Age-related Macular Degeneration (AMD)
The eye works like a camera. It has two parts, a lens and a film. The film layer lines the back wall of the eye and is called the retina. The area of the retina responsible for the central vision is called the macula.
Age-related macular degeneration (AMD) refers to specific age-related changes in patients 50 years and older. It comes in a spectrum from very mild changes which cause no visual changes to more severe changes that can lead to significant loss of central vision. In general, the dry form is the more mild and wet is the more severe form of macular degeneration.
Many forms of dry macular degeneration cause no noticeable visual changes in most patients. Amongst patients who do notice a change, the most common complaint is difficulty with contrast. Reading the newspaper or pill bottles can be challenging. Directing focused light (such as with a gooseneck lamp) can dramatically improve the ability to read low contrast text.
What is The Goal of AMD Treatment
The goal of treatment in dry AMD is twofold:
- Prevent the worsening of existing macular degeneration
- Early detection should worsening occur
What are the Steps That Patients Can Do to Help Slow Vision Loss
Patients who have both eyes affected by wet AMD do not need to take eye vitamins. Patients with only one eye affected by wet AMD will benefit from taking eye vitamins. The Age-Related Eye Disease Study Number 2 (AREDS2) vitamin decreases the risk of losing vision from macular degeneration by 25%. This formulation is different from a multivitamin. Taking a multivitamin plus lutein/zeaxanthin does not contain the same contents as an AREDS2 vitamin. Patients who regularly take a multivitamin may take an AREDS2 in addition if recommended by their doctor.
Patients may incorporate green leafy vegetables, fish, and omega-3s to provide their retina with the nutrients needed to decrease the risk of macular degeneration worsening. Studies have also demonstrated that maintaining a healthy weight can be beneficial for macular degeneration. Utilizing polarized sunglasses outside when outside for extended periods of time can decrease the risk of retinal damage from sun exposure.
Discontinuing smoking decreases this risk by 50%. Smoking increases the risk of macular degeneration worsening by 3 times compared to a non-smoker. Discontinuing smoking decreases this risk by 50%.
Monitoring vision with an Amsler grid dramatically decreases the risk of vision loss from this condition. Changes on an Amsler grid may be a sign of wet macular degeneration. Early detection and treatment of wet AMD can result in a complete reversal of vision loss. Late detection can result in permanent central visual loss. An Amsler grid should be used to check each eye individually at a reading distance. Patients are instructed to look at the black dot in the center of the grid paper. Patients who notice new distortion or missing lines may be experiencing a conversion to the wet form of macular degeneration.
Have routine eye exams. Patients who are experiencing a change in their vision or on the Amsler grid should be seen promptly. Those who are not experiencing any change should still follow-up at their next scheduled appointment.