become blurred, a blind spot may develop in the center of your visual field and many fine-detail activities, such as reading and writing, may become difficult or impossible to do with your accustomed ease. Your peripheral vision, however, remains intact.
No-one knows what causes age-related macular degeneration (AMD), but by some estimates, about one-quarter of people over age 65 and fully one-third of those over age 80 show evidence of this condition. Nearly 90 percent of those with AMD have what's called the dry (or nonexudative or atrophic) form, in which the light-sensitive cells
in the macula slowly decay, and yellow spots of fatty deposits called drusen appear on the macula (see Illustration below.) Dry AMD is the less severe of the two forms, progressing slowly and sometimes stablising temporarily. You might not even notice symptoms of vision loss, especially if it is restricted to one eye and your 'good' eye compensates.
When you have dry macular degneration, the cells of the macula, which occupies the center of your eye's retina, slowly breakly down. Tiny yellowish fatty deposits called drusen appear (and may grown in size over time). Because vision loss is gradual with this type of AMD, there are a number of self-help measures that can keep it in check.
LIKELY FIRST STEPS
pipleline that may be available soon.
What is happening
Roughly the size of a rubber on a pencil, your macula occupies the center of the retina in your eye. Despite its small size, it is responsible for the sharp, high-definition, central vision that allows you to read, drive, recognise faces and distinguish fine details. When you have macular degeneration, it means that the macula in one or both eyes has broken down irreverisbly over time. Your vision may become blurred, a blind spot may develop in the center of your visual field and many fine-detail activities, such as reading and writing, may become difficult or impossible to do with your accustomed ease. Your peripheral vision, however, remains intact.
No-one knows what causes age-related macular degeneration (AMD), but by some estimates, about one-quarter of people over age 65 and fully one-third of those over age 80 show evidence of this condition. Nearly 90 percent of those with AMD have what's called the dry (or nonexudative or atrophic) form, in which the light-sensitive cells
in the macula slowly decay, and yellow spots of fatty deposits called drusen appear on the macula (see Illustration below.) Dry AMD is the less severe of the two forms, progressing slowly and sometimes stablising temporarily. You might not even notice symptoms of vision loss, especially if it is restricted to one eye and your 'good' eye compensates.
When you have dry macular degneration, the cells of the macula, which occupies the center of your eye's retina, slowly breakly down. Tiny yellowish fatty deposits called drusen appear (and may grown in size over time). Because vision loss is gradual with this type of AMD, there are a number of self-help measures that can keep it in check.
LIKELY FIRST STEPS
- Monitoring your vision for signs of change.
- For some people, daily supplements of high-dose antioxidants and zinc.
- Laser surgery or photo dynamic therapy to stop certain cases of wet AMD.
QUESTIONS TO ASK
- How often should I have the status of my AMD re-evaluated?
- What are some signs that my AMD might be worsening?
- Could I be a candidate for laser surgery or for photodynamic therapy?
MEDICATIONS
------------------------------------------------------------------------------------------------------------------------------------------Antihistamines Photodynamic therapy Drug/laser treatment for wet AMD.
PROCEDURES
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Laser photocoagulation Seals leaking blood vessels of wet AMD.
LIFESTYLE CHANGES
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Vision watch Regular checkups and home monitoring.
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Healthy diet Low in fat, high in fruit and vegetables.
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Avoid smoke & UV rays Can make AMD worse.
NATURAL METHODS
-----------------------------------------------------------------------------------------------------------------------------------------------
Antioxidants & Zinc supplements Shown to be very helpful for people with intermediate dry AMD.
TAKING CONTROL
Ask your eye doctor for a referral to a low-vision specialist or low-vision center, where you can get training in the use of low-vision aids, devices designed to help you maximise your vision and help with reading and writing (see on shortly). Brighten your home with more illumination and remove or secure clutter that could cause a fall. To get around outside, use miniature telescopes focused for distant vision, either mounted in your glasses or handheld. Use protective filters and sun lenses to improve contrast and reduce glare.
