Macular Degeneration: 9 Things Eye Doctors Want You to Know

  • Macular Degeneration Affects Central Vision
    Age-related macular degeneration (AMD) is the leading cause of blindness among Americans over 50. It damages the center of the retina, or macula, affecting your central vision. This is your ability to see what's right in front of you, such as faces or words you're trying to read. About 2.1 million people in the United States have AMD. That number is likely to hit 3.5 million by 2030 and 5.4 million by 2050, as our population ages. We talked to ophthalmologists to find out what you need to know about AMD symptoms and treatment.




  • 1. "The older you get, the greater your chances of getting macular degeneration."
    “Your greatest risk factor for AMD is living longer,” says Dr. Catherine Blume Meyerle, an ophthalmologist at Johns Hopkins' Wilmer Eye Institute. "Usually people are 60 or older when they are first diagnosed with the condition,” she says. The numbers go up as people get into their 70s, 80s and beyond. Other risk factors include having a family history and ethnicity. "It's more likely to affect Caucasians and whites—those with lighter pigmentation, who are fair, with blue eyes. These risk factors predispose you to AMD, but don’t necessarily mean you will get it," she says.




  • 2. "Stop smoking—it can save your eyesight."
    You can't do anything about your age or genetic make-up. But you can change your behavior. And one behavior that's linked to AMD is smoking. "Smoking is the main modifiable risk factor we know about that contributes to macular degeneration," says Dr. Mark Michels, MD, an ophthalmologist and founding partner at Retina Care Specialists in Florida. "Smoking is very detrimental for your retina," adds Dr. Meyerle. "Your retina is highly metabolic tissue that requires a lot of oxygen. Smoking interferes with that."




  • 3. "Eat plenty of leafy green vegetables, blueberries, and fish."
    “The other way to reduce your chances of developing macular degeneration—or slowing its progression—is to eat the right foods,” says Dr. Meyerle. "Multiple nutrition studies have found people with better nutrition have a lower risk of macular degeneration," she says. She recommends getting lutein—a key antioxidant for retinal health—by eating blueberries and leafy greens like spinach, kale and arugula. Fish oil is also important. “People need to eat fish. Supplements haven't been shown to help,” she says. Dr. Meyerle advises people with intermediate AMD to take "AREDS 2" supplements—a mix of antioxidants and vitamins.




  • 4. "Macular degeneration comes in two types—dry and wet."
    “Most people with macular degeneration—at least 80%—have the dry type,” says Dr. Michels. “This type happens when cells in the middle of the retina degenerate,” he says. “In advanced stages, this can result in atrophy and loss of central vision. The wet type occurs when there is bleeding and fluid from blood vessels under the retina, which causes more rapid loss of vision. About 90% of blindness from macular degeneration occurs in the wet form of the disease.”




  • 5. "Blurry vision can be a symptom of macular degeneration."
    “Early-stage macular degeneration may have no warning signs. You'll only find you have it with a comprehensive eye exam, which people should have starting at age 40,” says Dr. Meyerle. But there are macular degeneration symptoms you should know about. “For early or intermediate AMD, you may notice blurred, cloudy, distorted or central smudging of vision,” says Dr. Michels. “Signs of advancing AMD include straight lines starting to look wavy," says Dr. Meyerle. “Blind spots in your vision are another sign,” she says. “It’s like something is blocked out."




  • 6. “Test your eyes at home to make sure you aren't developing wet AMD."
    “Sometimes, dry AMD converts to the more severe wet form. This unwelcome change can happen quickly,” says Dr. Michels. “Easy at-home tests can catch this, such as the Amsler grid. These intersecting lines on a piece of paper or computer screen will appear wavy or smudged if AMD is worsening. It’s about 60% accurate,” says Dr. Michels. “A new computerized device—ForeSee—is more expensive but about 85% effective. And Medicare covers it.” “Or, look at windowpanes or blinds to check your perception of straight lines,” suggests Dr. Meyerle. If any of these tests show problems, see your ophthalmologist right away.




  • 7. "Newer treatments for wet AMD have helped save vision for many patients."
    “Thermal laser eye surgery and cold laser therapies used to be common AMD treatments,” says Dr. Michels. “Over the past decade, however, we have largely replaced these procedures with drugs injected painlessly into the whites of the eyes—usually every month or two, for the rest of a patient's life. We occasionally still use cold laser for someone who doesn't respond to injections, but those are few and far between," he says. “People used to go blind from wet AMD much more frequently before we had these injections," says Dr. Meyerle. “Unfortunately, there is no treatment for advanced dry AMD,” she says.




  • 8. "Even in the worst-case scenario, you will still have some sight."
    "People never go completely blind with macular degeneration," says Dr. Michels. "I tell people I don't have a single seeing-eye dog in my practice." Treatment and early intervention help more patients today, so fewer reach advanced stages of vision loss. “But even for those who do suffer impairment,” he points out, “their peripheral vision should still be healthy, allowing them to get around a room and find their way."  Dr. Meyerle agrees, noting she tries to reassure her patients who fear blindness that even if the disease reaches its worst stage, they will retain some vision.




  • 9. "More treatments are being developed that could help even more people with AMD."
    Researchers continue to work on improving treatment for macular degeneration. Dr. Meyerle notes that new delivery systems for the medication doctors currently inject into the eyes are under development, as well as longer-lasting drugs. This means people can avoid having to trek to the doctor for monthly shots. Clinical trials also are taking place for new drugs to treat advanced dry AMD, for which there is currently no treatment. "So that's pretty exciting," he says.




Macular Degeneration Facts | Things Eye Doctors Want You to Know

  1. Age-Related Macular Degeneration (AMD). National Eye Institute. https://nei.nih.gov/eyedata/amd

  2. Amsler Grid. Macular Degeneration Partnership. http://www.amd.org/the-amsler-grid/

  3. Facts About Age-Related Macular Degeneration. National Eye Institute. https://nei.nih.gov/health/maculardegen/armd_facts

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Last Review Date: 2019 Mar 8
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