Age-Related Macular Degeneration 101: Symptoms, Causes, Stages & Treatment

Macular degeneration is a common eye disease where the optic nerve is damaged. Find out more about age-related macular degeneration, its symptoms, causes, stages, and treatment options.

by Hannef Esquander

What is Age-Related Macular Degeneration?

Macular degeneration is a chronic eye condition that causes loss of central vision because of damage to the macula in the central part of the retina. Age-related macular degeneration (AMD) is most common in people older than 50 years. The condition is more common in Western countries than in Asia.

Stages & Types

While there is no way to cure macular degeneration, in some people it worsens slowly or stays the same for years. The stages of macular degeneration can be divided into three.

  • Early AMD

There is typically no change in vision, but a doctor can see medium-size drusen during an eye exam.

  • Intermediate AMD

An eye exam shows larger drusen or changes in the color of the retina. There may be no symptoms yet or some minor symptoms.

  • Advanced AMD

There are symptoms such as wavy or blurred vision, blind spots and trouble seeing in low light. Advanced macular degeneration can be dry AMD or wet AMD.

Symptoms 

The symptoms of macular degeneration varies in different people. In the early stage, the condition may be hardly noticeable. In different cases, only one eye loses vision while the other eye continues to function as usual for many years. Once both eyes are affected, the loss of central vision may be noticed more quickly.

The following are some common ways that vision loss is detected:

  • Blurred vision of words on a page
  • Appearance of empty area in the center of vision
  • The appearance of blind spots
  • Straight lines appear to look wavy and distorted
  • Difficulty in recognising faces and watching television

Risk Factors of Age-Related Macular Degeneration

 

Macular degeneration is part of the human’s natural body aging process. The two most common types of age-related macular degeneration are “dry” (atrophic) and “wet” (exudative.)

  • Dry macular degeneration: Most people have dry macular degeneration. It is characterised by yellow fatty deposits (drusen) in the retina caused by aging and the thinning of the tissues of the macula. Vision loss is usually gradual.
  • Wet macular degeneration: Wet macular degeneration accounts for about 10% of all cases. It is more severe. It happens when new blood vessels grow underneath the retina. The new vessels may leak blood or fluid, Vision loss may be rapid and serious.

Causes

It is hard to pinpoint the exact factors that cause age-related macular degeneration. There are a lot of different factors that can lead to the condition. These factors are mostly unavoidable and beyond our control.

  • Age: One in three Malaysians aged 80 and older has AMD.
  • Family history: Genetics is an important contributing factor. Those who have relatives with AMD history are three times more likely to develop the condition.
  • Gender: AMD is more common in women than men. This difference may possibly due to the fact that women tend to live longer than men.
  • Skin colour: People with light skin are more likely to develop AMD than people with darker skin.
  • Eye: People with lighter coloured eyes may be at higher risk.

On top of all of these unavoidable risk factors, there are different aspects of our lifestyle that we can control in preventing and reducing the risks of AMD. Some changes and adjustments might work in the long run.

  • Smoking: People who smoke or live with smokers are considerably more likely to develop AMD.
  • Sun exposure: UV rays from the sun may increase the risk of AMD; sunglasses and hats can protect your eyes.
  • Diet: A high-fat diet is linked to increased risk; some foods such as dark leafy greens, along with eye vitamins, may help protect vision.
  • High blood pressure and cholesterol levels: Unmanaged, these conditions can increase the risk of macular degeneration and its progression.
  • Obesity: Being obese is linked to a significant increase in the risk of AMD.
  • Inactivity: Lack of aerobic exercise may be linked to macular degeneration; being active may slow its progression.
  • Medications: Some antipsychotics and malaria treatments may increase the risk of AMD.

Diagnosis Age-Related Macular Degeneration

A lot of AMD cases are detected late when blurred vision becomes obvious. Consult your ophthalmologist to detect early stages of macular degeneration during a medical eye examination that includes the following:

  • Viewing the macula with an ophthalmoscope
  • A simple vision test where you look at a grid resembling graph paper
  • Sometimes special photographs called angiograms are taken to find abnormal blood vessels under the retina. Fluorescent dye is injected into your arm and your eye is photographed as the dye passes through the blood vessels in the back of the eye.

Treatment

Currently, there is no treatment for macular degeneration but the symptoms can be reduced and slowed down in a number of ways. Schedule regular checkups with your eye doctor to spot the symptoms early. It will also help greatly aid eye care, treatment and management of the condition.

What works for wet macular degeneration:

  • Photodynamic therapy (laser therapy) – This is a treatment that is performed in the outpatient department with the help of light-activated drugs, called photosensitising or photosensitiser agents. Photodynamic therapy works like this — The inactive form of said medication is put into a syringe and administered into a vein in the arm. It then migrates to the abnormal blood vessels in the macula where it builds up. Next up, special cold laser light of low intensity is shone at the retina, as a result of which the drug is activated on the new blood vessels in the region. What is good about this treatment is that the retinal cells are not damaged. The treatment generally works to reduce leakage.
  • Intravitreal Injections – This treatment delivers anti-vascular drugs directly into the blood vessels in the eye by a quick and painless procedure. The abnormal blood vessels are then suppressed. The suppression of these abnormal blood vessels will then lead to alleviated symptoms of the disease.

