Age-related macular degeneration (AMD), also known as macular degeneration, is a common eye disorder. It’s caused by deterioration of the macula, a small area in the center of the retina in the back of the eye.
The first sign of AMD is often blurred vision. Reading, writing, recognizing faces, and driving can become more difficult. However, there is usually enough peripheral vision to allow other daily activities. Total vision loss is unlikely.
There are two types of macular degeneration –
• Dry macular degeneration affects about 85 to 90 percent of people with the condition. It occurs due to small yellow deposits called drusen developing under the macula.
• Wet macular degeneration affects the remaining 10 to 15 percent. It occurs when abnormal blood vessels develop under the retina and macula.
• Visual distortions, such as straight lines seeming bent
• Reduced central vision in one or both eyes
• The need for brighter light when reading or doing close-up work
• Increased difficulty adapting to low light levels, such as when entering a dimly lit restaurant
• Increased blurriness of printed words
• Decreased intensity or brightness of colors
• Difficulty recognizing faces
• A well-defined blurry spot or blind spot in your field of vision
Causes & Risk Factors –
It isn’t known why some people develop macular degeneration, while others don’t. However, certain factors can increase your risk of developing the disease.
As the disease progresses, it becomes increasingly difficult to read or complete other activities.
• Unable to drive a car
It’s common for people with macular degeneration to be unable to drive a car. If your doctor diagnoses you with macular degeneration, you may have to complete a vision test periodically to ensure you’re capable of operating a car.
People with macular degeneration experience some form of depression, which can be partially attributed to vision loss.
• Visual hallucinations
As your vision decreases, your brain may compensate by creating false images or hallucinations.
If vision problems start to occur, a person should contact an eye doctor, an optometrist, or an ophthalmologist.
The doctor will give the person some eye drops to dilate the pupil and then examine the eye.
They may also recommend –
• Optical coherence tomography: Special light rays scan the retina and take an image. The image can show if the macula has any unusual features.
• Amsler grid: The person looks at a grid with vertical and horizontal lines. If AMD is present, some of the lines on the grid may seem distorted, broken, or faded.
• Fluorescein angiography: The doctor may recommend this if they suspect wet AMD. The doctor injects a dye into the person’s arm and examines their eyes with a special magnifying device. They can take pictures of the eye that show whether the blood vessels behind the macula are leaking.
Treatment for AMD cannot restore vision, but it can slow vision loss.
▪︎ Dry AMD
There is no treatment for dry AMD, but tips that can help a person manage it include:
• choosing larger print books or increasing the font size on screens
• using magnifying devices
• changing the lighting
▪︎ Wet AMD
Some treatments can help slow the progression of wet AMD.
☆ Anti-vascular endothelial growth factor medication
Vascular endothelial growth factor (VEGF) is a chemical that contributes to the formation of new blood vessels in the eyes. In people with wet AMD, anti-VEGF drugs block this chemical and prevent the overproduction of blood vessels.
Examples include –
• ranibizumab (Lucentis)
• bevacizumab (Avastin)
• aflibercept (Eyelea)
To deliver the drugs, a doctor will:
• apply an anesthetic
• clean the eye, usually with Betadine, to reduce the risk of infection
• inject the drug into the eye with a very fine needle
The person may need this injection once a month, at least to start with. After this, the intervals may be longer.
Possible side effects include bleeding under the conjunctiva.
☆ Photodynamic therapy
Doctors sometimes use this type of laser treatment alongside anti-VEGF injections.
☆ Home and natural remedies
For a person with AMD in one eye, dietary supplements may help prevent or slow the development of AMD in the other eye.
AREDS 2 supplements consist of a special formulation for people who have or are at risk of AMD.
They contain –
• vitamin C
• vitamin E
• beta carotene
• cuprid oxide (copper)
It’s important to have routine eye exams to identify early signs of macular degeneration. The following measures may help reduce your risk of developing dry macular degeneration:
• Manage your other medical conditions.
For example, if you have cardiovascular disease or high blood pressure, take your medication and follow your doctor’s instructions for controlling the condition.
• Don’t smoke.
Smokers are more likely to develop macular degeneration than are nonsmokers.
• Maintain a healthy weight and exercise regularly.
If you need to lose weight, reduce the number of calories you eat and increase the amount of exercise you get each day.
• Choose a diet rich in fruits and vegetables.
Choose a healthy diet that’s full of a variety of fruits and vegetables. These foods contain antioxidant vitamins that reduce your risk of developing macular degeneration.
• Include fish in your diet.
Omega-3 fatty acids, which are found in fish, may reduce the risk of macular degeneration. Nuts, such as walnuts, also contain omega-3 fatty acids.
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