Macular Degeneration – Is Your Eyesight in Danger?

Most of us notice as we age that our eyesight isn’t quite what it was when we were younger. Many seniors experience visual disturbances such as blurred or double vision and it is important to keep up with visiting our eye doctor regularly to get the proper diagnosis to see if we are at risk for degenerative eye disease such as Macular degeneration.

What Is Macular Degeneration?

Macular Degeneration, also referred to as AMD (age-related macular degeneration), is the leading cause of vision loss and is affecting over 10 million Americans. That total is higher than those suffering from cataracts and glaucoma combined.

The disease is caused by the central portion of the retina deteriorating. This part of the eye referred to as the macula, controls our ability to do things like drive, read a book, recognize colors or see in fine detail. It is the most sensitive part of our eye. There is currently no cure for macular degeneration.

We may not even know we have the disease because the early stages do not affect our vision. As it progresses, we could start to notice wavy or blurred vision. Eventually, our central vision can ultimately degenerate, and all that remains is our peripheral eyesight.

Types Of Macular Degeneration Or AMD

Wet

Wet Macular Degeneration is caused by abnormal blood vessels growing under the macula. The vessels are fragile and tend to leak blood and fluid which raise the macula from its normal position in the back of the eye.

Dry

Dry Macular Degeneration is a bit more involved than the wet type. It occurs when the light-sensitive cells in the macula begin to break down. As it progresses, you may start to see a blurred spot in your central vision. Slightly blurred vision is the most common symptom and will typically affect both eyes.

Something called “drusen” is one of the most common early signs of the dry version. They are usually found in people over 60 and are yellow deposits underneath the retina.

Dry macular degeneration has three stages:

  • Early
  • Intermediate
  • Advanced

In the early stage, there are either several small or medium drusen. At this juncture, there are no symptoms and no vision loss.

The intermediate stage will have medium to large sized drusen, and some people will start to see a blurred spot in the center of their vision. At this point, more light may be needed for reading as well as other tasks.

In the advanced stage, there will be a breakdown of the light-sensitive cells and other tissue in addition to the drusen. As a result, you can develop a blurred spot in the center of your vision. The spot can continue to get larger and darker over time.

The dry type affects approximately 80-90% of individuals who have AMD, but the wet type is considered the more severe of the two and can cause degeneration of the central vision very quickly.

Causes Of Macular Degeneration/AD

The specific factors that cause this disease are still relatively unknown and research has been limited by insufficient funding. At this point, heredity and environment are two factors that are believed to be a couple of causes but ultimately, the causes are complex and not completely understood otherwise.

Are You At Risk?

There are several risk factors for AMD, the first and largest of those being age. Although it can occur earlier, the disease is most likely to occur after the age of 60.

Other risk factors include:

  • Smoking – According to research, smoking doubles your risk of AMD.
  • Race – AMD is less common amongst African-Americans or Hispanics than it is Caucasians.
  • Family history and genetics – Those who have a family history of AMD are at higher risk. There are many more genetic risk factors that are suspected as well.

You cannot control race or family history, but you can lower your odds of falling victim to this disease by making healthy lifestyle choices which in addition to not smoking include but are not limited to: getting regular exercise, maintaining healthy blood pressure levels and eating a diet rich in fruits, vegetables, and fish.

How To Detect AMD

Because the early and intermediate stages can often show no signs or symptoms, a comprehensive eye exam is required to correctly diagnose AMD. The exam may include the following:

  • Visual acuity test – measures how well you see at distances
  • Dilated eye exam – allows the examiner to check the retina and optic nerve
  • Amsler grid – changes in central vision could cause the lines in the grid to either appear wavy or disappear completely
  • Fluorescein angiogram – dye is injected into the arm and then photos are taken as the dye passes through the blood vessels in the eye to determine if the vessels are leaking
  • Optical coherence tomography – uses light waves to take high-resolution pictures of any tissues that are penetrable by light

The eye care professional will look for drusen during the exam. It is worth noting that most people develop some very small drusen as a part of the regular aging process, so the mere presence does not necessarily coincide with AMD. However, the appearances of medium or larger sized drusen could indeed indicate that the patient does have the disease.

Treatment For AMD

Unfortunately, there is no actual treatment for the early variation of AMD. The best treatment is preventative care to lower your odds of getting it in the first place which has been mentioned previously in the article. However, results from an age-related eye disease study (AREDS) showed that high levels of both antioxidants and zinc could significantly reduce the risk of advanced AMD and the associated vision loss.

Our eyesight is precious and a vital part of our everyday living. If you suspect that you may be at risk for AMD, be sure you visit your eye doctor as soon as possible and mention your concern. In the meantime, take all of the preventative care measures you can to lower your risk.


Sean Byers, MD

Sean Byers, MD

Sean Byers is currently a Resident in the Internal Medicine program at UTMB. He studied at the University of Queensland School of Medicine as well as received his Master’s in Public Health with a focus in epidemiology and biostatistics at the University of Southern California. His background is in biology, computer science, public health, and internal medicine.

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Sources

  • American Macular Degeneration Foundation. What is Macular Degeneration?. https://www.macular.org/what-macular-degeneration
  • Mogk, Lylas G., M.D. The Difference Between Wet and Dry Age-Related Macular Degeneration. Vision Aware https://visionaware.org/your-eye-condition/age-related-macular-degeneration-amd/wet-and-dry-amd/
  • News in Health. Age-Related Macular Degeneration (AMD) Data and Statistics. https://www.nei.nih.gov/learn-about-eye-health/outreach-campaigns-and-resources/eye-health-data-and-statistics/age-related-macular-degeneration-amd-data-and-statistics