January 2020

Prevention is Key for This Eye Disease: Age-related macular degeneration the leading cause of vision loss in people age 60 and older

Author: Dr. Peter Liggett

Wrinkles and arthritis are often the go-to concerns many people have as they grow older. However, irreversible blindness and visual impairment should also top the list. As many as 11 million people in the United States experience vision loss resulting from age-related macular degeneration (AMD), according to the American Academy of Ophthalmology.

People with AMD may develop blurred and distorted vision and may not recognize faces due to a developing blind spot in the middle of their vision. In the early stages of the disease, there are often no warning signs. And for some people, AMD can cause total vision loss.

Unfortunately, in many cases, AMD treatment options are limited. While new drugs, therapies and technology begin to emerge in the medical world, the only sure-fire way to treat AMD is through knowledge and prevention.

The part of the eye affected by AMD
To understand how AMD develops, it’s important to become familiar with the part of the eye affected. At the center of the retina, the light-sensitive tissue covering the back of the eye, is the macula. This small area is responsible for our finest vision needed to read, to write and to drive a car.

Some people with AMD experience blurred central vision slowly over time, while others may experience a faster deterioration. Over time, the central, blurry area may become larger, or you may see blank spots while the peripheral vision remains normal. If you are looking at a clock with hands, you might see the numbers but not the hands of the clock.

The difference between dry and wet AMD
There are two types of AMD: dry and wet. Everyone who develops AMD starts with the dry type, which may progress gradually and not necessarily lead to significant visual loss. Dry AMD occurs when parts of the macula thin out with age, causing protein called drusen to grow and leading to central vision loss.
About 10 percent of dry AMD patients will develop wet AMD, which typically results in substantial visual loss and blindness. Wet AMD occurs when abnormal blood vessels form under the retina, leak blood and other fluids and cause scarring. Patients typically lose vision faster with wet AMD than with dry AMD.

Treatment options available for AMD
Because many people don’t realize they have AMD until they experience noticeable vision distortion, it’s important to schedule annual comprehensive eye exams with an eye care specialist who will dilate your eye to thoroughly examine the retina for signs of the disease. If you show signs of AMD, an eye specialist will refer you to a retina specialist.

In some cases, patients may notice that straight lines appear wavy. This can be a warning sign for late AMD. If you experience this symptom, visit your eye doctor right away.

Unfortunately, there isn’t a cure-all for dry AMD. There are many new treatments for wet AMD that can help preserve your vision including drugs injected into the eye, photodynamic therapy, and laser treatment. A combination of treatments is sometimes needed to preserve your vision.

Understand your risk factors
As AMD’s name indicates, people who are age 60 and older typically suffer from this eye disease. Other risk factors include:
• a diet high in saturated fat (found in foods like meat, butter, and cheese)
• being overweight
• smoking cigarettes
• over 50 years old
• diagnosed with hypertension (high blood pressure)
• a family history of AMD

If you smoke, quit that habit now. Smokers are four times more likely than non-smokers to develop AMD. The chemical compounds in cigarettes can break down antioxidants, leading to damage to eye vessels. Cigarette smoking is also known to substantially raise cholesterol levels, leading to hypertension.

If you have high blood pressure with a diastolic pressure of more than 95, you more than double your risk for developing wet AMD. Make lifestyle changes now to prevent the disease in the future. What’s good for the heart is good for your eyes.
There are many healthy lifestyle strategies that can significantly decrease your chances of developing AMD and eventual visual loss:
• A diet rich in fruits and vegetables has natural antioxidants which will protect the eye and prevent damage from AMD.
• Exercising 20 minutes or more three times a week has been shown to decrease visual loss from AMD by 25 percent.

The good news is that you can reduce your risk of visual loss from AMD three-fold with a combination of healthy diet, physical activity and not smoking. 

Dr. Peter Liggett is a leader in the evaluation and treatment of macula and retina diseases. He is the only full-time retina specialist on Hilton Head Island with a practice located at 15 A Lafayette Place near the Indigo Run entrance.

Dr. Liggett is a nationally renowned educator who is a Clinical Professor of Ophthalmology at both Yale School of Medicine and the Cornell Weill College of Medicine in New York. He taught at Johns Hopkins University, Georgetown University and the Doheny Eye Institute at the University of Southern California. He has received numerous grants and awards and has written more than 75 articles and chapters in peer-reviewed literature. He has written four major textbooks on diseases of the macula and retina. He is an examiner for the American Board of Ophthalmology. For more information, visit Hilton Head Macula & Retina at www.hhmr.org.

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