The Facts About Age-Related Macular Degeneration (AMD): What Seniors Should Know

Many seniors in their 60s and 70s have likely noticed some vision loss, and this can be a normal part of aging. However, an eye condition known as age-related macular degeneration, or AMD, can impact the severity of the vision loss that is due to aging. This is why it is important to know the basic facts about AMD. The good news is, these facts include preventive steps seniors can take to reduce the risk of developing AMD.

Understanding AMD

We rely on the macula, which is found at the center of the retina, to help us read the fine print and do needlework and other similar tasks that require sharp focus. AMD is a progressive eye condition that affects this area of the eye, and there are two types: dry AMD and wet AMD. 

Dry AMD: According to Retina International, dry AMD accounts for 90% of all AMD and occurs when yellow deposits, called drusen, build up on the macula. This happens because a layer of photoreceptor cells, which is part of the retina, starts to break down and dies. The result is vision distortion, especially when our eyes need to focus on small items or detailed tasks. A person can have these deposits and not have AMD, but having them does increase the risk for dry AMD, especially if they are soft and rather large. Fortunately, the dry form of AMD does not typically necessitate that the affected person give up reading altogether. 

Wet AMD: Retina International reports that the wet form of AMD accounts for only about 10% of AMD cases, but the vision loss associated with it can be devastating. Wet AMD occurs when abnormal blood vessels grow in a part of the macula known as the choroid, a thin layer of cells. Eventually, wet AMD leads to blood and protein leakage resulting in more severe visual distortion than occurs with dry AMD. If these blood vessels form scar tissue, the person can experience a permanent loss of central vision.

Know the risks and symptoms for AMD

People in their 60s and 70s have the highest risk for developing AMD. While experts are not completely sure if AMD is genetic, it does tend to run in families, especially first-degree relatives (a person's mother, father, and siblings). It is therefore important for patients who have family histories of AMD to make sure their eye doctors know about it.

The symptoms of wet AMD include visual distortion that causes straight lines to look like waves, blurred vision, and trouble seeing details (up close or far away). Advanced forms of wet AMD are more serious and include images similar to hallucinations. One of the most important facts about AMD is that it does not cause pain as a warning signal, so seniors should never skip routine eye exams.

Sometimes seniors confuse the condition of AMD with other eye conditions such as cataracts and glaucoma, as well as a condition associated with diabetes called diabetic retinopathy. However, these conditions are not associated with AMD, do not increase the risk of developing AMD, and do not make AMD worse if it already exists.

Dealing with AMD

The progression of dry AMD varies greatly from person to person. It also develops slowly over a number of years and can remain stable in between routine eye exams. Those who have dry AMD often develop the ability to work around the vision loss by learning to compensate with their remaining vision, although most people with advanced AMD do become legally blind. Wet AMD progresses faster than dry AMD and is more likely to cause severe vision loss.

Even if a person's AMD is not advanced, it can be dangerous to drive. As seniors age, they worry about the day they will no longer be able to get around by themselves as driving represents a symbol of remaining self-sufficient. However, continuing to drive with visual impairment is putting everyone who drives and rides in a vehicle at risk for accidents. Even though it is a difficult decision, their ability or inability to drive needs to be discussed with those who have developed AMD, and it is better to err on the side of caution.

Treating AMD

There is currently no cure for AMD, although there are some treatments that can help halt the progression of the condition. In the case of wet AMD, there is photodynamic therapy or PDT. This treatment utilizes light-sensitive medicine, which is injected into the bloodstream. Another treatment option for wet AMD is called laser photocoagulation. Doctors can determine if a patient is a good candidate for these treatments and may prescribe additional medicines that boost their effectiveness.

Another important recommendation for those who already have AMD is adding an Age-Related Eye Disease Study (AREDS) formula vitamin supplement. Some of those that are on the market include Bausch + Lomb Ocuvite PreserVision^®, ScienceBased Health MacularProtect Complete^®, and Alcon I-Caps^®. Ask your doctor before taking an AREDS formulation supplement.

The Most Critical Question

After knowing and understanding all the facts about AMD, an important question remains: Can AMD be prevented? Fortunately, there are a variety of things seniors can do to help ward off AMD. All About Vision offers these tips:

• Do not smoke.
• Improve their diet by eating dark leafy green vegetables, such as spinach; increasing their intake of fish; and consuming nuts and fruits daily. Doctors also recommend reducing refined carbohydrates. 
• Add supplements to their diet, including a multivitamin/multimineral supplement such as Centrum Silver^® (They should ask their doctors for a recommendation.); and a fish oil supplement if their diet lacks sufficient fish protein. (An enteric-coated fish oil does not have a fishy aftertaste or cause belching.)
• Get plenty of exercise.
• Keep their cholesterol, blood pressure and weight all in check. 
• Wear sunglasses outdoors that block UV and blue-ray light, the type of sunlight that may cause eye damage.
• Get regular eye exams.

^{References
WebMD. (2011 July 20). Age-related macular degeneration overview. Retrieved from webmd.com/eye-health/macular-degeneration/age-related-macular-degeneration-overview
Mayo Clinic. (2012 November 20). Diseases and conditions: Dry macular degeneration. Retrieved from mayoclinic.org/diseases-conditions/macular-degeneration/basics/definition/con-20075882
National Eye Institute. (2013 July). Facts about age-related macular degeneration. Retrieved from nei.nih.gov/health/maculardegen/armd_facts.asp
\nKnobbe, Chris A, MD. (2013 August 13). Eleven Steps to Help Prevent Macular Degeneration. In All About Vision. Retrieved from allaboutvision.com/conditions/amd-prevention.htm
EyeSmart. (n.d.). What is age-related macular degeneration? Retrieved from geteyesmart.org/eyesmart/diseases/amd.cfm
\nMacular Degeneration Partnership. (n.d.). What is AMD? Retrieved from amd.org/what-is-amd.html}