"Clarifying Age-Related Macular Degeneration"

We approach the world with our eyes, mostly living through our central (straight-ahead) vision. It enables us to read, drive, determine fine detail and color and engage in most of the activities that fill our daily lives.

If you are over 60 and are relying more on your peripheral (side) vision, because your central vision in either one of your eyes has become blurred or even nonexistent, chances are that you may be suffering from an eye disease known as age-related macular degeneration (AMD).

AMD is the leading cause of vision loss in people 60 years or older living in the United States. According to the Archives of Ophthalmology, a professional medical journal published by the American Medical Association, an estimated 1.75 million U.S. residents have advanced age-related macular degeneration with associated vision loss, this number is expected to grow, reaching almost 3 million by 2020.

The highest numbers of people suffering from AMD are Caucasians, women in particular. William B. Hart, M.D., an ophthalmologist at Hart Eye Center says “There is not only the genetic input, there’s also the environmental input, fair skinned people lack the pigment behind the retina which makes them more vulnerable to the components of the disease.”

With such staggering numbers, it is imperative to learn about the nature of this disease and how to prevent its progression.

AMD is an eye disease that usually occurs in individuals after age 60. It impairs central vision by progressively destroying the macula. The macula is a small area in the center of the retina; containing layers of nerve cells that are sensitive to light, fine detail and color.
Central vision is the work of the macula. When we read, light is focused on the macula. The millions of cells within the macula change this light into nerve signals that travel to the brain to relay the message of the image we are viewing. This is how central vision operates, if functioning properly, we are able to read, drive and perform our regular daily activities that require fine, sharp, straight-ahead vision.

AMD progressively attacks the macula; its deterioration alters central vision. Dr. Hart says, “Macular degeneration operates as a programmed self-destruction.” However, the disease can take two different routes.  Keith Menard, O.D., an optometrist with Hart Eye Center, says “There are two forms of macular degeneration: dry and wet. The dry form is the most common, but wet is the most severe. It is vital that these conditions are monitored by both patient and eye care professional.”

Researchers have not pinpointed an exact cause of AMD, but most attribute the disease to ageing and the macula’s tissue weakening over time. Other contributing factors include:

•    Smoking
•    Sun exposure
•    Genetic predisposition
•    Poor diet
•    Obesity

Dr. Menard gives the following advice “Shielding your eyes from the sun and limiting smoking are two very important precautions to take. Individuals are responsible for maintaining their own health, and these are easy ways to prevent permanent eye disease.”

Medical science has not yet discovered a cure for AMD, however there are a variety of effective treatments available to weaken its effects. Dr. Hart says, “The treatments are designed to shut down the growth of blood vessels in order to prolong the course of the macular degeneration, preserving the patient’s vision.”

Early detection is the key preventive measure to keep AMD from progressing. It is imperative to maintain regular visits with your eye doctor to have your vision tested and protected. Dr. Menard says, “Dilating the eye gives a much clearer view of how the macula is functioning. Many people hesitate to have their eyes dilated, but it is in the best interest of their eye care,” says Dr. Menard. “And, most patients are capable of driving home after their visit and dilation.”

Aside from visiting your doctor, if you have AMD or are concerned you may have the   disease you can monitor your vision and condition of your macula through using the Amsler Grid screening test. “The Amsler Grid Test is an easy way for individuals to monitor the development of AMD within their own homes.” Dr. Menard says, “Looking at the chart once a day, one eye at a time allows patients to monitor their own vision.” Eye doctors have the grid in their office and give them to patients to take home, they are also available online. When taking the test, Dr. Menard advises “If you notice one of the following changes in your vision, you should contact your eye care professional as soon as possible: straight lines and the center of vision appear distorted; a dark, blurry area or a “white-out” appears in the center of vision; or color perception changes or diminishes.”

Hart Eye Center is dedicated to helping people achieve their best possible vision. For more information on age-related macular degeneration, call Hart Eye Center at 439-4014.