Globally, macular degeneration is the leading cause of vision loss in people aged 65 and older. Fortunately the vast majority of cases of vision loss can be prevented with early detection and preventative measures.
Age-related macular degeneration is a degenerative eye condition that affects the macula, which can result in decreased central vision or distortion of vision.
The elderly are most at risk for developing macular degeneration. Therefore its name “age related”, if you are older than 65, you may be at a greater risk. You are also at an increased risk if your family has a history of macular degeneration. Medical conditions such as obesity, high blood pressure and high cholesterol increase your risk of developing macular degeneration. When you smoke, this greatly increases your risk of progressing from the milder form of macular degeneration to the more severe form.
There are two types of macular degeneration: the dry form, which is the milder form, and the wet form, which is the more severe form.
In the dry form of macular degeneration, metabolic waste products accumulate underneath your macula. Your vision may be slightly reduced, you may experience distortions or you may be completely asymptomatic. The goal is to ensure that the dry form doesn't turn into a more severe wet form. Therefore, you should always go to your eye care provider for a dilated fundus examination so your macula could be checked for any changes or progression. At our office we have invested in the latest technology for the diagnosis and care of macular degeneration, these technologies include an ocular coherence tomography (OCT) and electroretinography (ERG). The benefit of these technologies is that they provide the eye doctor with more information and a better baseline for ongoing evaluation.
Milder form of AMD just needs to be monitored at home and with regular eye exams. Your eye doctor may send you home with an amsler grid and your eye doctor will explain it to you how to use it. The patient will monitor themselves to identify if any changes occurred, they would cover each eye and check the grid. Typically, the line should be straight. If at any point the lines appear wavy, distorted or if there is any blackening in the vision, you should schedule a follow up immediately. Even with mild forms of AMD, it is extremely important to schedule eye exams annually.
Different supplements are recommended if you have a moderate, but still dry form of macula degeneration. There have been different studies that have been done to determine which supplements are best for patients who have macular degeneration and to slow down or prevent the progression of the dry form to the wet form. The Age Related Eye Disease Study showed that Lutein and zeaxanthin were determined to be beneficial at reducing the progression of moderate AMD. As for other treatment options, it's definitely important to quit smoking if you're a smoker because it increases your risk by 40 times to convert from the dry form to the wet form. Another thing that is very important is having proper UV protection. It is important to wear sunglasses with a lot of UV protection when you go outside as UV rays can accelerate the progression of macular degeneration. As with mild AMD, it is important to make sure to have an annual eye exam to make sure that your AMD is not getting worse.
The wet form of macula degeneration, which is the more severe form, means an abnormal growth of new blood vessels beneath the macula. They're more susceptible to leaking because they're abnormal. This can cause swelling and greatly reduce your vision, causing a lot of distortions. There is a protein called VEGF that causes these new abnormal blood vessels to grow, so the treatment is to block this VEGF by injecting anti-VEGF injections. An ophthalmologist would numb your eye, then you would be injected with anti-VEGF injection to stop these new blood vessels from growing, but you would have to get these injections every four to six weeks. Treatment options may differ based on the severity of the condition.