Understanding Age-Related Macular Degeneration
Hi there and a warm welcome from the Sight Research UK team! You're probably here because you're curious about Age-Related Macular Degeneration. Whether it's for you or a loved one, rest easy—this is your go-to resource for reliable information on this eye condition.
What Is Macular Degeneration and How Does it Affect Eyesight?
AMD is a painless eye condition which affects the small central part of your retina at the back of your eye, called the macula.
The macula is responsible for your detailed central vision (the vision you use when looking straight at something), which is needed to recognize faces, drive and read. As such, AMD affects your central detailed vision, but not usually your peripheral (side) vision.
Approximately 600,000 people in the UK currently have sight loss caused by AMD, and 70,000 new cases are diagnosed every year (that’s nearly 200 a day!). It is the most common cause of sight loss in the developed world and the third most common globally.
What are the Different Types Of Macular Degeneration?
There are two different types of Macular Degeneration: Dry AMD and Wet AMD.
With Dry AMD, your macula gradually deteriorates as the cells which make it up die off and are not replaced over time.
Dry AMD is more common than wet AMD, and develops more slowly over time (sometimes it can take years for dry AMD to reach its final stage).
Having dry AMD does not mean you have dry eyes.
Wet AMD develops when your body grows new blood vessels to try and fix cells which have stopped working properly in the macula. These abnormal blood vessels can cause leakage of fluid and/or blood, which damages the macula and leads to vision loss.
Wet AMD accounts for 10-15% of people who develop AMD, and many have had dry AMD to start with. It can develop much faster than dry AMD, and you may notice significant changes in your central vision in the space of just a few days or weeks.
What are the Symptoms of Macular Degeneration?
AMD often has no symptoms until the condition is advanced and your vision is affected. As such, it is very important you have regular eye tests so AMD can be caught early and your vision preserved.
Symptoms of AMD can vary, but below are listed some of the symptoms associated with this condition. Make an appointment with your optician if you notice any of these symptoms:
- Small blurred area in the middle of your vision
- Problems with night driving
- Unable to see fine details like small text
- Distorted vision may make straight lines appear wavy or have bumps in them
- Visual hallucinations (seeing things that aren’t there)
What Causes AMD?
Unfortunately, the exact causes of AMD are not yet known, but there are a number of risk factors which may increase your risk of developing the condition:
- Age: AMD develops as people get older, and is most often seen in those who are over 60, but it can develop from your forties onwards.
- Gender: AMD is more common in women than men.
- Ethnicity: White people and people of Chinese ethnicity are more likely to get AMD than other ethnic groups.
- Lifestyle: A lack of exercise and high blood pressure may increase your risk of developing AMD.
- Smoking: The risk of developing AMD is greatly increased by smoking.
- Genetics: There are certain genes which seem to be linked to some people developing AMD, but not all AMD is thought to be genetic. If you have a family history of AMD, you may be at greater risk.
- Diet: A poor diet high in saturated fats (found in foods like processed meat, butter, and cheese) can increase your risk of AMD. A healthy balanced diet with plenty of leafy greens, vegetables, fruit, nuts, and fish can reduce your risk of developing AMD or slow the progression of the disease.
- Cardiovascular disease: Diseases that affect your heart and blood vessels may increase your risk of AMD.
- Sunlight: Some researchers believe that exposure to high levels of UV light in sunlight may increase your risk of developing AMD, but this has not yet been proven.
How is AMD Diagnosed?
- You may be asked to attend regular appointments for your optician to monitor changes to your AMD and your sight. Between appointments, if you think that your eyesight has deteriorated, make sure you let your optician know straight away.
- They may take a photo of your retina to allow them to track changes to your macula over time.
- They may take a detailed scan of your macula using optical coherence tomography (OCT).
- Your optician may refer you to a hospital to see an ophthalmologist if they are worried about your dry AMD diagnosis or if your eyesight has deteriorated.
If your optician thinks that you have wet AMD you will be referred quickly to an ophthalmologist at a hospital.
Wet AMD can progress very quickly so it is very important that you are seen as soon as possible to start receiving treatment. Guidelines from the National Institute for Health and Care Excellence (NICE) state that you should start receiving treatment within two weeks of your first appointment.
At your hospital appointment you will have a dilated eye examination. This will allow your ophthalmologist to thoroughly inspect your macula and check for any changes caused by AMD.
The ophthalmologist may be able to diagnose AMD from looking at your macula, or they may need to perform an optical coherence tomography (OCT) test, and sometimes a fluorescein angiogram.
Treatments For Macular Degeneration?
There is some evidence that certain nutritional supplements may help slow down the progression of dry AMD in some cases. Ask your eye healthcare professional if there are any supplements which could help slow the progression of your AMD.
Avoiding AMD risk factors and eating a balanced diet with plenty of fresh fruit and vegetables may also benefit your eye health.
Anti-vascular endothelial growth factor (anti-VEGF) medication.
This medication can be injected in to your eye to treat wet AMD, by stopping abnormal blood vessels growing in the retina. These drugs cannot undo damage to your retina which has already occurred, but can minimise any further damage and preserve remaining sight. This is why it is so important for wet AMD to be diagnosed and treated as quickly as possible.
The injections will be administered at a hospital at regular intervals (usually monthly), and anaesthetic eye drops are used to numb your eye so the injection will not hurt. Your ophthalmologist will also use antibiotic eye drops to prevent infection. The number of injections you will receive can vary.
Your eyes will be checked regularly at the hospital even once your course of injections is complete. Your ophthalmologist will let you know how often you need your eyes checked and for how long.