Macular Degeneration: The simplified AMD fact sheet

What is macular degeneration?

• Leading cause of sight loss in the UK
• Condition affecting the central part of vision, caused by damage to the macula
• Two types: Wet and Dry
• Dry: slow loss of central vision, most people with early dry Age-Related Macular Degeneration don’t notice any problems
• Wet: more aggressive than dry, abnormal blood vessels form under the retina these can leak and cause damage to the macula cells

The Amsler test– this can help to detect signs and changes of AMD

• Wear your reading glasses
• Hold the chart around 30cm away from your face
• Cover each eye in turn and look towards the black spot in the centre. Whilst looking at the black spot do the lines look to be straight? Are there any waves in the lines or any patches missing?
• If you see anything unusual see your optometrist straight away

Symptoms of macular degeneration

• Straight lines appearing to wave
• Blurred vision
• Dark spots in central vision
• Words disappearing when reading
• Difficulty changing between dark and light
• Discomfort in bright light

Reducing risks

• Maintain a healthy lifestyle
• Stop smoking
• Maintain a healthy weight
• Wear sunglasses with full UVA and UVB protection
• Eating a diet rich in vitamins such as zeaxanthin, lutein and Omega 3. These can be found in eggs, oily fish and brightly coloured vegetables i.e. kale, spinach, bell peppers

Treatment and other aids

• There is currently no treatment for dry AMD
• Wet AMD can usually be treated by an injection if caught early. This shrinks the new vessels at the back of the eye.
• Good lighting can help with vision
• Low vision services can offer help with day to day living by providing certain equipment.
• Magnifying glasses can also help, which low vision services can provide tailored to you.

Risk factors of macular degeneration

• Age
• Family history
• Poor diet and lifestyle
• Smoking
• High blood pressure
• Exposure to UV light
• Being overweight.

Now for the not too simplified description of Age-Related Macular Degeneration

The macula is the central area of the retina. We use this area to look straight ahead, for our most accurate vision.

Over time, some people are susceptible to these cells becoming damaged, or degenerated, much like developing wrinkles or grey hairs. When these cells start to degenerate, the function of capturing high quality details for us is reduced, and in some cases, the central vision is lost.

This is very upsetting for patients with the condition, as it prevents them using the central area of their vision, meaning it is very difficult to read, do accurate tasks or recognise faces. The peripheral vision, which is largely used to navigate and move around is usually unaffected.

Wet and Dry macular degeneration

There are two main types of AMD, these are commonly referred to as dry and wet.

In Dry AMD, the central cells of the retina slowly and progressively deteriorate. This makes up approximately 90% of AMD cases, and can take years for a patient to realise they have any visual changes, only affecting day to day life in moderate to end stage cases.

Wet AMD usually starts as dry AMD, but these patients develop new, abnormal, leaky blood vessels at the macula area, which are prone to seepage and bleeding. When the macula becomes ‘wet’, this usually causes sudden and/or severe visual distortion for the patient, most frequently reporting that straight lines look wavy.

How do you treat dry macular degeneration?

There is no current treatment for dry AMD. These patients are usually advised and counselled on the condition, and it is recommended that they avoid risk factors which can cause the condition to progress quicker. Risk factors include; smoking, UV exposure and obesity. There are other risk factors which are largely out of our control, such as having a family history, aging and being female.

It is generally recommended to follow a ‘healthy lifestyle’ of gently exercising, and eating a diet rich in coloured fruit and vegetables such as kale and spinach. There are also dietary supplements available to buy.

Visual improvements are usually gained by the use of stronger reading spectacles, good lighting and magnifiers. Support from charities and social services is often encouraged to aid daily living tasks.

Anyone with signs of early AMD should be diagnosed and counselled about this by their Optometrist. Patients are often given an ‘Amsler Grid’, to look at periodically at home to check for new distortions in the vision. If you are known to have AMD and notice any sudden changes to your vision you should always seek your Optometrist’s advice, as your condition may have progressed into wet AMD.

How do you treat wet macular degeneration?

There is treatment available for wet AMD.

The leaks at the back of the eye can easily be identified and monitored on a 3D scanning camera known as an OCT. Once wet AMD is confirmed by the doctor, a special gel can be injected inside the eye.

This treatment is aimed at ‘drying up’ the leaks at the macula region. It is not painful and is carried out in day clinics under the NHS. However, most people need multiple sessions of this treatment, which can involve a huge amount of commitment, time, and energy from the patient and their family.

Are you concerned about your eyes?

AMD can be easily picked up by your Optometrist at a routine eye examination.

Most practices have the ability to photograph and document their findings to allow easier monitoring in future. This is much like a dentist taking x-rays of your teeth.

As AMD is the leading cause of sight loss in the UK, it is very important to be aware of the risk factors and report any sudden changes to your vision quickly.