Adapting to Age-Related Macular Degeneration
Imagine when you look at things directly that your vision is blurry and you can’t really make out what you’re seeing. The center of your eye is the culprit and it seems like your range of vision is deteriorating quickly each passing day. You may have age-related macular degeneration.
Age-related macular degeneration (AMD) is the leading cause of vision impairment and blindness for adults age 65 and older. Because the center of the vision is affected, people rarely go blind from it, but it can make it difficult to read, drive, or perform other activities that require good central vision.
The macula is the center of the retina, the light-sensitive layer of tissue at the back of the eye. In AMD, the light sensitive cells in the macula break down, and the central vision deteriorates. AMD doesn’t affect your peripheral vision at all.
According to the National Eye Institute, from 2000 to 2010 the proportion of people age 65 and over with AMD rose 18 percent from 1.75 million to 2.07 million. The disease is more common among older white Americans compared with blacks, Hispanics and people of other races. Women are more likely to develop the disease due to their longer life expectancy.
AMD is classified into two phases: dry macular degeneration and wet macular degeneration. AMD typically starts out in the dry phase and progresses into the wet phase. Dry macular degeneration can occur in one eye or both. In the dry phase, the retina pigmentation epithelium deteriorates. This deterioration causes the macula’s light sensitive cells to deteriorate due to a build up in waste products. Eventually, fat like deposits called drusen accumulate and the field of vision diminishes.
In wet macular degeneration, the blood vessels underneath the macula leak blood or fluid. This causes blurriness or fuzzy vision. Left untreated, wet macular degeneration may lead to rapid and permanent central blindness.
Symptoms of AMD may include blurred vision, blank or dark spots in your field of vision and the appearance of curves or waves in straight lines, the need for brighter light when reading or doing close up work, decreasing intensity or brightness in colors, and difficulty recognizing faces.
Some risk factors for AMD are obesity, having a family history of AMD, smoking, high blood pressure, and a diet high in saturated fats.
Annual eye exams are instrumental in diagnosing AMD. Other tests your physician may perform are visual field test where the patient must examine an Amsler grid of straight lines with a dot in the center; a dilated eye exam so your doctor can look inside your eye; a fluorescein angiography where yellow dye is injected into a vein in your arm to travel to the eyes and reveal leakage under the macula of your eye; optical coherence tomography (OCT) where an imaging machine takes detailed images of the back of the eye including the macula and the retina; and optical coherence tomography angiography (OCTA) a diagnostic tool that uses laser light reflection and the OCT scanning device to produce 3D images of blood flow through the eye.
There is no cure for AMD but it can be treated and managed effectively. Your health care provider may suggest such measures as nutritional supplements like vitamin C, vitamin E, lutein, zinc, copper, zeaxanthin and beta carotene. Other treatment options are antivascular endothelial growth factor (anti-VEGF), which is used for wet macular degeneration to block the production of VEGF, a protein that produces new blood cells to possibly improve vision (where your doctor injects anti-VEGF into a numbed eye).
Your doctor may also suggest photodynamic therapy (PDT) where a combination of an injectable light sensitive drug and a laser are used to destroy extra blood vessels in the eye (PDT can be combined with anti-VEGF).
Some complications that may occur with wet AMD include eye infection, structural eye damage, retinal detachment, faster onset of cataracts, and severe vision loss. In addition, if your AMD is severe enough, you can be considered legally blind.
There are some things you can do to prevent AMD like quitting smoking, losing weight, staying physically active, maintaining a healthy blood pressure and cholesterol level, and eating a healthy diet.
And speaking of a healthy diet, you might want to load up on foods that contain the antioxidants lutein and zeaxanthin such as kale, spinach, turnip greens, collard greens, romaine lettuce, broccoli, zucchini, corn, green peas, brussels sprouts, carrots. Foods high in beta carotene like carrots, sweet potatoes, kale, turnip greens, spinach, red bell pepper, winter squash, mangos, apricots, cantaloupe are also key in warding off AMD. Consuming fatty acids like omega 3 is another way to slow the progression of AMD. Enjoy oily fish like tuna, salmon, and mackerel. Here's a recipe to get you started.
If you or your family member have symptoms of AMD, don’t hesitate to see your doctor. Early detection is the key to staving off permanent damage.