In the less common form, called wet (or exudative or neovascular) AMD, fine blood vessels grow beneath the retina, leaking and damaging the macula. Wet AMD progreses more quickly than dry AMD and it causes more severe vision loss, sometimes within days or weeks. if left untreated, wet AMD can lead to legal blindness (defined as vision of 20/200 or worse) although it won't lead to total blindness. About 15 percent of people with the more common dry AMD go on to develop wet AMD.
Although, it's rare, macular degeneration can develop in young people due to a genetic disorder or as a drug side effect. Most often, however, it is related to the ageing process. Your odds of getting AMD are also higher if you have a family history of it,or if you're female, white and have light-coloured eyes. Other risk factors include exposure to smoke and direct sunlight and having a condition such as high blood pressure, high cholesterol or obesity.
------------------------------------------------------------------------------------------------------------------------------------------Antihistamines Photodynamic therapy Drug/laser treatment for wet AMD.
PROCEDURES
---------------------------------------------------------------------------------------------------------------------------------------------
Laser photocoagulation Seals leaking blood vessels of wet AMD.
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
Vision watch Regular checkups and home monitoring.
----------------------------------------------------------------------------------------------------------------------------------------------
Healthy diet Low in fat, high in fruit and vegetables.
----------------------------------------------------------------------------------------------------------------------------------------------
Avoid smoke & UV rays Can make AMD worse.
NATURAL METHODS
-----------------------------------------------------------------------------------------------------------------------------------------------
Antioxidants & Zinc supplements Shown to be very helpful for people with intermediate dry AMD.
TAKING CONTROL
- Keep up with the news about AMD. Researchers are currently testing and developing new treatments that may turn out to be just what you need. Ask your doctor about clinical trials fo therapies that might help your particular case.
- Don't be afraid to use your eyes. Doing your normal activities won't make your AMD get worse. So go ahead and read, watch television and use a computer as much as you want.
Ask your eye doctor for a referral to a low-vision specialist or low-vision center, where you can get training in the use of low-vision aids, devices designed to help you maximise your vision and help with reading and writing (see on shortly). Brighten your home with more illumination and remove or secure clutter that could cause a fall. To get around outside, use miniature telescopes focused for distant vision, either mounted in your glasses or handheld. Use protective filters and sun lenses to improve contrast and reduce glare.
In the less common form, called wet (or exudative or neovascular) AMD, fine blood vessels grow beneath the retina, leaking and damaging the macula. Wet AMD progreses more quickly than dry AMD and it causes more severe vision loss, sometimes within days or weeks. if left untreated, wet AMD can lead to legal blindness (defined as vision of 20/200 or worse) although it won't lead to total blindness. About 15 percent of people with the more common dry AMD go on to develop wet AMD.
Although, it's rare, macular degeneration can develop in young people due to a genetic disorder or as a drug side effect. Most often, however, it is related to the ageing process. Your odds of getting AMD are also higher if you have a family history of it,or if you're female, white and have light-coloured eyes. Other risk factors include exposure to smoke and direct sunlight and having a condition such as high blood pressure, high cholesterol or obesity.
Treatments
Because the cause of AMD is still unknown, there is no cure for it at present and no sure way to reverse the vision loss that may result. Simply put, there are no proven remedies for dry AMD and treatments for only certain cases of wet AMD. Still, there is plenty of cause for optimism. AMD is currently a hot area for research, especially as the population ages and the disease becomes more prevalent. There is also growing evidence that diet and nutritional supplements can make a real difference. Further, macular degeneration does not cause total blindness--in fact, most people experience no serious vision loss from dry AMD. And even if you have the wet form, with its more severe ramifications, you'll still be able to see well enough to perform most activities of daily living.
Because the cause of AMD is still unknown, there is no cure for it at present and no sure way to reverse the vision loss that may result. Simply put, there are no proven remedies for dry AMD and treatments for only certain cases of wet AMD. Still, there is plenty of cause for optimism. AMD is currently a hot area for research, especially as the population ages and the disease becomes more prevalent. There is also growing evidence that diet and nutritional supplements can make a real difference. Further, macular degeneration does not cause total blindness--in fact, most people experience no serious vision loss from dry AMD. And even if you have the wet form, with its more severe ramifications, you'll still be able to see well enough to perform most activities of daily living.
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