Age-Related Macular Degeneration 

Age-related macular degeneration, shortened as AMD, or ARMD is an eye condition affecting a part of the retina known as the macula. AMD causes vision loss in the central view, preventing you from seeing fine details at a far and close distance. With AMD, peripheral or side vision is unaffected or less effected. People with AMD might see the numbers on a clock but not the hands of the clock. 

AMD is a common vision problem in developing countries and is a leading cause of blindness in people above 50 years. 

Types of AMD

Two types of AMD affect individuals. They include:

• Dry AMD 

This is the most common AMD, affecting about 80% of AMD patients. Dry AMD occurs when some parts of the macular (centre of retina) become thinner as you age, and the growth of tiny protein clumps called drusen occurs. The result is a gradual loss of central vision. No treatment is available for dry AMD, but you can manage the condition to slow the rate of vision loss. 

• Wet AMD 

Wet AMD is a less common condition but more serious. This condition occurs when new but abnormal blood vessels develop under the retina. The blood vessels eventually leak blood and other fluids, resulting in scarring of the macula. Wet AMD causes faster vision loss than dry AMD. 

Most people with AMD do not know they have the condition until their vision becomes blurry. This makes regular visits to the ophthalmologist necessary.as gradual change may not be noticeable in early stages. The eye doctor can check for early AMD signs during the visit before vision problems occur. 

Who is at risk of developing AMD?

You are likely to have AMD if you:

• Are overweight 
• Are over 50 years 
• Have a family history of AMD
• Eat foods rich in saturated fat, such as butter, cheese, and meat
• Have high blood pressure 
• Smoke cigarettes

People with heart disease are also at risk of developing AMD due to high cholesterol levels. Caucasians also have a higher risk of AMD. 

Diagnosing AMD

The ophthalmologist will ask you to use an Amsler grid during your eye exam. Looking at the Amsler grid will help the ophthalmologist notice location of distorted, blank, or blurry spots in your vision. The eye doctor will also look inside the eye through a special lens. This helps check for changes in the macula and retina. 

The ophthalmologist will put eye drops to dilate your eyes. The eye drop will widen the pupil, allowing the doctor to look through the special lens to see inside the eye. 

Another option to examine the retina is optical coherence tomography (OCT). This machine scans the retina, providing a better view of the macular and retina. 

The doctor may also carry out fluorescein angiography to check the retina. The doctor will inject a yellow dye, known as fluorescein, into a vein during the procedure, usually in the arm. The yellow dye will travel through the blood vessels. Then, a special camera will take photos of the retina as the dye travels through the retinal blood vessels. The images can detect abnormal new cells in the retina. 

Another method for detecting abnormal blood vessels in the retina is optical coherence tomography angiography. This method is similar to the fluorescein angiography but doesn’t require a dye. Optimal Vision doctors have access to advance technology for diagnosis and investigation for easy detection.

Treatment for AMD

• Dry AMD treatment 

No treatment is available for dry AMD, but people with serious vision loss or lots of drusen can take nutritional supplements to manage the condition by slowing down its progress. 

A large study showed that taking the following minerals and vitamins daily slows the progress of advance dry AMD. 

• Vitamin E (400IU)
• Vitamin C (500mg)
• Zinc (80mg)
• Lutein (10mg)
• Copper (2mg)
• Zeaxanthin (2mg)

Your doctor will inform you if these minerals and vitamins can relieve your dry AMD because certain forms of dry AMD won’t respond to the AREDS supplements. Smokers should avoid taking beta carotene as it increases the risk of lung cancer. 

Eating dark, leafy greens, fish, and fruits, including healthy, nutrient-dense foods, can help people with AMD. 

• Wet AMD

Medications known as anti-VEGF can treat wet AMD. Treatment with Anti-VEGF helps to reduce the number of abnormal retinal blood vessels. These medications also slow leaking from blood vessels. The doctor will administer the medication into the eye through a small needle. This treatment is done under local anaesthesia and is well tolerated no needle can be seen and has minimal discomfort.

Another treatment option for wet AMD is laser surgery in some cases. The surgeon will shine a laser beam on the abnormal blood vessels during this procedure. This reduces the number of abnormal vessels and slows leaking in these vessels. 

Few of the more popular macula degeneration drugs or Anti VEGF injection treatment are as below:

Eylea (Aflibercept)

Lucentis(Ranibizumab)

Avastin(Bevacizumab)

Managing your vision 

If you have AMD, you can learn to manage your condition. You can still carry out different tasks using special vision tools such as handheld computers and magnifying tools. You can also learn to use your side vision for different tasks. 

A vision rehabilitation specialist can assist you in maximising your side vision and recommend the right low vision tools and services. You can ask the our ophthalmologist to refer you to a vision rehabilitation specialist within our team.

Using an Amsler grid 

AMD will result in changes in vision over time. You may not notice the changes, but noticing changes in your vision early will help improve your prognosis. Treating AMD early can stop or slow down further vision loss.  

You can use the Amsler grid daily to monitor your vision. Below is information on how to use the Amsler grid. 

• Place the Amsler grid in a location where you can see it daily. Most people keep the Amsler grid on the refrigerator door or bathroom mirror 
• When there is good light, stand about 12 – 15 inches away from the grid and look at it. Ensure you wear your reading glasses while looking at the grid 
• Cover an eye, then look directly at the dot in the middle of the grid with the uncovered eye. Check if lines look wavy or bent and if any part of the Amsler grid looks dim, blurry, or irregularly-shaped
• Cover the second eye and check your vision with that eye

If you notice changes in your vision, such as dim, blurry, or wavy lines, ensure you contact your ophthalmologist immediately.  

You can contact Optimal Vision on 020 7183 3725 to schedule an appointment with our ophthalmologist.