Posted on: August 25, 2015
Living Well with Age-Related Macular Degeneration
Not a day goes by that I don’t see vibrant and articulate patients in their 90s. The fact that Americans are living longer – much longer – also means that I’m seeing more cases of age-related macular degeneration (AMD), a disease of the retina that is the leading cause of visual impairment in people over 65, and it’s on the rise.
This typically progressive disease involves the deterioration of the macula, a small area at the center of the retina (essentially the film of the camera which captures visual images and transfers them to the brain). The macula provides your most sensitive vision, the kind you use to look directly ahead. It is the area of the eye you are using right now, to read this article; and which enables you to look at faces. Fortunately, recent advances in treatments for AMD are offering vision-saving results, while a host of low-vision aids can boost quality of life even for those with significantly impaired sight.
Age is the main risk factor for AMD, though smoking doubles your chance of developing the illness. AMD is more common among Caucasians, and genetics also play a part. Detected through a dilated eye exam, AMD has dry and wet stages. The dry stage, involving atrophy of the macula, can cause visual impairment or produce no symptoms at all. In the wet stage, blood vessels growing abnormally below the retina leak fluid and blood that can severely impair central vision or cause central visual blindness.
In recent years, medications have been developed that “are nothing short of a miracle.” When these new drugs are injected through the white of the eye into the vitreous — the fluid-filled cavity that comprises the back of the eye – they can prevent additional visual loss in 90 percent of patients, even preventing central vision blindness. What is more, the medications restore some lost central vision to approximately 40 percent of patients. To be effective, they must be administered by a retinal specialist for the rest of a patient’s life, either monthly or bimonthly.
Recently, a national eye study showed that for people in the intermediate stage of AMD, taking certain combinations of vitamins may slow the progression of the disease, thereby decreasing the risk of the dry stage progressing to the wet.
Dr. Fern adds that there is some evidence that once a person has AMD, maintaining a healthy weight, normal blood pressure and cholesterol level, not smoking, engaging in regular exercise, and eating a diet rich in green leafy vegetables and possibly fish, can prevent or slow the development of the disease.
Boosting Quality of Life
First, remember that no one goes completely blind from AMD because you don’t lose peripheral vision. You can still live independently even with an advanced stage of the disease. In addition, certain eye professionals — usually optometrists — specialize in low-vision aids. The wide range of supportive devices includes high-powered lenses for reading, and closed-circuit monitors on which a book’s print appears much larger. The Kindle e-book reader or similar devices can now dramatically enlarge the size of a book’s text. These devices allow you to keep reading many of the things you enjoy.
Editor’s Note: Dr. Craig Fern is an Ophthalmologist and Chief of the Division of Ophthalmology at Northern Westchester Hospital (NWH).