As we get older, we tend to lose the perfect vision we were used to in our twenties. If you ever had to study a menu at arms-length in a restaurant, you will know what we are talking about. For many of us, aging is a natural thing and we get used to not being able to see as well as we used to, but for some of us, it could be worse.
Age-related macular degeneration (AMD) is the leading cause of blindness in people older than 50 years – and there is no effective cure for it yet. Scientists estimate that around 12 to 13 million people in the USA will have this disease by 2020. But there is hope. Worldwide, there are many research groups focused on developing effective treatments and it is expected that they will be able to recover vision in people that went blind due to AMD in the next ten years or so. Fortunately, there is a lot that we can do ourselves to prevent this disease.
What is age-related macular degeneration?
AMD causes damage to the most sensitive part in the retina which is responsible for sharp central vision, called the macula. The macula is made up of millions of light-sensitizing cells and helps to turn light into electrical signals that are sent to the brain which in turn transforms it into the images we see. Damage to the macula is serious and can lead to permanent blindness if not treated. Symptoms normally are blurring in the center of your vision. This blurred spot grows larger over time and can also lead to blank spots. For some, objects might not look as bright as they used to be. AMD does not cause total blindness, but it will prevent you to perform everyday tasks like reading, driving, seeing faces or fixing things around the house.
How do I know if I have AMD?
Early detection of AMD is important and you will probably not even know if you have it until it is too late. That is why it is important to visit your eye-care professional every two years if you are over 50 years old. There are several tests that they can do to check for AMD.
Normal eye test. Your specialist will perform a normal eye test to see how well or badly you can see at a distance in front of you. The normal eye chart is used.
Dilated eye exam. Drops that dilate your pupils are put in your eyes after which your eye-care professional will inspect the retina and optic nerve for signs of AMD.
Fluorescein angiogram. A fluorescent dye is injected in your arm and pictures are taken as it passes through the blood vessels in your eye. Your ophthalmologist will look for places where blood (the dye) is leaking from the arteries. This means that there is some damage somewhere.
Optical coherence tomography (OCT). OCT uses light waves to capture images of cell tissue in your eye. It is a painless procedure and does not take very long. In most cases, your eye-care professional will not require dilating drops to enlarge your pupils for the test.
The clinical indicator that your eye-care professional is looking for is usually the presence of drusen, yellow deposits beneath the retina. Most people develop some very small drusen as a normal part of aging. The presence of medium-to-large drusen may indicate that you have AMD.
Another sign of AMD is if there are changes to the pigments of your eye under the retina. In addition to the pigmented cells in the iris (the colored part of the eye), there are pigmented cells beneath the retina. Your eye care professional will look for dark clumps of released pigment and areas that are less pigmented than others. These changes will not affect your eye color, but they are indicative of AMD.
6 Ways to Prevent AMD
Here are some steps you can follow to give your body the best chance it needs to prevent AMD:
Smokers are at much higher risk than non-smokers, so stop if you are. Just stop. Studies have shown that people who stop smoking early enough are not at increased risk in their later years. Smoking is so bad for you in many other ways too. It affects your cardiovascular (heart) health which in turn also increases the risk for AMD.
Eat a lot of fresh fruit and vegetables, especially the dark, green, leafy kinds, which are high in anti-oxidants and vitamins. The antioxidants and vitamins in fruits and vegetables contribute a lot to eye health. Kale, spinach, broccoli, carrots, peas and other vegetables have high levels of antioxidants, including lutein and zeaxanthin, which may benefit people with macular degeneration. The meat-lovers can also rest assured. Zinc is found in high protein sources like beef, pork and lamb – just not the fatty bits. Non-meat sources high in zinc include milk, cheese, yogurt, whole-grain cereals and whole-wheat bread.
Stay away from fatty and/or sugary foods. Studies have shown that foods that increase blood sugar levels rapidly increase risk for AMD. If you can, eat a lot of fish like salmon. Fish are rich in omega-3 fatty acids, essential for eye health. If you have to settle for second best (nature is always better than supplements) and use an omega-3 supplement make sure that it comes from a fish source. Store it in the fridge as it can become rancid like any other oil stored at high temperatures.
Ask your doctor about AREDS
AREDS was a large study conducted over many years in which participants were given a specific formulation that contained some vitamins, minerals and anti-oxidants. It found a 25 % reduced risk for AMD in the participants who took these supplements. There are several eye-care companies that sell AREDS formulations, just ask your eye-care professional.
Get more active, lose the weight
Overweight people have increased risk of AMD. Try to reduce the number of calories in your diet and increase the amount of exercise you get each day.
Use better options when you cook
Fried foods are just not good for you. Try to use olive oil instead. It is rich in fatty acids and safe to use.
Manage your blood pressure and cholesterol
Cardiovascular diseases like high blood pressure or cholesterol increase the risk of AMD. Don’t mess around if you are on medication; use it according to your doctor’s instructions.
Current Treatments for AMD
Intravitreal anti-angiogenic therapy is currently the primary therapy for neovascular age-related macular degeneration. The injections that are used most often contains specific antibodies similar to those used in cancer therapy.
Photodynamic therapy involves a light-sensitive dye that is intravenously administered and then activated with a laser beam focused on the macula.
Lens replacement surgery in one eye is an option for people who have advanced AMD in both their eyes. The telescopic lens implant looks like a tiny plastic tube and is furnished with lenses that increase your field of vision. The telescopic lens implant may improve both distance and close-up vision, but it has a very narrow field of view. It can be particularly useful in an urban environment to aid in identifying street signs.
Low-vision rehabilitation specialists will help you to find ways to adapt to your changing vision. AMD doesn't affect peripheral vision but it will minimize your central vision necessary for driving, reading etc.
Coping and Support
One can only imagine what a traumatic experience loss of vision is. This is especially true if you are used to a fast-paced lifestyle or if you don’t have good family support. These tips might help you to cope with AMD:
Make sure your prescription is up to date and get reading glasses with high-powered lenses.
You may also use a closed-circuit television system that uses a video camera to magnify reading material and project it onto a video screen.
There are many handheld magnifiers available on the market for you to use.
Computers with large-print and speech-output systems are readily available and could be an enormous benefit to you if you are used to working on one. You might still get to work on that book you promised yourself to write.
Talking watches, clocks, and calculators are great and there are many on the market.
Consider safe options for your transport. It is not a good idea to drive around by yourself.
Join a support group if you can. If it is not possible or if there are none in your area, try to find at least one person with experience who you can talk to. Having someone to talk to might just be the best medicine for AMD.