Age-related macular degeneration (AMD), or senile, is a chronic retinal disease that causes vision loss and mainly affects individuals over the age of 50. It is currently incurable and is the leading cause of vision loss in the elderly population; in the United States alone it affects more than ten million people. There are two types of macular degeneration: dry which represents 85% of cases and exudative which affects the remaining 15% of affected patients; this second type is characterized by the production of secretions and liquids inside the eye. It is extremely important to get an early diagnosis, because there are some treatments that can slow the progression of the disease and allow you to preserve your vision for a little longer.
Steps
Part 1 of 3: Recognizing the Common Symptoms
Step 1. Don't ignore the fuzzy central vision
Age-related macular degeneration usually develops gradually and without any pain, so it is not easy to realize its presence. The characteristic symptom is the progressive formation of a blurred area in the center of the visual field, in one or both eyes. Over time this "spot" becomes larger or becomes filled with black points that completely block the vision of the images; peripheral vision, on the other hand, is not affected by the disease.
- Objects in the center of the field of view are not as well defined as usual and colors can become dull.
- Age-related macular degeneration affects only central vision, since it corresponds to where the macula is located; this is the portion of the retina needed to see clearly the objects in front of you.
Step 2. Watch out for distorted images
Another typical symptom of AMD is the appearance of strange distortions of the visual field, objects appear deformed or straight lines appear wavy, bent or slanted. When these abnormalities develop, people believe they are hallucinating. Although there are other eye conditions that cause blurred vision, only macular disease (including degeneration, cystoid, diabetic, and other edema) creates this type of distortion.
- The deformed images associated with the advanced stages of the disease make it impossible to drive, read and recognize faces.
- AMD often affects both eyes at the same time, but when it is unilateral, the patient has difficulty noticing the changes, as the healthy eye tends to compensate for the impaired capacity of the diseased one.
Step 3. Observe the problems of adapting to dimly lit environments
This is another symptom of degeneration, which occurs when you enter poorly lit rooms, such as bedrooms, offices or restaurants. You may also feel like you need to increase the intensity of the lighting when reading or doing work at close range. If you find that you or your partner are forced to turn on the lights more often than usual, it could be a sign of macular degeneration.
- The more blurred vision of objects is accompanied by the perception that the colors are less intense or bright; the world tends to be grayer and darker for AMD patients.
- The disease spares peripheral (lateral) vision, so it does not cause absolute blindness - although patients suffering from an advanced stage of the disease are considered legally blind and cannot drive or operate heavy machinery.
Step 4. Be aware of the risk factors
The etiology of this disorder is not yet well understood, but numerous risk factors have been found, such as genetics, older age, sex (women are more affected), smoking, obesity, cardiovascular diseases and ethnicity (Caucasian people are more likely to suffer from it). Most patients fall into at least two of these categories, if not more.
- In terms of age, degeneration is more frequent among the population over 65.
- Smoking tobacco and being overweight, especially obese, increases the chances of developing the disease. These factors are aggravated by the simultaneous presence of hypertension and cardiovascular pathologies that damage the health of the retinal vessels.
Part 2 of 3: Getting a Diagnosis
Step 1. Go to the ophthalmologist
If you notice any of the symptoms described above that don't go away within a week, make an appointment with a specialist. After an exam and several tests, your doctor can rule out other common eye conditions, such as retinopathy or cataracts, and tell you what stage of macular degeneration you are suffering from.
- The early stages typically cause no visual impairment or other symptoms; this is why it is important to have regular eye exams, especially if you fall into a risk category.
- The first stage of AMD is diagnosed by detecting the presence of small yellow deposits (called drusen) under the retina.
- The intermediate stage usually causes some vision loss, but no other disturbances; in this case, the presence of large drusen is noted and the retinal pigment appears altered.
- The advanced stage involves severe vision loss in addition to other symptoms, macular and retinal changes are significant.
Step 2. Ask to perform the Amsler test
In addition to undergoing the normal visual acuity test and dilating your pupils (with eye drops), your ophthalmologist may use a reticle, called the Amsler test, to assess for AMD. It is basically a sheet of graph paper with bold lines that form a grid with a dot in the center - however, there are some versions with white lines drawn on a black background. The Amsler test allows you to accurately identify distorted or blurred lines, the common symptoms of the disease.
- By observing the lattice you can realize the pathology early, an important detail because the treatment of the exudative form is more effective when it is implemented before serious damage develops.
- You can download a free Amsler test from the web or ask your doctor to give you one to take home.
- If you have a computerized version of the reticle, position yourself 35 cm from the screen, cover one eye and observe the dot in the center. The surrounding lines must not be blurry or distorted.
Step 3. Evaluate other diagnostic tests
These include fluorangiography (performed with a fluorescent dye that is injected into a vein to reach the retinal vessels) and phase coherence tomography (OCT). The latter is similar to a very detailed ultrasound, only it uses light waves instead of sound ones; allows to obtain high resolution images of the cross sections of the eye and small blood vessels.
- Fluorangiography uses a special dye and a video camera to observe the blood vessels of the retina and choroid, the two back layers of the eye.
- OCT provides doctors with images of ocular tissues in real time, thus allowing them to diagnose AMD in the early stages.
Part 3 of 3: Undergo the Treatments
Step 1. Take anti-angiogenic drugs
They are the first line of treatment for macular degeneration; they are injected directly into the eye to block the progression and development of new blood vessels. They are also able to stop exudation from abnormal blood vessels that cause wet or wet macular degeneration. This treatment has proven effective in many patients and some have even regained lost vision.
- Anti-angiogenetics are active ingredients that are injected into the eye at 4-12 week intervals to narrow blood vessels.
- After treatment, your ophthalmologist may order angiography (a special photograph of the fundus of the eye with the help of dyes) to make sure there is no bleeding from the blood vessels.
Step 2. Do some research on supplements
Some research has found that taking a high dose of vitamins and minerals daily can slow the progression of the disease in the intermediate and advanced stages. Specifically, a combination of vitamins E and C, zinc and copper can reduce the risk of developing advanced AMD by 25%. By adding other plant compounds with antioxidant effects, such as lutein and zeaxanthin, more intense preventive effects are obtained.
- As for vitamins, the effective daily dose corresponds to 500 mg for C and 400 IU for E.
- You should take 80 mg of zinc oxide and 2 mg of cupric oxide every day.
- Approximately 10 mg of lutein and 2 mg of zeaxanthin have been found to be useful for prevention.
Advice
- Women tend to develop age-related macular degeneration more frequently and earlier than men.
- If you are over the age of 50 and have a familiarity with this condition, go to the ophthalmologist at least once a year for a complete examination that also includes an inspection of the fundus.
- To reduce your risk, stop smoking, lose weight and avoid exposing your eyes to ultraviolet radiation by wearing sunglasses.
