Age related Macular Degeneration (AMD) is a common condition which occurs in people over the age of 50, and is the biggest cause of sight impairment in the UK.
The macular is a small area in the central part of the retina which is the light sensitive layer at the back of the eye. At the macular there is a very high concentration of receptors that allow us to see fine detail. In macular degeneration these receptors become damaged or die off and therefore this affects our ability to read or see faces, however this does not affect your peripheral vision so will not affect your ability to walk around.
There are two types of macular degeneration:
This type of AMD is the commonest, affecting approximately 85% of people. This occurs when there are degenerative changes at the macular and the receptors become damaged and die off. Currently there is no treatment for Dry AMD, although lifestyle changes can help with progression. Around 10 to 15 % of people with dry AMD will go on to develop Wet AMD
In wet AMD abnormal blood vessels grow under the macular and these can bleed and leak fluid which will damage the receptors and quickly cause rapid loss of vision. This can develop suddenly – if you experience these symptoms you need to have an urgent assessment. If you are diagnosed with wet AMD there is treatment available in the form of special injections using a drug to stop the blood vessels from bleeding and leaking. These drugs are known as anti-Veg F drugs ( Lucentis and Eylea). The sooner you can be treated for this condition the better the outcome.
For people who have significant visual impairment through AMD, there is lots of help with low vison aids. Many societies have aids you can trial before you buy – also referral into the local hospital low vision clinic will be beneficial. Local hospitals also have an eye clinic liaison officer (ECLO) who can offer help and advice. Also many societies have large print books, large face clocks and watches, talking clocks, talking books and newspapers. Access to aids in the kitchen, such as talking kitchen scales audible level indicators to warn when a cup is full are also available.
Improving the lighting in your home can make a significant difference, particularly using daylight lamps for reading.
- UV Family History
- Lifestyle BMI >30 risk factor
- Light exposure
As we age it’s important to have regular eye examinations, and particularly we advise enhanced examinations with OCT and Optomap retinal imaging. These tests are able to pick up these changes at an earlier stage, and allow us to monitor any changes.
With AMD it is important to keep healthy, eat lots of fruit and vegetables particularly dark green leafy vegetables (which contain antioxidants lutein and zeoxanthin, which help to protect the macular). Do not smoke, protect your eyes from sunlight and exercise regularly. Also dietary supplements may be of benefit for some people.
As AMD affects the central part of your vision you may notice increased difficulty with reading and recognising faces. Watching TV and driving may become more difficult. With dry AMD these changes tend to be more gradual. However in wet AMD the changes are often sudden but not always. If you notice any sudden onset reduction in vision, distortion (lines looking wavy) or a dark spot in your central vision you should seek advice urgently as this may be suggestive of wet AMD.