What works for dry macular degeneration:

So far the treatment for the dry form of Age-Related Macular Degeneration is best prevented by refraining from smoking, improving nutrition and lutein/zeaxanthin supplements.

Additionally, an occupational therapist or a rehabilitation specialist might partner up to help you adapt to it. Talk to your doctor for more details.

Another way to significantly improve your eyesight is to have a telescopic lens implanted in one or both eyes. It comes packed with lenses that improve close-up and distant vision alike. The only drawback is its field of view is quite narrow, which means its use is restricted to an urban environment

Age-Related Macular Degeneration Prevention

It is not all bad news as there are steps that you can take to fend off or manage the disease.

Schedule routine eye exams

It is important to visit an eye doctor every now and then to make sure one of the most important organs in your body is in good health. Depending on your condition, the specialist will tell you how often you should have check-ups. In between those, you can self-assess your vision at home with the Amsler grid. The test is literally a piece of the grid with a small dot in the centre and you have to look at it with each eye separately. If everything is fine with your site, you will see straight lines. If a macular disease is present, some of the lines may be missing or you might see wavy lines. You can purchase a package on the Internet.

Manage your personal nutrition well

Choose your food intake wisely. The richer in vitamins, minerals and omega-3 fatty acids present in the food you eat, the less often you will have to reach for the bottle of nutritional supplements. However, if your eating habits or diet is not capable of providing your body with everything it needs, then pill supplements are highly recommended.

Quit smoking

It may be easier said than done, but breaking a bad habit is always great. Smoking is proven to do harm to your body overall, including your eyes. By quitting, you’ll be doing your own body a favour. From a lifestyle perspective, your family and friends will benefit from this change as well.

Building these good habits can reduce the risk of AMD occurring, ensuring continued good health for your eyes and greatly improved quality of life for you.

As for those who suffer from an advanced stage of AMD, adjustment can be difficult as vision deteriorates to blurred vision, and possibly, to complete vision loss. Do not lose hope as there are ways to make it bearable for both the sufferer and the caregiver.

Get specialist opinion

Trained in the management of patients with visual impairments, a low-vision specialist is a licensed optometrist who evaluates the degree of vision loss. A specialist teaches sufferers about non-optical adaptive devices like proper light fixtures and clocks to incorporate into your home in order to help ease the symptoms of macular degeneration. Care professionals at Homage might also help in providing more tips and information about caring for AMD patients.

Learn more about AMD

Research macular degeneration so you can understand what it looks like when the macula, the most sensitive and central part of the eye, isn’t working properly—causing images to seem unclear. You’ll be able to empathize with your loved one and engage in meaningful conversation. Also research support groups for the sufferer. Support groups give sufferers the opportunity to vent their frustrations and learn how others are coping with low vision.

Offer emotional support

It’s common for people diagnosed with macular degeneration to feel angry, shocked, stressed, and sad. But if these symptoms persist for longer than a few months, contact a doctor. Keep in mind that watching a loved one and hovering are not the same thing. The sufferer needs time to come to terms with their diagnosis alone.

Make home adjustment

Remove obstructions in your home such as unnecessary doors, rugs and coffee tables. Provide natural lighting and reduce glare for optimal eyesight. Contrast is also a great way to set up the home for someone with macular degeneration. For instance, pair a brightly coloured toothbrush with a white background to help your loved one find it easily.

Adopt healthy lifestyle

People who suffer from macular degeneration should stay active. Yoga, walking and riding a stationary bike are great, non-intimidating ways for people with macular degeneration to keep their heart pumping. Encourage them to eat foods that contain carotenoids including sweet potatoes, cantaloupe, spinach and corn. Carotenoids can reduce the risk of eye disease and certain cancers.

References

What is Macular Degeneration?. Sight Matters website. Available at: https://www.sightmatters.com/what-is-amd. Accessed July 31, 2021.

Macular Degeneration. Mount Elizabeth website. Available at: https://www.mountelizabeth.com.sg/specialties/medical-specialties/eyes/macular-degeneration. Accessed July 31, 2021.

Macular Degeneration. Illinois Eye Center website. Available at: https://www.illinoiseyecenter.com/macular-degeneration/. Accessed July 31, 2021.

Age-Related Macular Degeneration Treatment. Asia Retina Eye Surgery Centre website. Available at: https://asiaretina.com/age-related-macular-degeneration-treatment/. Accessed July 31, 2021.

Caring For Someone With Macular Degeneration. Beebe Healthcare website. Available at: https://www.beebehealthcare.org/health-hub/caring-someone-macular-degeneration. Updated May 11, 2018. Accessed July 31, 2021.

Caring For Someone With Macular Degeneration. Beebe Healthcare website. Available at: https://www.beebehealthcare.org/health-hub/caring-someone-macular-degeneration. Updated May 11, 2018. Accessed July 31, 2021.

About the Writer
Hannef Esquander
With more than a decade of experience writing about all different aspects of lifestyle; from entertainment and fashion to art and travels, Hannef now finds himself gaining interest towards health, well-being and spirituality.
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