What is ARMD?
Age-related macular degeneration (ARMD) is a deterioration or breakdown of the eye macula leading to a blurring of the central vision. The primary cause of macular degeneration is ageing, hence the name.
The macula is that part of the retina which controls sharp, straight-ahead vision. When the macula degenerates, minute tasks like reading, threading a needle, etc., becomes difficult. Although the macula makes up only a tiny part of the retina, it is much more sensitive to detail than the rest (called the peripheral retina). The peripheral retina gives you side (or peripheral) vision. If someone is standing on your one side, your peripheral retina will register it by allowing you to see their general shape.
Many older people develop macular degeneration as part of the natural ageing process. There are different kinds of macular problems, but the most common is age-related macular degeneration.
Intravitreal Injection
How does macular degeneration happen?
As we grow old, our eyes begin to accumulate deposits known as drusen under the macula. In other cases, there is an abnormal growth of blood vessels under the retina. These phenomena cause damage to the macula resulting in blurred vision. With or without treatment, macular degeneration alone rarely causes total blindness. People with more advanced cases of macular degeneration continue to have some amount of eyesight using their peripheral vision. While in some cases, there is a minimal impact due to macular degeneration. Macular degeneration usually begins in just one eye and gradually affect the other eye. People are not aware of their macular degeneration till they undergo an eye examination or develop a noticeable vision problem.
No one knows what causes dry macular degeneration. But research indicates it may be due to a combination of heredity and environmental factors, including smoking, obesity, and diet.
What are the different types of Macular Degeneration?
There are two types of ARMD:
Dry macular degeneration (also known as atrophic ARMD) is a common eye disorder among people over 50. It causes blurred or reduced central vision due to thinning of the macula. Macular degeneration usually begins when tiny yellow or white pieces of fatty protein called drusen form under the retina. Eventually, the macula may become thinner and stop working.
Dry macular degeneration may first develop in one or both eyes and affect both eyes. Over time, your vision may worsen and affect your ability to do things, such as read, drive, and recognize faces. But this doesn't mean you'll lose all your sight. Vision loss is typically central, and people retain their peripheral vision. Some people have only mild loss of central vision, while it can be more severe in other cases. Early detection and self-care measures may delay vision loss due to dry macular degeneration.
Most people have dry macular degeneration. With dry macular degeneration, vision loss is usually gradual. People who develop dry macular degeneration must carefully and constantly monitor their central vision. If you notice any changes in your vision, you should tell your ophthalmologist right away. The dry form can change into the more damaging macular degeneration called wet (exudative) macular degeneration. While there is no medication or treatment for dry macular degeneration, some people may benefit from Vitamin therapy.
Dry macular degeneration symptoms usually develop gradually and without pain. They may include:
- Visual distortions, such as straight lines seeming bent
- Reduced central vision in one or both eyes
- The need for brighter light when reading or doing close-up work
- Difficult to adjust to low light levels, such as when entering a dimly lit restaurant
- Increased blurriness of printed words
- Decreased intensity or brightness of colours
- Difficult to recognize faces
- A well-defined blurry spot or a blind spot in your field of vision
Wet macular degeneration occurs when abnormal blood vessels begin to grow underneath the retina from the choroidal layer region. These new blood vessels tend to leak fluid or blood, causing blurred vision or distortion of central vision.
Vision loss from this form of macular degeneration may be faster and more noticeable than dry macular degeneration.
The longer these abnormal vessels leak or grow, the more risk of losing more of your detailed vision. Also, if abnormal blood vessel growth happens in one eye, there is a risk that it will occur in the other eye. The earlier the wet macular degeneration gets diagnosed and treated, the better chance you have of preserving some or much of your central vision.
What are the symptoms of ARMD?
The symptoms of ARMD depend on the stage. Dry ARMD develops in 3 stages-early, intermediate, and late. ARMD is a progressive disease — which means symptoms usually worsen over time.
In early and intermediate dry ARMD, there are no noticeable symptoms.- Early mild symptoms include blurriness in the central vision or trouble seeing in low lighting.
- In the late stage of ARMD (wet or dry type), many people notice that straight lines start to look wavy or crooked. You may also notice a blurry area near the center of your vision. Over time, this blurry area may get bigger, or you may see blank spots. Colours may also seem less bright than before, and you may have more trouble seeing in low lighting.
- Straight lines looking wavy is a warning sign for late ARMD. If you notice this symptom, see your eye doctor right away.
When do you need to see an eye doctor?
If you notice any changes in your central vision and have difficulty in seeing colours and fine details or if you are over 60 years, it is time to check for ARMD.
People with a family history are more likely to develop ARMD. People who smoke, have heart-related problems or are overweight have a higher chance of developing ARMD.
How is ARMD Diagnosed?
During an eye examination, the doctor may ask you to look at an Amsler grid. This grid helps you notice any blurry, distorted, or blank spots in our field of vision. The doctor will also examine your eyes through a camera lens. The doctor can see if there are changes in the retina and macula.
Maa Nursing Home and NetraJyoti Eyecare Centre has advanced Optical Coherence Tomography (OCT). This machine helps to look closely at the retina. It scans the retina and provides very detailed images of the retina and macula.
Another advanced diagnostic technique is Optical Coherence Tomography Angiography (OCTA) to look closely at the blood vessels in and under the retina. It is like fluorescein angiography but does not use a dye. This procedure is also available at our Centre.
How is ARMD treated?
Maa Nursing Home and NetraJyoti Eyecare Centre offers an array of treatment, depending on the type and stage of the eye disease.
- Anti- VEGF injections help to reduce the number and the leaking of abnormal blood vessels under the retina.
- LASER therapy (surgery): Some types of Wet ARMD can be treated with this surgery. The surgeon shines a laser light beam on the abnormal blood vessels. It reduces the number of blood vessels and slows their leaking.
- Photodynamic therapy: In some patients,the doctor may use a combination of Anti-VEGF injections and LASER treatment to block the leak and reduce the growth of vessels. This treatment is known as photodynamic therapy.
- Nutritional Supplement –The doctor will prescribe you nutritional supplements which contain vitamin C and E, Beta carotene, zinc, and copper.
How do you prevent ARMD?
It is important to have routine eye examinations to identify early signs of macular degeneration.
Research proves that you may be able to lower your risk of ARMD (or slow vision loss from ARMD) by making these healthy choices:
- No smoking
- Get regular physical activity
- Maintain healthy blood pressure and cholesterol levels
- Eat healthy foods, including leafy green vegetables and fish