MACULAR DEGENERATION

Retina is the light sensitive nerve layer of the eye. The central part of it which is responsible for sharp vision like reading and recognising faces is called macula.

Age related damage in this area is called macular degeneration and may lead to distortion (where straight lines appear wavy), blurring and loss of central vision. The condition can affect one or both eyes.

ARMD can worsen with time, however, it never causes complete blindness, because your peripheral (side) vision remains normal.

There are two types of ARMD

Dry ARMD

The most common type – results in a gradual loss of central vision which happens due to the progressive loss of retinal cells.

Wet ARMD

Leads to a sudden change in central vision which happens due to growth of abnormal vessels beneath the Retina

What causes ARMD?

ARMD, generally occurs as a result of age-related insults to the retina and macula. Risk factors include

Old age-Age 60 years +

Family history of ARMD/genetics

Smoking

High blood pressure

Heart disease

High cholesterol levels

Excess weight

High saturated fat diet

Lack of exercise

UV exposure

What are the symptoms of macular degeneration?

Dry ARMD is usually symptomless in the early stages and may only be detected in an eye exam.

When present, symptoms include:

Difficulty seeing fine detail in the centre of your vision – the size of the affected central area may increase. New corrective spectacles may not improve the difficulty.
Blurred vision
Dark spots or missing areas of vision(scotomas)
Distorted vision (straight lines appearing wavy)
Words disappearing when reading
Difficulty discerning colours and shades of colours (contrast sensitivity)
Poor adaptation to dark conditions from lighter environments
Impaired depth perception – an inability to properly judge distances which can make walking harder and lead to falls.

Around 10 to 15 percent of people with dry ARMD develop wet ARMD, so, if you have been diagnosed with dry ARMD and notice any sudden change in vision, you should seek advice urgently as early detection and early treatment gives better outcomes.

How is ARMD diagnosed?

Everybody above 60 should have regular eye checks for ARMD where Opticians or Ophthalmologists will check for early signs of ARMD. If you have any of the symptoms listed above, please attend to them ASAP.

1/ They will provide ‘Amsler Grid’ for diagnosis and future self-monitoring of the condition. Contact your ophthalmologist immediately if you notice that lines, or parts of the grid look wavy, blurry or dim or missing.

2/ They will take photographs and scans of the macula to diagnose and monitor the response to treatment.

3/ Sometimes they will use intra venous dye tests called Fluorescence Angiography to diagnose and decide treatment modality.

How is ARMD treated?

Wet ARMD

Though this cannot be cured it can be controlled to preserve the vision using

Injectable drugs into your eye to stop growth of abnormal blood vessels
Photodynamic therapy which is a combination of drug and laser treatment aimed at sealing leaky blood vessels
Laser treatment onto the retina to seal leaky blood vessels.

Your Ophthalmologist will discuss and decide the best treatment options for you.

Dry ARMD

Unfortunately, currently there are no treatments for dry ARMD.

How can ARMD be prevented?

A healthy lifestyle is important in reducing the risk of macular degeneration and in slowing its progression.
1/Abstinence of Smoking - Research shows that the risk of developing ARMD is at least double in smokers than in non-smokers.

2/Maintaining a healthy weight

3/Eating a nutritious diet that includes green leafy vegetables, yellow and orange fruit, fish, and whole grains

4/Maintaining normal blood pressure and controlling other medical conditions

5/Exercising regularly

6/Wearing sunglasses and hats outdoors

7/Taking vitamin supplements – Research supports this for people at risk of ARMD

8/Having regular eye tests to spot problems.