Macula Degeneration

Age‑Related Macular Degeneration (AMD) is an eye disease that is the leading cause of vision loss in our senior population. This disease impairs central vision. People who are affected by AMD have problems reading, driving and performing activities that require clear central vision. Currently, there are no treatments for the majority of people who are affected. Macular degeneration causes damage to the macula of the eye. The macula is a small area at the back of the eye that allows us to see fine details clearly. Macular degeneration makes close work like threading a needle or reading a book difficult or impossible. When the macula doesn’t function correctly, we experience bluntness or darkness in the centre of our vision. Although macular degeneration reduces vision in the central part of the retina, it does not affect peripheral vision. For example, you could see a clock but not be able to tell what time it is. Macular degeneration alone does not result in total blindness. Most people continue to have some useful vision and are able to live independently.

There are two types of macular degeneration:
The Dry Type. This is the most common form. In this type of macula degeneration, the delicate tissues of the macula become thinned and slowly lose function.

The Wet Type. This is less common, but is typically more damaging. The wet type of macula degeneration is caused by the growth of abnormal blood vessels behind the macula. The abnormal blood vessels tend to haemorrhage or leak, resulting in the formation of scar tissue. In some instances, the dry stage of macula degeneration can turn into the wet stage.

Macular degeneration develops differently in each person. Because it will affect regions of the macula differently from person to person, the symptoms tend to vary. Macular degeneration causes a progressive loss of central sight, however, it does not cause total blindness. Peripheral vision is unaffected, allowing a certain amount of mobility in normal surroundings. If left untreated, the wet type of macular degeneration may progress rapidly.

What are the symptoms?

  • The loss of the ability to see objects clearly
  • Vision that is noticeably distorted
  • Straight lines appear wavy
  • Objects may appear as the wrong shape or size (metamorphopsia)
  • The loss of clear, correct colours
  • Difficulty reading
  • A dark, empty area in the centre of vision

The symptoms described above may not necessarily mean that you have age‑related macular degeneration. However, if you experience one or more of these symptoms, contact the practice for a complete exam.

Can AMD be treated?
Currently, there are no treatments for the majority of people who are affected with AMD. Genetic studies are under way which should enable us to identify those patients at risk. For individuals with macula degeneration, it is recommended that a regular schedule of eye examinations be maintained. During these examinations, detailed documentation with photographs may be performed. With this information, your optometrist is better able to monitor the condition and note any changes that may occur.
Treatment for Dry Macular Degeneration. There is currently no form of treatment that is known to stop the progression of this type of macula degeneration, although vitamin supplements are often prescribed. Once the retinal tissues are affected, there is little that can be done to stop its slow progression. Nothing has yet been found effective to restore the loss of sight.

Treatment for Wet Macular Degeneration
This form of macula degeneration is controlled in some cases by using a new drug called Lucentis whilst others respond better to laser treatments (PDT). Laser treatment seals the leaking blood vessels, halting the damage they can inflict upon the retina. These laser treatments are effective in slowing the progress of wet type macula degeneration; however, no treatment has been discovered to restore sight lost to this condition.

Photodynamic Therapy(PDT).
New treatment for a small percentage (<10%) of patients with a specific type of wet maculopathy (where new vessels grown directly beneath the centre point of vision) is now becoming available. Treatment involves absorption of laser light by an injected dye. Patients have to fulfil very specific criteria before treatment is considered. These criteria are based on age and on angiographic findings. The ophthalmologist will be able to advise patients on their eligibility but this treatment will only be available in certain centres.

Lucentis
Very recent developments allow an ophthalmologist to inject directly into the eye with a new drug which inhibits the growth of the abnormal vessels at the macula. This therapy can produce remarkable results in some people but results can still be variable. Prompt diagnosis and referral immediately to a specialist are most important.

Remember

  • Normal use of your eyes will not cause any further damage.
  • Patients who have lost vision to AMD should not be afraid to watch TV or carry out any other usual activity.
  • Low vision Aids are available to maximise remaining vision. Our practice is fully accredited by the Welsh Assembly Government to assess and supply these aids to suitable patients.
  • All the usual good health advice may be important to reduce the rate of progression of ARMD. That is;
  • Stop smoking
  • Eat plenty of fresh fruit and vegetables
  • Modest alcohol consumption
  • Regular exercise to maintain circulation