What is macular degeneration?
Age-Related Macular Degeneration (AMD) is an ocular disease that affects the central part of the retina, called the macula. The macula provides our central vision, most of our color vision, and our ability to see fine details.
As the name implies, the macula degenerates as the disease progresses. Initially there may be no symptoms, but in advanced stages of the disease, patients will begin to notice a loss of their central vision, making it difficult to drive, recognize faces, and make out small print.
Who is at risk for macular degeneration?
As you might expect, Age-Related Macular Degeneration is more likely to develop later in life. In fact, macular degeneration is the leading cause of severe vision loss in adults over the age of 50!
In addition to age, there are other risk factors that greatly increase your risk of developing macular degeneration including:
- History of smoking
- Chronic sun exposure
- Gender (females are more likely to develop AMD than males)
- Genetics/family history (if someone in your family has been diagnosed with macular degeneration you are more likely to develop it as well)
- Having light colored eyes
- History of high blood pressure or cholesterol
- Obesity/poor diet (a diet high in saturated fats can increase your risk of developing macular degeneration)
- A low density of macular pigment (a simple reading that can be tested in our office to determine risk)
What are the symptoms of macular degeneration?
Symptoms of macular degeneration can vary from patient to patient and change depending on the severity of their condition. Macular degeneration has two stages called dry (atrophic) and wet (exudative).
Dry macular degeneration (atrophic) is the most common type as 80% of AMD patients have the dry form. In this initial phase, you may or may not have any symptoms depending on severity. If you do begin to experience symptoms, they may include:
- Gradually blurred vision
- Decreased intensity or brightness of colors
- Poor nighttime vision
- Difficulty adjusting to different light levels
- Noticing that straight lines appear wavy
- A dark area, or blind spot in central vision
Wet macular degeneration is much less common but leads to more severe vision loss. In this advanced phase, new blood vessels begin to grow to try to nourish the sick macula, but these vessels are weak which causes them to break and leak, causing further visual damage. Patients with wet AMD experience similar symptoms to those with dry AMD, but to a more aggressive degree. These patients may have complete central vision loss, relying only on their peripheral vision to function.
How do you treat macular degeneration?
Treatment for macular degeneration depends on multiple factors including the patient’s age, overall health, extent of their AMD, and patient preference. It is important to note that there is no cure for macular degeneration, and treatment is focused on slowing the progression of the disease.
For those with dry macular degeneration, the primary goal is to prevent the disease from progressing into wet macular degeneration. This can be accomplished with regular monitoring of macular health with Optomap retinal imaging and macular OCT scans. It is imperative that the patient aim to reduce modifiable risk factors (such as sun exposure and smoking), and monitor their vision at home using an amsler grid (see below).
Another form of treatment is nutraceutical vitamins with high levels of zeaxanthin and lutein, which are highly concentrated in the macula. These vitamins help to increase the density of macular pigment to help prevent progression to wet AMD.
For patients with wet macular degeneration, the best form of treatment is called anti-VEGF injections. VEGF stands for “vascular endothelial growth factor,” which is linked to development of the leaky vessels in wet AMD. Anti-VEGF agents help to slow the disease process and level of damage by preventing the growth of these vessels in the first place.
For those who are suffering from the visual side effects of macular degeneration, low-vision devices are available to assist in developing new ways to perform daily tasks. Referral to a local low-vision specialist can be arranged to provide these patients with the proper resources.
What can I do to protect myself against macular degeneration?
The most important step you can take to help protect yourself against macular degeneration is having an annual eye exam. Similar to glaucoma, symptoms of macular degeneration are not noticeable until you have already reached the advanced stages of the disease. Therefore, it is imperative to have your eyes examined annually (or more!) so our doctors can monitor for early signs of macular degeneration.
Other than having your eyes examined, it is also important to help reduce your modifiable risk factors for macular degeneration as much as possible. This includes all of the following suggestions:
- Quit smoking
- Wear good UV protection (even on cloudy days!)
- Maintain a healthy diet
- Be evaluated and treated for any underlying issues such as high cholesterol
An excellent way to protect yourself against macular degeneration is by taking nutraceutical vitamins. There are specific vitamins available to patients who have only risk factors for macular degeneration, as well as patients who already have signs of it. You can read more about these on our eye health vitamins page.
Lastly, careful monitoring of your visual capabilities can help to detect changes in your macula over time. It is recommended that patients who have macular degeneration monitor their vision at home regularly using an amsler grid, watching for new distorted or missing sections of the grid. (Be sure to ask our doctors or staff about our magnetic amsler grids you can keep on your refrigerator for convenience!)
To properly use the amsler grid, follow these instructions:
- Always wear your glasses that you would normally use to read. Hold the grid about 12-15 inches from your face.
- Cover one eye and focus directly at the center dot.
- While focusing on the center dot, take note if all of the grid lines appear straight or if they appear wavy, dark or blank.
- Repeat with your other eye.
This is a quick and simple test that can be performed at home to monitor for change in your macular health. If you notice any new areas of distortion, be sure to contact us right away so our doctors can examine your macula for changes.