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Macular degeneration

Dr. Manveen Bedi, March 3, 2021

Age-related vision loss affects more than a million Canadians.

Macular degeneration, also known as age-related macular degeneration (AMD), is the leading cause of irreversible blindness in adults over the age of 50 years, affecting 1.4 million Canadians, according to Fighting Blindness Canada. Although AMD is most commonly associated with ageing, there are some forms that can affect younger people.

AMD affects the macula — the part of the eye responsible for central vision and is important for driving, reading and distinguishing faces — and results in central vision distortion. Central vision is the center portion of your vision when looking straight ahead. While this condition does not result in total blindness, as your peripheral vision — the side vision when looking straight ahead — remains relatively unaffected, it can result in extensive vision loss.

There are two forms of macular degeneration: dry AMD and wet AMD. Dry AMD is diagnosed when the macula becomes thinner and less able to convert light — as the cells die, vision loss occurs. While this form of AMD is more common and less severe, it can progress to wet AMD, in which blood vessels below the thinning macula swell and begin to grow abnormally; if left untreated, they also begin to leak blood and fluid into the eye (hence the name “wet”). The damage can result in rapid vision loss.

What are the signs of AMD?

Some of the signs of AMD include: blurry central vision, straight lines appear wavy or bent, difficulty recognizing faces and adapting in low light conditions, decreased colour vision, and eventually with progression, there can be a blind spot in the central field of vision

Risk factors

The risk factors for developing AMD include, genetics, age (it’s most commonly diagnosed in people over 60 years of age), ethnicity (AMD is commonly noted in the Caucasian population), smoking, obesity and high blood pressure and cholesterol.

How to prevent AMD

Here are some important preventive strategies that can help reduce risk of developing macular degeneration.

Take care of your eyes. Routine eye examinations are crucial in early detection of signs of macular degeneration.

Heart health.  Cardiovascular factors: It is important to manage your blood pressure, cardiovascular diseases, and cholesterol with healthcare professionals.

Lifestyle. Increasing physical activity and intake of green leafy vegetables that are rich in lutein, zeaxanthin, and antioxidants can help prevent AMD Foods such as egg yolk, corn, kale, broccoli, spinach, squash have high concentrations of lutein and zeaxanthin.

Don’t light up. Smoking has been shown to increase the risk of developing macular degeneration.

Get some shades. Sunglasses and hats when outdoors help with reducing UV light damage to the retina.

How can I cope with my changing vision?

Magnifiers. There are a number of magnifying glasses that can help you with reading and other close-up work, such as reading. These can include hand-held magnifying lenses or magnifying lenses you wear like glasses.

Accessibility on digital devices. Computers, iPads, and phones have magnification features that can help with reading. Adjusting the contrast and brightness of screens can also help ease with adapting to screen light. As well, the VoiceOver feature on iPhones gives you an audible description of what’s on the screen, including battery level and which app your finger is on.

Make it brighter. More light can make it easier to read and other activities.

Monitor your vision. Using the Amsler grid daily can help you track your vision loss and problem areas. The grid is black and white with horizontal and vertical lines, and a dot in the centre. To use, hold the grid 12-15 inches away from your eyes, focus on the center black dot, and notice if some of the lines appear wavy, broken, or missing. It is important to monitor your vision regularly with the grid one eye at a time. If the distortions increase, seek advice from your eye care professional.

While there is currently no treatment for dry AMD, you can slow progression by eating healthily and not smoking. For patients with wet AMD, treatments such as injections are needed to prevent progression of vision loss. Optometrists and other healthcare professionals are able to perform routine eye exams to monitor vision loss, and provide recommendations about treatment and optical aids that can help you with maintaining your quality of life.