What Is Age-Related Macular Degeneration?
Age-related macular degeneration (AMD) is a common eye condition that affects the macula, the part of the retina responsible for sharp, central vision. It is more common in people aged 50 and above, with the risk increasing with age.
Although peripheral vision is generally preserved, advanced AMD can significantly affect central vision and make everyday activities such as reading and recognising faces more difficult.
Symptoms
Common symptoms include:
- Blurred or distorted central vision
- Straight lines appearing wavy or bent
- Dark or blank patches in central vision
- Difficulty reading or recognising faces
- Colours appearing less vivid
- Difficulty seeing clearly in dim lighting or adjusting to changes in lighting
Risk Factors
Modifiable risk factors include smoking, obesity, high blood pressure, and unhealthy dietary habits.
Non-modifiable risk factors include age, family history, and genetic factors. Having late AMD in one eye also increases the risk of developing AMD in the other eye.
How Is AMD Diagnosed?
AMD is usually diagnosed through a comprehensive eye examination. Your eye doctor may examine the retina after dilating the pupils and use retinal imaging, such as optical coherence tomography (OCT), to look for changes in the macula. Other tests may be recommended depending on your symptoms and the type of AMD suspected.
Types of AMD
Extensive bleeding at the macula in wet AMD.
Treatment Options for AMD
Dry AMD Treatment:
- Lifestyle Modifications: Stop smoking, maintain a healthy weight, and monitor your central vision regularly if you have risk factors.
- Dietary Changes: Eat a balanced diet that includes vegetables, fruit and other nutrient-rich foods.
- Vitamin Supplementation: People with intermediate AMD, or late AMD in one eye, may benefit from AREDS2 supplements. These supplements can help slow the progression to advanced AMD in appropriate patients. Your eye doctor can advise whether they are suitable for you.
Wet AMD Treatment:
- Intravitreal Injection Therapy: Anti-VEGF medicines are injected into the eye to reduce abnormal blood vessel growth, bleeding and fluid leakage. Multiple injections may be required over time, depending on the severity of the condition. Many anti-VEGF medications are now available, including Lucentis (ranibizumab), Eylea (aflibercept), and Vabysmo (faricimab). Early diagnosis and treatment can help reduce the risk of further vision loss.
- Laser Therapy: In some cases, laser therapy may be used alongside intravitreal injections to target abnormal blood vessels and reduce fluid leakage. This may help stabilise vision and control the condition.
FAQs about AMD
An Amsler chart is a simple tool for monitoring central vision at home. It can help people with age-related macular degeneration (AMD) notice changes in their vision and seek assessment promptly.
How do you use the Amsler chart?
- Use the chart in a well-lit area.
- Hold the chart approximately 30 to 40 cm away. Wear your usual reading glasses if needed. Progressive lenses may affect how the chart appears, so ask your eye doctor which glasses to use.
- Look at the chart using 1 eye at a time.
- Fixate on the central black dot. You should be able to see the rest of the chart while fixating on the black dot.
- Contact your eye doctor promptly if:
- There are distorted lines, blind spots or abnormal shadows blocking your view of the chart.
- Your view of the chart is blurred.
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Studies have shown that individuals with certain stages of AMD can reduce their risk of deterioration by taking a specially prepared vitamin supplement. This preparation contains very specific combinations of nutrients which are at much higher doses than normally found in general health supplements. Therefore, a thorough eye examination should be done to confirm suitability before starting on this supplement.
Currently, wet AMD cannot be cured. However, intravitreal injection therapy using anti-VEGF drugs is extremely effective. This treatment can now stabilize and even recover lost vision if treatment is started early and before there is irreversible damage.
Intravitreal injectionMaking changes to the home environment can make a big difference.
These may include:
- Installing adequate white lighting in important living spaces like the kitchen, reading room, etc. Motion-controlled lights that turn on upon entering a room will prevent accidents from poor lighting.
- Stick colored marking tape on the edge of steps to prevent falls.
- Use modified clocks, watches, and reading material with large print to make reading easier. Magnifiers and visual aids may be useful. Otherwise, talking clocks and audio books are also available. Ask your eye doctor about the range of devices available and where to get hold of them.
- If one hopes to drive, one will need to be formally assessed by an eye doctor to confirm if driving safety guidelines are met.