Macular Degeneration

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The macula is the most sensitive part of your eyes, made of millions of light-sensing cells located in the back of your eye on the retina. The retina is the part of your eye that translates light into electrical signals that then are relayed to your brain by way of the optic nerve.    

Two basic forms of AMD can lead to vision loss: wet and dry.   

• Wet macular degeneration is less common and refers to the neurovascular effects of the disease. New blood vessels actually grow on your retina in places where they aren’t supposed to, and that causes the AMD symptoms.    

• Dry macular degeneration, on the other hand, is the most common and the most deteriorating. It affects nearly 90 percent of seniors with AMD, but its symptoms aren’t necessarily as severe as the wet form’s in all patients.   

Dry macular degeneration actually is an early stage of the disease, so it hasn’t yet affected the nerves. Instead, it results from the deterioration of the macular tissue, combined with pigment deposits in the affected eye.   

Age-related macular degeneration, commonly referred to as AMD, is the number one cause of severe loss of vision among Americans over the age of 50.   

Different from drusen, it’s a progressive illness that affects nearly 15 million seniors in the United States — and tens of millions more across the globe.  AMD worsens as you get older too. It hits close to 25 percent of adults over the age of 65, but the number increases to a whopping 40 percent of those at least 74 years old.   

With more than 200,000 new cases of age-related macular degeneration diagnosed every year, the numbers continue to rise with the baby boomers reaching retirement age. In 2016, about one in three seniors had some level of AMD.    

AMD delivers its devastating consequences on the macula of the eye, which is where you have the sharpest central sight. It’s through the macula that you are able to:    

• Perform everyday tasks with ease

•  Distinguish faces  

• Navigate pathways  

• Drive safely  

• Read print large and small 

• Watch TV  

• Do fine, detailed work   

You won’t go completely blind due to AMD, but you will eventually lose your entire central vision. That leaves you with only peripheral vision, able to see only what some people refer to as “out of the corner of your eye.” Age-related macular degeneration leaves you with only dim shadows or black holes in your central line of vision with just the ability to view images around the edges of your sightline.    

Age-related macular degeneration doesn’t affect everyone in the same way or at the same pace. AMD can progress slowly over time for some people, while in others, it can come on rapidly. It can affect one or both eyes. For some, the only effect is that light isn’t as bright as it once was, but for others, the effect is devastating, as they lose all central vision.      

Wet and dry AMD share many of the same symptoms. While the symptoms in both often come on in stages, wet AMD’s symptoms typically come on more suddenly and worsen more quickly than the symptoms of dry AMD. 

Common signs include the following:

• Defined spots called drusen appear in your central line of vision. In the early stages, the drusen are about the size of a human hair and may not affect your vision, but rather act as annoying distractions. 

• The scope of your central vision in one or both eyes becomes noticeably reduced. 

• Bright colors and lights lose intensity. 

• You find that you need more light to be able to read. 

• Printed words become blurry. 

• You have difficulty recognizing faces. 

Since AMD rarely affects your peripheral vision, you won’t experience total blindness, but as the disease progresses through intermediate stages, the drusen become bigger and your retina may begin to lose some of its color. 

You will notice the most drastic changes in your vision when you reach the third stage of AMD — slowly with dry AMD and quickly when it’s endovascular, or wet, AMD.  

Regular visits to your ophthalmologist prepare you for the changes. But if you don’t make those regular appointments, be sure to see your medical eye doctor when:  

• When you first notice changes in your central vision 

• When you begin to notice changes in brightness, colors and details 

If you are having any visual abnormalities you should always be evaluated with a thorough consultation and examination by a physician for an accurate diagnosis and treatment plan as it may be a symptom or sign of a serious illness or condition.  

Little is known about the causes of age-related macular degeneration, although research continues to escalate as baby boomers demand more answers. 

While heredity plays a role in the condition, lifestyle also can affect the onset of AMD. Your risk of developing the debilitating eye disease increases with:  

• Age 
• Genetics and a family history of AMD 
• Race, as Caucasians are more prone to AMD than any other race
• Heart disease that affects your blood vessels and heart function
• Obesity, which seems to add to the severity and rapid onset of AMD 
• Smoking and exposure to second-hand smoke 

Our office has an array of tools on hand to definitively diagnose AMD, including:  

• A dilation test done with drops in your eyes so the doctor can see any mottling on your retinas that’s caused by those pesky drusen 
• Eye tests that specifically test your central vision 
• Optical coherence tomography, a non-invasive scan that reveals cross sections of your retina to identify swelling, thickening or thinning.

There is no cure for macular degeneration. Low-vision training is the most popular and beneficial option, which helps you relearn how to move about and interact in your world. 

At the same time, you can take steps to reduce your risk of developing AMD and slow down its progression by:  

• Quitting smoking 
• Taking increased vitamin supplements, as suggested by your doctor 
• Undergoing injections of proteins into your eyes that slow progression 
• Considering various laser eye surgical options — they’re continually being updated from new research 
• Maintaining a healthy weight 
• Follow your doctor’s advice and seek low vision assistance if you need it.