Age-related macular degeneration

Age-related macular degeneration is an eye condition resulting in the loss of central vision.

How age-related macular degeneration (ARM) affects vision

What is age-related macular degeneration (AMD/ARMD)?

The macula is the part of the eye where incoming rays of light are focused and is essential for seeing straight ahead, seeing details, and seeing colour. The cells in the macula can become damaged for many different reasons. When it happens in people who are older it is referred to as age-related macular degeneration. It normally affects both eyes, although not necessarily at the same time.

Macular degeneration is not painful and does not lead to complete blindness as it is only the central vision which is affected. People normally have enough side vision to lead independent lives.

There are two different types of AMD. They are referred to as wet and dry because of their appearance to the ophthalmologist. The most common type is dry AMD. Wet AMD is rarer and accounts for only 10% of cases.

Dry age-related macular degeneration (AMD)

Dry AMD happens when visual cells stop functioning. It occurs gradually resulting in central vision loss.

Wet age-related macular degeneration (AMD)

Wet AMD happens when new blood vessels begin to grow in or around the macula. This happens when there is a lack of oxygen in the cells in the eye. The body tries to deliver more oxygen to these cells by growing extra blood vessels. The new blood vessels are fragile and can leak fluid and blood, causing scarring in the macula, which consequently leads to sight loss.

What are the symptoms of age-related macular degeneration?

The most common symptom is a loss of central vision. There should not be any pain and symptoms may develop quickly or over several months.

Main symptoms to be aware of are:

  • Blurred or distorted central vision – objects look an unusual size or shape.
  • Blank patch or dark spot in central vision.
  • Difficulty seeing details or identifying people’s faces.
  • Sensitivity to light.
  • Seeing lights which are not there.

What are the causes of age-related macular degeneration?

The exact cause for AMD is not yet known. There are thought to be a number of factors which might increase the chance of someone developing AMD:

  • Age - older people are more likely to suffer from AMD.
  • Family history – AMD seems to run in families. Specific genes are present in most people who have AMD.
  • Smoking – a major risk factor and can increase chances of getting AMD. Stopping smoking can reduce the chance of developing AMD.
  • Sunlight - intense exposure to sunlight can cause damage to the retina. It is advisable to wear sunglasses in strong sunshine.
  • Nutrition – research has shown that some vitamins and minerals can protect against AMD.

Eating a well-balanced diet, not smoking and protecting eyes from strong sunlight may help to delay the development of AMD.

What should I do?

If you think you have any of the symptoms for AMD you should make an appointment to see your optician or doctor.
If you have a rapid change in vision you should either see your doctor or go to an Accident and Emergency department at a hospital.

If you already have AMD in one eye and start to show signs of AMD in the other eye seek medical advice urgently to ensure you begin immediate treatment.

Can it be treated?

Treatment is available for some cases of wet AMD. There are many visual aids available to help cope with sight loss.

Photodynamic therapy

If wet AMD is affecting the middle of the macula, photodynamic therapy can be used. A light sensitive drug is used to identify new blood vessels which are growing in the wrong area behind the retina. A laser is then used to activate the drug, which stops the new blood cells from growing and prevents the AMD from progressing any further.

Anti vascular endothelial growth factor treatment (Anti-VEGF)

Anti-VEGF treatment can be used for wet AMD. The treatment involves an injection into the vitreous jelly in the eye preventing new blood vessels from growing. Anti-VEGF treatment is most effective when used in the early stages of the condition, as it can stop sight loss from progressing and on occasion can improve sight already lost.

Treatment for dry AMD

There is no known medical treatment for dry AMD. Research has suggested that vitamin supplements can slow down the development or even prevent dry AMD.

Nutrition

There are reported benefits of high levels of antioxidants and zinc for slowing macular degeneration and helping eye health.
A supplement containing the following may help:

  • Nutrients – zinc, lutein, zeaxanthin.
  • Vitamins – A, C and E.

Please contact your doctor before taking any supplements.

Is there a cure?

Unfortunately there is no cure at present for age-related macular degeneration (ARMD).

How will I cope?

Adjusting to having AMD might be difficult and overwhelming at first as it may involve some changes to your life. Action for Blind People is here to support you, to make life easier and to answer any questions you may have about your sight or day-to-day living.

There are some things which can be done to help:

  • You will still have peripheral vision.
  • There are visual aids which can help you use your remaining vision.
  • Counselling is available if you need any emotional support or to talk about your diagnosis with someone.

What support does Action offer?

We have Action for Blind People resource centres across the country where expert staff can show you resources which are available and advise you on the best products for your needs.

Action for Blind People has regional offices all over England with trained staff who will know what resources and support services are available in your area.

You can call the RNIB Helpline on 0303 123 9999 and coordinators will provide you with impartial support and advice on everything to do with visual impairment.

Further information and other organisations

You might find it useful to read the eye anatomy section on our website as it explains in detail how the eye works.

RNIB have information on eye conditions from the Royal College of Ophthalmologists. There are more details on eye health and nutrition which may be of particular interest if you have AMD.

The Macular Society has information about local services and offers a counselling service.

Moorfields Eye Hospital is one of the world’s largest centre for eye care and research.

NHS Direct is the website to the NHS Direct health advice service, with information and advice about macular degeneration.

NHS Choices has extensive information and recent news about eye health with videos about specific eye conditions.