Common eye disease can be treated by a retina specialist

Age-related macular degeneration is a common eye condition and a leading cause of severe vision loss in adults older than 50. This eye disease occurs when there are changes to the macula, a small area near the center of the retina and the part of the eye responsible for central or straight vision.

AMD can occur in two forms: “dry” or atrophic and “wet” or exudative. The dry form is more common and it advances slowly so that vision loss does not occur for a long time, perhaps not at all. The wet form of the disease progresses faster and may lead to loss of vision in one or both eyes. AMD by itself does not cause complete blindness. However, the loss of central or straight vision can interfere with simple everyday activities, such as recognizing people’s faces, driving, reading, writing, or doing close work such as cooking or fixing things around the house. Objects look distorted in shape and straight lines look wavy or crooked, which is more noticeable during reading.

Age is the major risk factor. Other factors that can increase your chance of developing AMD are race (white/caucasian), family history and smoking.

In the early stages of AMD, patients may have no symptoms. Only a comprehensive dilated eye exam performed by an eye care professional can detect early AMD. During the exam, your eye care professional will look for drusen, which are 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. If you are at risk for AMD because of age, family history, lifestyle, or some combination of these factors, you should not wait to experience changes in vision before getting checked by an eye care professional for AMD. Some common symptoms are a gradual loss of ability to see objects clearly, distorted vision, and a dark or empty area appearing in the center of vision.

Treatment for AMD depends on whether you have dry or wet AMD. Researchers at the National Eye Institute tested whether taking nutritional supplements could protect against AMD in the Age-Related Eye Disease Studies (AREDS). They found that the daily intake of certain high-dose vitamins and minerals can slow progression of the disease and reduce the risk of visual loss in people who have dry AMD. Here are the clinically effective doses tested in AREDS…

• 500 milligrams (mg) of vitamin C

• 400 international units (IU) of vitamin E

• 25 mg of zinc (as zinc oxide)

• 2 mg of copper (as cupric oxide)

• 10mg of Lutein

• 2mg of Zeaxanthin

Some vitamin supplements may have complications and risks. Tell your doctor if you smoke or have smoked in the past, because beta carotene supplements have been associated with a higher risk of lung cancer in smokers.

AREDS formulation is not a cure. It does not help people with early AMD, and will not restore vision already lost from AMD. But it may delay the onset of late AMD.

Wet AMD typically results in severe vision loss. However, eye care professionals can try different therapies to stop further vision loss. One option to slow the progression of wet AMD is to inject medication into the eye that is designed to combat the disease process. With wet AMD, abnormally high levels of vascular endothelial growth factor (VEGF) are secreted in your eyes. VEGF is a protein that promotes the growth of new abnormal blood vessels. Anti-VEGF injection therapy blocks this growth. If you get this treatment, you may need multiple monthly injections. A few different anti-VEGF drugs are available. They vary in cost and in how often they need to be injected, so you may wish to discuss these issues with your eye care professional.

For people with advanced AMD with poor vision, low vision rehabilitation services are available in most cities but the range of services available varies considerably. Low vision magnifiers and aids provide visual solutions for daily tasks and hobbies. Presently there are many low vision devices to choose from; each designed to meet the individual need with function and ease of use.

As is the case with many medical conditions, early diagnosis and treatment is of paramount importance when dealing with AMD. Be sure to see your eye care professional in a timely fashion if you notice persistent changes in your vision.

Matthew Pezda is board-certified by the American Board of Ophthalmology and an active member of the American Academy of Ophthalmology and the American Society of Retina Specialists. He can be reached at Retina Consultants of Nevada.

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