A 66-year-old woman presents to her eye doctor with complaints of progressively decreasing central vision in both eyes. She also reports that sometimes, when she covers her left eye and looks out of the right one, things seem to have a wavy texture. Her father had a similar gradual worsening of his vision as he grew old. A detailed examination reveals the presence of fluid collections behind the retina in both eyes. A number of imaging studies are performed and a diagnosis of age-related macular degeneration is established.
What is age-related macular degeneration (AMD)?
A thin layer of tissue, known as the retina, lines the back of the eye. The central part of this layer is referred to as the macula. It is highly sensitive and enables us to have a sharp and high-resolution central vision. Age-related macular degeneration (AMD) is a chronic, progressive condition that affects the macula, and therefore, results in the loss of central vision.
The peripheral vision comes from the rest of the retina, which is not affected by AMD. Hence, AMD may not result in total blindness. However, the loss of central vision can still interfere with everyday activities, like recognizing faces, reading, writing, or driving.
Age-related macular degeneration is considered to be the leading cause of irreversible vision loss in the Western world and accounts for 8.7% of all types of blindness throughout the world.
What causes AMD?
- Advanced age is considered the most significant risk factor associated with the development of AMD.
- Smoking, high blood pressure, obesity, high cholesterol, and a family history of AMD are other risk factors.
Symptoms to look out for!!
AMD may affect one or both the eyes. Following are some of the common symptoms that may be associated with this condition:
The central part of your visual field may appear blurred or distorted
Straight lines may seem wavy or crooked
Objects may seem smaller than normal
Color vision may get affected
A drastic decrease in visual acuity may occur
If you are experiencing any of these symptoms, it may be a good idea to make an appointment with your eye doctor and get a dilated eye exam.
What to expect at the eye doctor’s appointment?
Dilating drops are often used to perform a comprehensive examination of the back of the eye. These drops can lead to a blurring of your vision for a few hours. Remember to take a driver with you to your appointment!
Different eye tests may be performed to confirm the diagnosis. These may include optical coherence tomography (OCT), fluorescein angiography (FA), and indocyanine green angiography (ICGA). The FA and ICGA are dye tests in which a dye is injected into one of the veins, typically in your arm, and then pictures of the back of the eye are taken.
How can AMD be treated?
AMD can generally be divided into two types: dry AMD and wet AMD. The treatment usually varies with the type.
• Dry AMD
It leads to slow, progressive visual loss, usually over a period of several years. There is no particular treatment for dry AMD; however, research suggests that the use of a combination of zinc, antioxidant vitamins, like vitamin C and E, and beta-carotene may help slow down the progression of the disease.
• Wet AMD
The damage may be severe and quick in the case of wet AMD, and rapid distortion of vision may occur over weeks to months. Regular eye injections (anti-VEGF intravitreal injection therapy) given once every one or two months for as long as necessary may be used for the treatment of wet AMD.
A laser treatment, known as “photodynamic therapy (PDT)” may be required in a selected minority of cases, if injections alone do not help.
Age-related macular degeneration usually has a few symptoms in the initial stages. Therefore, it is essential to have a regular examination of the eyes. If you are at risk of developing AMD due to advanced age, family history, lifestyle, or a combination of these risk factors, it is better to get checked for AMD without waiting to experience any drastic changes in your vision.