If you have age-related macular degeneration (AMD), you’re not alone. About 50 million Americans have this eye condition. Of those, about 2 million have a form called wet AMD, which is a leading cause of vision loss in the United States, according to the National Eye Institute (NEI).
“That number is expected to go up to nearly 5 million in the future, as the population ages,” says Rahul N. Khurana, MD, a retina specialist at Northern California Retina Vitreous Associates in Mountain View and an associate clinical professor of ophthalmology at the University of California, San Francisco.
AMD tends to develop in people who are in their 60s or older. “As people live longer,” notes Dr. Khurana, “they are getting affected more by age-related conditions like AMD.”
Dry vs. Wet AMD
About 80 percent of people with AMD have a form called dry AMD, which typically does not have symptoms, according to the American Academy of Ophthalmology (AAO).
In fact, many people with dry AMD don’t even know they have it, Khurana says.
That’s why it’s important to get regular eye exams, particularly as you get older. The AAO recommends that people 65 and older see an ophthalmologist for a comprehensive eye exam every one to two years, even if they have no symptoms or changes in vision.
For about 10 to 20 percent of people with dry AMD, the condition progresses to wet AMD. In this type, abnormal blood vessels form on a part of the retina called the macula, which is located in the back of the eye and affects your central vision.
These abnormal blood vessels can bleed or leak fluid, which results in the inability to see clearly.
“Think of the eye as like a camera,” Khurana says. “The retina is like the film in a camera. If you have abnormal blood vessels that are leaking or bleeding on the retina, the film doesn’t work, and the retina cannot process light. That’s why people [with wet AMD] can lose their central vision.”
Problems with central vision can make everyday activities — reading, watching TV, driving — difficult and obscure faces.
Managing and Monitoring Dry AMD
Even though dry AMD typically doesn’t cause vision symptoms, it still needs to be managed. If you’ve been diagnosed with dry AMD, these steps can help you stay on top of your condition.
- See your eye doctor regularly. Khurana says he typically sees people with dry AMD every six months. Talk to your ophthalmologist about how frequently you should schedule visits if you develop dry AMD.
- Monitor your vision at home for any changes. Your eye doctor may suggest that you use an Amsler grid, which looks like a piece of graph paper. You stare at the grid to make sure your vision is stable. If the lines suddenly become distorted or blurry or a spot develops in your vision, it may mean your AMD is changing. “I recommend that people with dry AMD use the Amsler grid once a week,” says Khurana. “Close each eye [in turn] and check the lines. That way, if something changes, you can spot it right away and visit your eye doctor.” Your eye doctor might also recommend a more sophisticated at-home AMD monitoring system, which may be covered by your insurance.
- Stop smoking. If you smoke, one of the many reasons to quit is that it can worsen AMD. According to a review of existing research published in March 2020 in the journal Ophthalmic and Physiological Optics, smoking can quadruple a person’s risk for AMD and speed vision loss by up to 25 percent.
- Take eye vitamins. In the Age-Related Eye Diseases Study (AREDS) sponsored by the NEI, researchers found that for people with dry AMD, a specific formulation of antioxidants may help decrease the chances of developing wet AMD by 25 percent over five years. These antioxidants, now known as AREDS supplements, include large amounts of vitamins A, C, and E, as well as zinc and copper. A different formulation, based on a follow-up NEI study, contains lutein and is called AREDS2. Talk to your eye doctor about whether eye vitamins could help your dry AMD and, if so, which formulation would be best for you to take.
Treating and Managing Wet AMD
If dry AMD progresses to wet AMD, the earlier the wet AMD is detected by your eye doctor, the better the outcome for preserving your vision, according to the AAO. With wet AMD, the focus shifts to actively treating the condition, not just monitoring it.
Here are effective steps to take when you have wet AMD.
- Get regular treatment. Wet AMD is often treated with anti–vascular endothelial growth factor (anti-VEGF) therapy, which is injected into the eye by an ophthalmologist or retina specialist, the American Macular Degeneration Foundation (AMDF) says. This treatment helps keep new blood vessels from forming behind the retina and reduce leakage. Anti-VEGF therapy also helps prevent further vision loss. The frequency of treatment varies, but you may have injections as often as monthly, depending on your symptoms. “It can seem burdensome to come in once a month,” Khurana notes, “but getting regular care is really important to prevent further vision loss.”
- Keep taking eye vitamins if only one eye has wet AMD. Wet AMD typically develops in one eye first, according to the AMDF. If your other eye still has dry AMD, it’s important to keep taking your eye vitamins to reduce the likelihood that wet AMD will develop in that eye as well, the AMDF says. “The purpose of the vitamins is to help prevent the development of the wet form,” explains Khurana. You can continue to monitor the eye with dry AMD at home with an Amsler grid to check for any changes in central vision.
- Make the most of low-vision aids. If your central vision has been affected by wet AMD, there are many ways you can adapt. Talk to your eye doctor about low-vision rehabilitation, which might include a referral to a low-vision specialist. Tools such as magnifiers can help you read, and there are helpful adjustments you can make in your home to make seeing easier.
In general, treatment for wet AMD has vastly improved over what was previously available. If you have wet AMD, staying proactive can help you preserve your vision and your quality of life.
Source: Everyday Health / Image by bearfotos from freepik