Macular Degeneration Testing & Treatment
What is age-related macular degeneration?
Have you heard about age-related macular degeneration (AMD) and are wondering if it affects you? You're not alone. Macular degeneration is the number one cause of legal blindness in people over age 60. About one in four people over the age of 64 will suffer from the effects of AMD. Those over age 75 have a 33% chance of developing the disease.
Age-related macular degeneration is a disease of the macula, which is a small area on your retina in the back of your eye. Your macula allows you to see the fine details you need to read or drive. The rest of your retina is responsible for your peripheral vision, which isn't affected by the disease.
If your macula degenerates, the fine details in the center of your vision become difficult or impossible to see.
Can I tell if I already have macular degeneration? What are the symptoms?
Symptoms can include loss of detail in the center of vision, a dark or empty area in the center of vision, the distortion of straight lines, and difficulty adjusting to changes in light. If only one eye is affected, the other may compensate, so you might not notice symptoms right away. Because AMD is painless and often progresses slowly, waiting for symptoms to become obvious is not the best idea.
Click the Amsler grid below to expand it, then look at the dot in the center with one eye at a time. Do you notice some lines are wavy or distorted? This may indicate damage to your macula. You should schedule an appointment with an eye doctor right away.
Even if the lines aren't wavy, you might have an early stage of the disease that can still be detected by an eye doctor. Catching the disease earlier can save more of your vision. Yearly eye exams are the best defense against irreversible damage to your vision caused by AMD.
Is there a genetic test to predict whether I'll get macular degeneration?
Yes. If you have a family history of AMD, your chances of getting the disease increase significantly. Being Caucasian also increases your risk. The best way to determine your actual risk is to get a painless genetic test like Macula Risk®. A simple swab of the cheek can tell you whether you're predisposed to develop the disease later in life.
If you know you're at risk, you can be more vigilant about regular eye exams. Catching the disease early means you might be able to save more of your vision.
What causes macular degeneration?
Many people develop macular degeneration as a natural part of aging. There are other forms of macular degeneration, but we'll consider only age-related macular degeneration, or AMD, here.
Our bodies are always balancing the good and bad effects of oxygen. We need oxygen to live, but oxygen can also damage our cells. Some people, including one in three Caucasians, have genes that predispose their macula to damage from oxygen.
Some preventable factors may change your risk for age-related macular degeneration. Smoking increases your risk more than twofold. Abnormal cholesterol levels may also increase your risk. The biggest factors, however, are not preventable: your genes and your age.
Can macular degeneration be prevented?
There's no cure for macular degeneration. If a genetic test tells you you're at risk, there's no way to prevent the disease entirely.
If you smoke, quitting is a good idea. If your cholesterol is high, doing something about it may help. Even if neither of these helps your vision, it's still in your best interest.
Scientific studies have shown that certain nutritional supplements can lower the risk of AMD by about 25%. The supplements are not a cure, and they will not reverse damage already done. You should talk to an eye doctor to discuss whether supplements are right for you.
If you're predisposed to develop AMD, it's worth focusing on the positives. Catching the disease early can make a big difference to the amount of vision you can preserve. Damage done by the disease, even if it's severe, will not take away all of your sight. Knowledge and early detection are the best weapons against AMD.
What's the difference between dry and wet AMD?
Dry macular degeneration accounts for 90% of the cases. Under your retina, yellow deposits called drusen can naturally form as you age. Having some drusen is normal, and doesn't mean you have AMD, but if the drusen grow too large or numerous, they can gradually thin your macula and cause dry AMD.
Wet macular degeneration occurs in 10% of the cases. Sometimes dry AMD will progress to the wet form. If abnormal blood vessels below your retina start to leak fluid or blood, it can cause rapid and severe vision loss. If you have dry AMD, it's important to monitor your vision closely for signs of wet AMD.
If I have dry macular degeneration, what are my treatment options?
If you suspect you have dry AMD, the first thing you should do is get an eye exam. Your eye doctor has special tools and the expertise to examine your eye and recommend the best treatment.
Depending on the stage of the disease, your doctor may recommend a combination of nutritional supplements that have been shown to limit the progression of dry AMD. These supplements are not a cure, and they might not help. They may even cause side effects, so it's important to discuss this treatment with your eye doctor to see whether it's recommended.
If you have dry AMD, you should know that there currently is no cure. You can make the most of your situation, however. Knowing that you have dry AMD may help you detect a possible progression to wet AMD early. If your dry AMD doesn't turn into wet AMD, you'll still be able to use all of your peripheral vision. There are many support services and assistive devices to help people with dry AMD lead active, independent lives.
Talk to your eye doctor about the latest options.
If I have wet macular degeneration, what are my treatment options?
If you have wet AMD, you might experience rapid and severe loss of detail in your vision. If you suspect this is happening to you, it's important to get an eye exam as soon as possible.
In some cases, wet AMD can be treated by injecting VEGF (vascular endothelial growth factor) blockers into your eye. These treatments target a specific chemical in your body that causes abnormal blood vessels to grow in your eye. It may stop the progression of the disease or even improve your vision.
In other cases, an outpatient laser surgery can slow or stop the leaking blood vessels from causing further damage to your eye.
Another surgical treatment called PDT, or photodynamic therapy, uses a special drug activated by a low-powered laser to close the abnormal blood vessels. This surgery doesn't cause as much damage to the retina as regular laser surgery.
These two surgeries can cause some damage to your vision, but the damage can be much less than if AMD were allowed to progress unchecked.
It's important to talk to your eye doctor about the latest treatments and which one is right for you. There are other treatments not mentioned here which might help in your case.
I think I might be at risk for AMD. What should I do?
Start with an eye exam from an eye doctor experienced with age-related macular degeneration. If you don't have AMD now, a painless genetic test can tell you your risk of developing it later in life.
Putting off exams increases the risk of AMD causing irreversible damage to your vision. Knowing what to look for, and when to look for it, can help save your vision.