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Macular Degeneration

This page deals with Macular Degeneration that affects adults primarily, but macular problems can affect children and young adults as well.

Macular Degeneration, (also called AMD, ARMD, or Age-Related Macular Degeneration) affects the Macula which is the central most sensitive part of the retina that is used to clearly identify objects.  Objects that had been clear before are no longer clear, even with eyeglasses.  The macula starts to break down and lose its ability to create clear visual images. The macula is responsible for central vision, the part of our sight we use to read, drive and recognize faces. The peripheral (side) vision is left unaffected so the person can navigate around, but may not be able to see the features or a face, for example, clearly.

AMD is the leading cause of vision loss and blindness in Americans of ages 65 and older. We are living longer, and therefore there will be more and more people that will be affected by AMD.

There are two forms of AMD: dry and wet.  The dry form is more common.  The wet form is due to blood vessels that are leaking.  Dry AMD is usually a result of nutrition not reaching the macula.  It usually causes gradual vision loss, and it is not as severe as wet AMD.

The National Eye Institute (NEI) did a study called the Age-Related Eye Disease Study (AREDS), and then did a follow up to that study, called AREDS II in an attempt to find out what can we do to minimize the effects of AMD.  From that study, we learned that high levels of antioxidants and zinc can significantly reduce the risk of advanced dry AMD and the associated vision loss.  It also indicated that taking high dose formulas containing beta-carotene, vitamins C and E and zinc can reduce the risk of early-stage AMD progression by 25%.

Wet AMD has more devastating effects.  New blood vessels (neovascularization) grow beneath the retina and leak blood and fluid. This leakage causes permanent damage to light-sensitive cells in the retina, causing blind spots or a total loss of central vision.

Macular degeneration usually produces a slow, painless loss of vision. Early signs of vision loss associated with AMD can include seeing shadowy areas in your central vision or experiencing unusually fuzzy or distorted vision. In rare cases, AMD may cause a sudden loss of central vision.

We can usually detect early signs of macular degeneration before symptoms occur, and can make recommendations to prevent further deterioration.

AMD appears to occur in whites and females in particular, and at times is a side effect of some drugs.  It can also occur in families.

Some risk factors for macular degeneration include the family member with AMD, high blood pressure, lighter eye color, and obesity.  Smoking, over-exposure to sunlight, and a high-fat diet may also contribute to macular degeneration.

Some vitamins (neutraceutical) using the information that came out of the AREDS study may delay the progression of AMD or even improve vision.  For wet AMD, there are several FDA-approved drugs aimed at stopping abnormal blood vessel growth and vision loss from the disease. In some cases, laser treatment of the retina may be recommended.

Complete recovery of vision lost to AMD probably is unlikely. One way to monitor progression is with an Amsler grid, a small chart of thin black lines arranged in a grid pattern. The lines on the grid may appear to become wavy, distorted or broken. Viewing the Amsler grid separately with each eye helps you monitor your vision loss.

If you have already suffered vision loss from AMD, low vision devices including high magnification reading glasses and hand-held telescopes may help you achieve better vision than regular prescription eyewear.