Age-Related Macular Degeneration Treatment
What is age-related macular degeneration?
Age-related macular degeneration is the most common cause of impaired vision in those aged 50 and over. The macular is a small spot near the centre of the retina that allows for sharp central vision. When it becomes damaged over time, this affects your ability to see objects directly ahead. Peripheral vision, the ability to see things at the side, is not lost.
There are two types of age-related macular degeneration:
· Dry
Most people who have age-related macular degeneration have the dry form. This occurs when parts of the macula becomes thinner with age along with a gradual accumulation of a protein called drusen. Central vision loss is gradual. There is no treatment for dry age-related macular degeneration.
· Wet
The wet form occurs when new, abnormal blood vessels grow under the retina, leaking blood or other fluids, causing the macula to scar. Vision loss is faster with the wet form compared to the dry type of age-related macular degeneration.
When should I see a specialist for age-related macular degeneration treatment?
It is important for older individuals to have regular visits to an ophthalmologist to check for early signs of any vision problems such as age-related macular degeneration.
You should consider seeing your specialist if:
· you are experiencing blurry vision
· you require more light to read
· colours are less vivid than they used to be
Did you know?
Early detection and prompt treatment of the wet form of age-related macular degeneration improves the visual outcome. Treatment with nutritional supplements as demonstrated in the Age-Related Eye Disease Study (AREDS) trials helps to reduces the progression of AMD in the fellow eye¹.
What are the complications of age-related macular degeneration?
If age-related macular degeneration is not treated, gradual vision loss will occur. With the wet form, the loss of the central vision can take place within months or weeks, making it difficult to adjust to the sudden transition. Most people still keep their vision in the good eye.
Age-related macular degeneration affects your central vision which may create frustration and inconvenience as you go about your daily activities. You may experience depression and anxiety arising from your impeded abilities. In addition, driving might be a challenge as central vision is very important for driving.
For some, their low vision may cause visual hallucinations known as Charles Bonnet syndrome. Your brain compensates for the loss of the vision by creating images to “make up” for the missing visual information. You may experience animated, dreamlike images to less complex visions of people, animals, and similar everyday images. They may last from a few minutes to few hours.
How should I prepare for my appointment?
The ophthalmologist will discuss your personal and family medical history with you. Your specialist is likely to ask questions regarding your vision problems, if it affects one eye or both, if you smoke, your diet and if you have a family history of age-related macular degeneration.
The following information should be prepared for the appointment:
· Your symptoms and how long you have had these symptoms
· All medication currently being consumed including dosage, vitamins, and other supplements
As the eye exam will require your eyes to be dilated, affecting your vision for a brief period after the consultation, you may find it helpful to have someone accompany or drive you after your appointment.
To confirm a diagnosis of macular degeneration, your specialist may do several other tests, including:
· Examination of the back of your eye (also called a dilated eye exam) to look for fluid or blood or presence of drusen deposits.
· Test for vision defects using an Amsler grid. If you have macular degeneration, some of the straight lines in the grid will look faded or distorted.
· Test where images of your eye will be taken before and after an injection of dye in your arm, to determine if you have abnormal blood vessels or retinal changes.
· Angiography to identify specific types of macular degeneration.
· Optical coherence tomography which is a non-invasive imaging test identifies areas of retinal thinning, thickening, or swelling.
What can I expect during age-related macular degeneration treatment?
The dry form of age-related macular degeneration cannot be cured. If diagnosed early, lifestyle changes such as taking vitamin supplements, eating well and quitting smoking can help slow its progression. Other ways to help you cope with the impaired vision includes:
· working with a low vision rehabilitation specialist or your ophthalmologist to help you find ways to adapt to your changing vision
· implanting a telescopic lens in one eye to help magnify your field of vision, possibly improving both distance and close-up vision but with a narrow field of view.
The treatment goals of the wet form of age-related macular degeneration are:
· slow down the progression of the disease
· preserve existing vision
· recover some lost vision if it is still in the early stages
Your ophthalmologist may prescribe the following treatments:
· medication (administered through injections into the eye) to help stop the growth of new blood vessels
· combination of light therapy and a medication to help block off abnormal blood vessels
· laser therapy to seal abnormal blood vessels under the macula. This creates a blind spot but stops vessels from bleeding, minimising further damage.
· working with a low vision rehabilitation specialist to help you cope with the changing vision
What happens after my age-related macular degeneration treatment?
As the treatment for age-related macular degeneration cannot cure your condition, learning how to cope with the vision loss will help in your daily activities. Below are some suggestions to help you cope:
Use magnifiers to help you with close up detailed work such as reading and sewing
Changing the font size and adjusting the contrast on your computer
Read large-print books
Use voice interface such as voice recognition features to reduce the need to read and type
Adjust the light settings in your home to make it brighter
1. American Academy of Ophthalmology Retina/Vitreous Panel. Preferred Practice Pattern® Guidelines. Age-Related Macular Degeneration. Published 2015. Accessed December 22, 2017.
