Macular Week 2017

This week is it national macular week.  But what is macular degeneration and what can be done to treat it. 

Age-related macular degeneration (AMD) is a painless eye condition that causes loss of the central vision, usually in both eyes. Central vision is what you see when you focus straight ahead. In AMD, this vision becomes blurred which means reading becomes difficult, colours appear dull and people's faces become difficult to recognise.  The degeneration usually happens gradually over time but in some cases it can sometimes be rapid.

AMD doesn't affect the peripheral vision (side vision) and, therefore, does not cause complete blindness. 

The symptoms of age-related macular degeneration

The main symptom is blurring of the central vision losing the ability to see fine detail, the ability to distinguish between objects such as faces against a patterned background or writing can become distorted in the centre.

Types of macular degeneration

There are two types of macular degeneration – Dry and Wet.

Dry AMD may take 5 to 10 years before the loss of vision significantly affects daily life. Sometimes the healthy eye will compensate for blurring or vision loss if only one of your eyes is affected. This means it will take longer before your symptoms become noticeable.

You may have dry AMD if:

- you need brighter light than normal

- when reading text appears blurry colours become dull

- you have difficulty recognising faces

- your vision becomes hazy and less defined

Wet AMD develops in people who've already had dry AMD and any blurring in your central vision will quickly worsen.  Other symptoms include

- distorted visuals such as lines appearing as waves

- blind spots

- hallucinations and seeing objects that are not there

Wet AMD needs to be treated as soon as possible to stop your vision getting worse.

Treating macular degeneration

There is currently no cure for either type of AMD, although vision aids and treatments may help.

Treatments for Dry AMD

The deterioration of vision can be slow with dry AMD and sufferers will not go completely blind as the peripheral vision shouldn't be affected.

Getting some practical help make it easier for you to carry out your daily activities. Often patients are referred to a low vision clinic who provide useful advice and practical support to help minimise the effect of dry AMD with magnifying lenses, large print books, very bright reading lights and using screen-reading software on computers.

There is some evidence that a diet high in vitamins A, C & E may slow down the progression of dry AMD and reduce the risk of getting wet AMD. However, there is no definitive proof eating these foods will be effective for everyone with dry AMD but a healthy diet has other important health benefits.

Treatments for Wet AMD

There two main treatment options for wet AMD which are anti-VEGF medication to prevent the growth of new blood vessels in the eye and laser surgery to destroy abnormal blood vessels in the eye. Anti-VEGF medicines block the chemical that causes growth of new blood vessels by stopping it producing blood vessels, thereby preventing wet AMD getting worse.  The medication is injected into the eye using a very fine needle and it can shrink the blood vessels in the eye and restore some of the sight lost as a result of macular degeneration.

Eye surgery involves having a light-sensitive medicine injected into a vein in your arm. The medication attaches itself to the abnormal blood vessels in the macula and a low-powered laser is then shone into the damaged eye. By destroying the blood vessels it stops them leaking blood or fluid and prevents further damage.  However, it will depend on where the blood vessels are growing and how severely they have affected the macula.

Laser surgery can be used to treat some cases of wet AMD but it is only suitable if the abnormal blood vessels aren't close to the fovea, as performing surgery close to this part of the eye can cause permanent vision loss.

Radiotherapy has been used to treat wet AMD with varying results. Research was carried out recently to see whether using radiotherapy in combination with anti-VEGF injections may be of benefit in reducing the number of injections needed. The early results of some studies are encouraging, but the long-term benefits are still unknown.

Stem cell therapy tries to create new retinal cells using stem cells which can be grown into retinal cells and then transplanted.

If you are suffering with AMD and would like some advice please contact one of our Consultant Ophthalmologists here at Ashtead Hospital who can talk to you about the possible treatments available to you for your condition.