Age Related Macular Degeneration

What is age related macular degeneration?

Age related macular degeneration (ARMD) is a disease, where damage to the macula causes blurring of central vision.

What is the macula? How is it important for my vision? What is its function?

Retina is the light sensitive layer which is situated in the back of the eye. The central point of the retina is the most sensitive part, called the macula. It is responsible for fixation and sharp central vision.

How does ageing cause damage to my eye?

Age appears to be the most predominant risk factor for this disease, with increased incidence in individuals over 50 years of age. A combination of genetic and environmental factors along with ageing seems to contribute to the development of AMD. Smoking is also significantly associated with ARMD. Other factors like high blood pressure, heart disease, exposure to UV light, diets high in fat and low in anti oxidants and minerals like zinc are also linked with the development of ARMD.

How common is this condition?

It is estimated that around 170 million worldwide are currently diagnosed with the disease. The proportion is expected to increase in near future with increase in older population.

Does ARMD run in families?

The genes associated with ARMD do not have a clear cut pattern of inheritance. About 10 – 15% of patients with ARMD may have a first degree relative with the condition.

How do I know if I have ARMD? What are the symptoms?

ARMD causes painless visual disturbances. It may cause distortion or blurring of your central vision. Symptoms like waviness of straight lines, objects appearing smaller or bigger than normal are also common. Colors may seem less bright than before. The central area of blurriness may gradually start increasing with time. The peripheral vision is usually normal. If untreated or in advanced cases may cause permanent loss of central vision, but usually doesn’t culminate in total blindness. It’s not uncommon for ARMD to be diagnosed during routine eye examinations before any symptoms develop. Therefore it is very essential to have regular eye examinations.

How is ARMD diagnosed?

Dilated eye examination by an ophthalmologist / retinal surgeon is essential for diagnosing ARMD. Your visual acuity and intraocular pressure and other parts of your eyes will be thoroughly examined to rule out other abnormalities if any. Optical coherence tomography scans re essential for diagnosis and monitoring response to treatment and are performed every visit. Invasive procedures like fundus fluorescein angiography and indocyanine green angiography are performed for selected patients.

What are the types of ARMD? What happens in the eye of a patient with ARMD?

ARMD can be of two types – dry and wet. In the dry type there is accumulation of yellow deposits in the macula called drusens, which are the hallmark of ARMD. In Wet ARMD abnormal blood vessels grow behind the retina leading to leakage of blood and fluid causing more rapid vision loss. Dry AMD can convert into Wet AMD.

What are the treatment options available for Dry AMD?

At present there are no treatments which can completely cure or reverse damage cause by ARMD. Supplements containing vitamin E and C, Lutein, zeaxnthin, copper and zinc have been shown to benefit patients with dry AMD in clinical trials and are hence prescribed to these patients.

What is the treatment of wet AMD?

Certain type of medications called as Anti VEGF agents are injected directly into the vitreous cavity to treat wet ARMD. This causes regression of the abnormal blood vessel growth and drying of the fluid and blood which has leaked beneath the retina.

I have been diagnosed with ARMD and am undergoing treatment. What next for me?

Getting routine eye exams, wearing appropriate prescription glasses, using low vision aids such as magnifiers for difficulty in near vision, maintain a healthy lifestyle including exercise and healthy diet rich in unsaturated fats and antioxidants are very essential. Minimal modifications like using brighter lights at home and changing settings – larger fonts, blue filters and increased brightness and contrast in your electronic devices may help you feel more comfortable.