Visual impairment is considered one of the significant health problems apart from the other common diseases and has a serious impact on the personal, economic, and social life of an individual. There are at least 2 billion people who suffer from visual impairment around the world and almost half of these cases could have been addressed and prevented. 

There are many conditions that will affect our vision such as refractive errors, cataract, diabetic retinopathy and age-related macular degeneration, to name a few. These conditions normally disrupt the light that passes from our eyes to the brain. In this context, we will be talking about what is age-related macular degeneration, discussing what are the common symptoms and ways to prevent or delay the progression of this disease. 

What is Age-Related Macular Degeneration?

Age-related macular degeneration, or AMD is an age-related eye disease that will affect our central vision. It happens when aging causes damage to the macular region of the eyes, which controls sharp, straight-ahead vision. As a result, people with AMD cannot see fine details, either near or far. In advanced stages of AMD, people may lose their ability to drive, see faces and to read. Currently there is no cure for AMD but treatment options are available to prevent or slow the progression of the disease. 

Common Causes of Age-Related Macular Degeneration

Age-related macular degeneration is the most common cause of visual impairment among people 50 and older. Although people rarely go blind due to AMD, it still affects the center of our vision and disrupts our day to day activities. 

The actual causes of AMD remain unknown but research indicates that a combination of heredity and environmental factors might contribute to the development of this disease. Risk of getting AMD increases if one is:

• Over 50 years old
• Overweight
• Smoking
• Having a diet that is high in saturated fat
• Having family history of AMD
• Having high blood pressure

What are the symptoms of Age-Related Macular Degeneration?

AMD in its early stages may have no signs or symptoms therefore people may not suspect they have it until they notice changes to their eyesight. Every individual may experience different symptoms of AMD but the most common symptoms are as follows:

• Mild blurriness in their central vision or trouble seeing in low lighting, which is necessary for driving, reading or performing certain tasks
• Straight lines start to look wavy or crooked
• Difficulty recognizing familiar faces
• Blurry area may gets bigger and may see blank spots

Experiencing metamorphopsia symptoms, where a linear object looks curvy or a flat thing looks rounded indicates a warning sign for late AMD.

What are the different types and stages of age-related macular degeneration?

There are two primary types of age-related macular degeneration, which are dry AMD and wet AMD. Both have different causes and people can develop both types of the disease, whether it’s in one or both eyes:

• Dry AMD, which is also called atrophic AMD. Dry AMD is the most common form, with about 80% of those with AMD having the dry form. The exact cause of dry AMD is unknown, both genetic and environmental factors are thought to play a role in the disease progression. Dry AMD happens when the macula gets thinner with age, and it usually progresses slowly over the years with a gradual loss of vision. It happens in 3 stages: early, intermediate and late. Late Dry AMD has no treatment, but there are ways that can be done to protect or to reduce the effect of vision loss on your life and to make the most out of the remaining vision.
• Wet AMD, which is the less common type of AMD. Wet AMD usually causes faster vision loss and it is the most common cause of severe loss of vision. This type of AMD happens when abnormal blood vessels start to grow in the back of the eye. Fluid or blood will leak into the macula, causing damage to the macula which leads to severe vision loss. Dry AMD can turn to wet AMD at any stage but it is always at the late stage when it reaches wet AMD. Treatment options are also available for wet AMD.

How is Age-Related Macular Degeneration Diagnosed?

Besides the regular family history and medication review, there are several test that will be carried out to diagnose AMD:

• Visual acuity test

  This is a common eye chart test that measures vision ability at various distances.

• Examination of the back of the eye

  The optometrist will put drops in the eyes to dilate them and use some tools to examine the back of your eyes to check your vision. These drops may make your vision blurry therefore do not drive or operate machinery after your vision is back to normal.

• Fluorescein angiography

  This test involves injecting a special dye into a vein in the arm. As the dye passes through the blood vessels in the retina, pictures are taken with a special camera to detect any leaking abnormal blood vessels or retinal changes. This test is used to detect wet AMD.

• Amsler grid test

  Amsler grid, which is a checkerboard like grid, can be used to detect any visual impairment by determining if the straight lines in the pattern appear faded, broken or distorted. These indications may signal the possibility of AMD.

How To Manage Age-Related Macular Degeneration?

Do not be overly worried even if you had received a diagnosis of AMD, as there are steps and healthy habits that can be taken to help and slow down the disease progression

• Quit smoking

  Smoking exposes you to dangerous free radicals that will cause damage to our eyes and will increase your risk of getting AMD.

• Choose a healthy diet

  Consume more leafy greens such as spinach, kale and broccoli as these contain antioxidants and vitamins, including lutein and zeaxanthin that are good for people with AMD. Foods that are high in zinc and protein content are also beneficial to eye health.

• Take supplements

  People with AMD may benefit from a mixture of vitamins and minerals as stated in ARED (Age-Related Eye Disease) study 2. These vitamins include lutein, zeaxanthin, vitamin C, vitamin E, zinc and copper. It is also recommended to add in omega-3 fatty acids to help with anti-inflammation. These supplements, although not a cure for AMD, may help to slow the disease in some people with certain forms of AMD.

• Maintain a healthy blood pressure and weight 

  Poor blood circulation due to uncontrolled blood pressure will restrict blood flow to the eyes and worsen the condition of AMD. Losing weight will help to achieve healthy blood pressure easier.

• Wearing sunglasses outdoors

  Wearing sunglasses can protect our eyes from the harmful effect of UV and blue rays which will cause retinal damages after prolonged exposure.

There are also certain treatment options available for wet AMD such as photodynamic therapy and injections given directly into the eyes. These treatment options destroy the abnormal blood vessels that cause wet AMD and stops vision from getting worse.

As the symptoms of age-related macular degeneration may look like other eye conditions, having a routine eye exam is important especially when you are above 50 for early detection of AMD or any other age-related eye diseases. With early detection, treatment can start earlier and preventive measures can be taken as well.

Reference

• Boyd, K. (2022, July 25). Vitamins for AMD. American Academy of Ophthalmology. Retrieved November 8, 2022, from https://www.aao.org/eye-health/diseases/vitamins-amd
• Mayo Foundation for Medical Education and Research. (2020, December 11). Wet macular degeneration. Mayo Clinic. Retrieved November 9, 2022, from https://www.mayoclinic.org/diseases-conditions/wet-macular-degeneration/diagnosis-treatment/drc-20351113 
• NHS choices. Retrieved November 11, 2022, from https://www.nhs.uk/conditions/age-related-macular-degeneration-amd/treatment/#:~:text=Treatment%20depends%20on%20the%20type,stop%20your%20vision%20getting%20worse.