Age Related Macular Degeneration (amd)

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Age Related

Macular Degeneration (AMD)

This is a translation of a booklet published by The National Institute for the Blind, Visually Impaired, and Deafblind in Iceland (NIB). The Blind Association in Iceland supported the Publication.

Age Related Macular Degeneration (AMD)
The eye is shaped like a ball.

The pupil (aperture) is in front of the eyeball and adjusts how much light passes into the eye. The lens is behind the pupil. The lens directs the light to the retina at the back of the eye. The retina is made of delicate tissue that converts light into pictures that are forwarded to the brain. The macula is a tiny dot in the middle of the retina. The macula is very important in enabling us to see clearly things right in front of us. It also makes it possible for us to see colours and details e.g. when reading and writing.

Sometimes, the delicate cells in the macula will be damaged, and stop working. There are various reasons for this. Damages that happen late in life are called Age Related Macular Degeneration (AMD). Two types of AMD are most commonly known: Dry AMD and Wet AMD. The names are descriptive of what can be seen when looking at the macula in the retina.
The dry type of AMD is more common.

It starts slowly, and gradually damages the central vision. People may find that their eyesight is deteriorating when things become unclear and colours fade. As of now, no cure for dry AMD has been found. However, aids like magnifiers may be of help when reading or doing handiwork up close.

New veins developing behind the retina cause the wet type AMD, resulting in swelling by edema, bleeding and scars that can lead to loss of eyesight. Wet AMD can evolve rapidly, but early treatment can sometimes be beneficial. Around a quarter of AMD-patients are diagnosed with the wet type.

Wet and dry AMD alike usually affect both eyes but it may start with one eye to be followed by the other. It can be difficult to recognize the sight loss when the eye not affected compensates the sight loss in the affected eye.

It is not possible to “overuse” the eyes so there is no reason for using the eyes sparingly.
AMD is the most common reason for deteriorating vision in people over sixty years of age. It is not painful and it will normally not lead to complete sight loss as only the central vision is affected. This means that most people will still have enough peripheral vision to move around with their autonomy and independence intact.

What causes AMD?
It still remains to find the cause for AMD. However, there are several known risk factors:

  • Age

Degeneration of the macula increases with age

  • Genetics

There is an indication that AMD may be hereditary

  • Smoking

Many researches have demonstrated a link between smoking and AMD. Stopping smoking could lower the risk

  • Sunlight

Some researches indicate that sunlight may affect the retina. Using sunglasses for protection is advisable

  • Poor diet

Researches have shown that some vitamins and minerals can slow down the effect of AMD
Even though it is not possible to avoid getting older or having any saying in our genetic heritance it is however possible to control the environmental aspects that can have influence on AMD.

Protecting the eyes from the sunlight, healthy eating together with non-smoking, can give positive results in reducing the risk of AMD.

At early stages, the central vision becomes unclear or distorted. Things may become unfamiliar in size and shape, straight lines seem warped and letters can disappear when reading. These changes can happen suddenly or they can progress over several months. Oversensitivity to light and colours can cause discomfort. All the same, AMD is not painful.

As AMD affects the central vision, it is common to see scattered blots or a spot in the middle of the vision field, at a later stage of the decease. This results in difficulties when reading or writing and recognizing faces.

In case of suspected AMD with no urgent symptoms, a doctor should be consulted. In case of rapid changes in the eyesight, an ophthalmologist should be contacted immediately.

Angiography is necessary to define whether the AMD is wet or dry.

Only wet AMD at the initial stage can be treated. Based on the angiography the ophthalmologist can conclude whether laser treatment or injections into the eye can be applied.
Lately a new treatment has been introduced, anti-VEGF treatment. The treatment is performed in hospital and sometimes needs to be repeated every 4-6 weeks.

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