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About Macular Degeneration

What is AMD?

Age-related Macular Degeneration (AMD) is a progressive eye condition that damages the macula, the part of the retina responsible for central vision. AMD is the leading cause of blindness in the United States for people over 65. When the macula is damaged, changes in your central vision may occur including blurriness, distortion or images, and potential loss of central vision.

In some cases, AMD advances so slowly that people notice little change in their vision. In others, the disease progresses faster and may lead to a loss of vision in both eyes. If you do notice any new changes in your vision, contact your eye care professional immediately.

Two Types of AMD

There are two forms of AMD, dry and wet. About 90% of people diagnosed with AMD have Dry AMD. Early AMD always starts out as dry, but in about 10% of cases it can develop into Wet AMD. People with AMD may not experience changes in their central vision until the disease progresses to the advanced stages. So it’s important for every one age 65 or older to have an annual eye exam.

The Three Stages of AMD

AMD has three stages, all of which may occur in one or both eyes:

  • Early AMD: People with early AMD have either several small drusen or a few medium-sized drusen. At this stage, there are no symptoms and no vision loss.

  • Intermediate AMD: People with intermediate AMD have either many medium-sized drusen or one or more large drusen. Some people see a blurred spot in the center of their vision. More light may be needed for reading and other tasks.

  • Advanced Dry AMD: In addition to drusen, people with advanced dry AMD have a breakdown of light-sensitive cells and supporting tissue in the central retinal area. This breakdown can cause a blurred spot in the center of your vision. Over time, the blurred spot may get bigger and darker, taking more of your central vision. You may have difficulty reading or recognizing faces until they are very close to you.

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Dry AMD

Dry AMD occurs when the light-sensitive cells in the macula slowly break down, gradually blurring central vision in the affected eye. As dry AMD gets worse, you may see a blurred spot in the center of your vision. Over time, as less of the macula functions, central vision is gradually lost in the affected eye.

The most common symptom of Dry AMD is slightly blurred vision. You may have difficulty recognizing faces. You may need more light for reading and other tasks. Dry AMD generally affects both eyes, but vision can be lost in one eye while the other eye seems unaffected.

Dry AMDOne of the most common early signs of dry AMD is drusen. Drusen are yellow deposits under the retina. They often are found in people over age 60. Your doctor at South Hills Eye Associates Eye  can detect drusen during a comprehensive dilated eye exam.

Drusen alone do not usually cause vision loss. In fact, scientists are unclear about the connection between drusen and AMD. They do know that an increase in the size or number of drusen raises a person's risk of developing either advanced dry AMD or wet AMD. Advanced AMD changes can cause serious vision loss.

Common Symptoms of Dry AMD

  • Blurred Vision: As fewer cells in the macula are able to function, you may see details less clearly in your central vision, such as faces or words in a book. This blurred vision will often go away in brighter light.

  • Non-Seeing Areas in Central Vision: If the loss of these light-sensing cells becomes great, you may notice small – but growing – non-seeing areas or scotomas in the center of your vision.

Wet AMD

Wet AMDWet AMD occurs when delicate, abnormal blood vessels form under the retina. These new blood vessels tend to be very fragile and often leak blood and fluid, causing the retina to distort or scar. Damage to the macula occurs rapidly.

With wet AMD, loss of central vision can occur quickly and cause rapid distortion of images. Your doctor can detect bleeding and/or swelling within or under the retina and recommend appropriate treatment options.

Common Symptoms of Wet AMD:

  • Non-Seeing Areas in Central Vision: If the loss of these light-sensing cells becomes great, you may notice small – but growing – non-seeing areas or scotomas in the center of your vision.

  • Straight Lines Appear Crooked: When fluid from leaking blood vessels gathers and lifts the macula, it can distort your vision and make straight lines – like door frames – appear bent or crooked.

Amsler Grid View

If you have AMD, using an Amsler Grid is a great way to check your vision regularly and monitor any changes. Download Amsler Grid (pdf) from Bauch & Lomb

 

Risk Factors

The exact cause of AMD is not known, however some people are known to be at greater risk.

The greatest risk factor for AMD is age. At age 50, you have just a 2% risk, but that risk increases to 30% by age 75.

Other risk factors you cannot control for AMD include:

  • Family History: The risk of AMD is three times higher if an immediate family member has the condition.

  • Skin/eye color: People with light colored skin and eyes are more likely to develop AMD.

  • Gender: Women get AMD more often than men.

Risk Factors You Can Control

  • Smoking: Tobacco is a very significant risk factor. Smokers are more likely to develop AMD compared to nonsmokers.

  • Nutrition: A diet low in certain antioxidants vitamins and minerals, such as vitamins A, C, E, lutein and zinc may be a risk factor. These nutrients can be found in some fruits, nuts, and dark leafy greens.

  • Obesity: Overweight patients with AMD are more than twice as likely to develop advanced forms of the disease compared with people of normal body weight.

  • Excessive Exposure to Sunlight: Research has shown that excessive ultraviolet light may increase the risk for developing AMD.

  • High Blood Pressure and High Cholesterol: Have been linked to the development of advanced AMD.

 

Reducing Your Risk

If you or a loved one has been diagnosed with AMD, here are some things you can start doing today to help you reduce your risk of progression.

  • If you smoke, quit. – Smoking can harm your eyes, just like it can harm your body. Cigarette smoke may damage the retina and can reduce blood flow in eye tissue, potentially leading to AMD and increasing the risk of progression.

  • Eat healthy – You might be able to slow progression of AMD by eating a balanced diet rich with fruits, green leafy vegetables, and healthy fats.

  • Control your weight, cholesterol, and blood pressure – Obesity, high levels of cholesterol and high blood pressure may contribute to the development of advanced AMD.

  • Protect your eyes when outside – Overexposure to the sun’s harmful ultraviolet (UV) rays can speed up progression of AMD. Consider wearing sunglasses with UVA and UVB protection.

  • See your eye care professional regularly – Changes in eye health may occur without notice. Only a qualified eye care professional can detect these changes so it is important to keep all of your scheduled eye appointments. Early detection increases the treatment options available to you.

  • Self-monitor your vision – In between regular visits with your eye care professional, you can monitor your vision at home using an Amsler grid. Contact South Hills Eye Associates if you notice any changes in your vision.