Age-Related Macular Degeneration

The macula is a specialized portion of the retina responsible for central vision. Located at the back of your eye in the center of your retina, the macula provides the sharp vision you need to drive, to read and to see details. However, if you’re over the age of 50, age-related macular degeneration (AMD) may affect your ability to see. In fact, among older people, AMD is the main reason for irreversible legal blindness . The disease runs in families and is much more severe in people who smoke. 

There are two types of AMD:

• Dry AMD is the first stage of the disease. It starts slowly, eventually leading to loss of central vision. While the disease affects both eyes and progresses faster in one eye compared to the other, most people eventually lose their central vision in both eyes.
• Wet AMD arises from Dry AMD and is characterized by the growth of abnormal blood vessels in your macula. These abnormal blood vessels leak fluid and blood. If untreated, then this fluid and blood causes a scar to form and significant vision loss occurs. If the Wet AMD is treated, then it can be converted back to Dry AMD.

When Should You See a Doctor?

Dry AMD progresses slowly, but the use of vitamin supplementation and a diet rich in dark-green leafy vegetables can help slow down the vision loss if you catch the problem early.  That’s why regular eye exams matter. If you can’t see people clearly at a distance, have trouble transitioning from dark to bright light, or if you need increasingly brighter light to read by, schedule an appointment with an eye doctor. 

Wet AMD damages the macula much more quickly. Again, if you experience noticeable differences in your sight, especially blurry or distorted vision, then consult an eye doctor as soon as possible.

AMD is worrisome for older people, but with proper diagnosis, the experts at Bascom Palmer Eye Institute, part of the University of Miami Health System, will help you manage your condition and protect your vision.

Comprehensive Eye Exam - The standard way of diagnosing macular degeneration is with a dilated exam. During your examination, your ophthalmologist will search for retinal damage and may perform other tests.

Distance Visual Acuity Measurement - In this test, you cover one eye, read a standard eye chart from a distance and then repeat the process with the other eye. Your eye care professional records how well your eyes see at a distance.

Amsler Grid - In this test, you look at an Amsler grid’s pattern of straight horizontal and vertical lines. If you have AMD, you will see wavy lines, distorted or missing lines or a black spot in the center of the grid.

Optical Coherence Tomography (OCT) - This non-invasive imaging procedure uses dim light and produces a cross-sectional, three-dimensional (3-D) images of the inside of your eyes. By performing OCT imaging, you doctor can determine if your AMD is getting worse and whether you need an injection into your eye.

Fluorescein Angiography - Using this method, your doctor can see changes in the structure or function of your retinal blood vessels. To perform the test, your eye care professional injects dye into a vein in your arm or hand, then photographs your retina as the dye outlines your blood vessels.

AREDS2 Vitamin, Multivitamin,  and Dark Green Leafy Vegetables - Research shows that high-levels of certain vitamins and zinc reduce the risk of Wet AMD by up to 25 percent. These over-the-counter vitamins are currently the only treatment for Dry AMD. In addition, a daily serving of cooked or raw dark-green leafy vegetables is recommended.  If you are a smoker, then stop immediately.

Anti-VEGF Injections - Injections of drugs into the eye that block vascular endothelial growth factor (anti-VEGF injections) prevent the severe vision loss that normally occurs in WET AMD, and in many patients, vision is improved.  If your doctor recommends this treatment, then the injections need to be given every month at first, and then the injections can be spaced out and become less frequent. By stopping or limiting the growth of new blood vessels, this medication helps preserve your vision.