"Age-Related Macular Degeneration—A Silent Thieve" by Allen Weiss, MD, MBA, President & CEO

Age-Related Macular Degeneration—A Silent Thieve

March 15, 2012 - Imagine not being able to read or drive a car. Think about how your life would change.

Age-related macular degeneration (AMD) is an insidious disease of the macula – the central area of the back of the eye called the retina – responsible for most detailed central vision. Degeneration of this tiny area is the leading cause of vision loss and blindness in the rapidly-growing over 65 age group in America. About 1.75 million Americans are currently afflicted with this insidious illness, with an anticipated 3 million by 2020.

There are two types of AMD—dry and wet. Typically, dry precedes the wet form but many folks never progress and there is no accurate way to predict if or when progression will occur.

Early symptoms of dry AMD include the need to have increasing light when reading or doing close work. This can manifest when entering a dark room or struggling with a menu in a dimly lit restaurant. Blurriness when reading and a decrease in intensity of bright colors can follow the first symptoms. Recognizing faces, a general haziness, and a progression to having a blurred or blind spot in the center of your field of vision are the next steps; these may be easily overlooked if the disease is in just one eye. The other “good” eye compensates.

No one knows the cause of AMD, or the cure. However, age, a family history, being Caucasian and/or female, smoking, obesity, poor intake of fruits and vegetables, high blood pressure and elevated cholesterol and triglycerides are all associated with this unfortunate condition. You can never go wrong by staying healthy, avoiding smoking, eating well, and controlling blood pressure . . . in regard to AMD or most any other disease.

AMD almost never causes complete blindness but it does worsen your quality of life. If this condition progresses to the wet form there can be a more rapid deterioration. The diagnosis of both the dry and wet forms of AMD can be made by examining the back of your eye by looking through the lens of your eye with a magnifying instrument called an ophthalmoscope. Another diagnostic procedure is a limited angiogram of the eye, in which a colored dye is injected into a vein in your arm. A camera is then placed so that it can visualize the vessels in the retina which, as mentioned above, are in the back of the eye and responsible for seeing fine objects such as lines, and enabling one to read.

An easy test, and one which is used to monitor progress, is the Amsler grid. This chart, which looks like graph paper, can be viewed by one eye at a time. If the lines appear faded, broken, or distorted then there may be early AMD.

Not only is there no cure for AMD, unfortunately, there is no known effective treatment. However, some vitamin combinations seem to slow the progression of dry AMD. Adding more fruits, vegetables, and fish to your diet has been recommended and may contribute to eye health in general.

While there is also no known prevention, having routine eye exams, managing your other diseases, stopping smoking, and keeping a healthy weight are all positives for eye and total health.

If you, or a friend or loved one suffers from AMD seek assistance from many of the support groups established; there is comfort and reassurance in talking to others in the same situation. The use of magnifiers, larger computer fonts, special appliances for low vision, and brighter lights can help. Anyone with AMD should seriously consider avoiding driving.

Most of all, keep your spirits up. Medical science is progressing rapidly and most folks with AMD can still see; they just have problems seeing small objects as well as they would like.


Past Health Advice Articles

Dr. Allen Weiss is CEO & President of the NCH Healthcare System. He is board certified in Internal Medicine, Rheumatology and Geriatrics, and was in private practice in Naples, Florida from 1977 - 2000. Dr. Weiss is active in a variety of professional organizations and boards, and has been published in numerous medical journals, including the American Journal of Medicine and the Journal of Clinical Investigation.