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Macular Degeneration

What is AMD? Treatment options for AMD
The Forms of AMD Tips for living with AMD
What causes AMD? Support Groups
Eye doctors, exams, and tests

Macular DegenerationWhat is AMD?
Age-related macular degeneration (AMD) is a chronic condition that causes central vision loss. It occurs when the macula-the part of the retina that lets you see color and fine detail-becomes damaged.

The Forms of AMD
Dry AMD occurs when cells under the macula break down and create deposits called drusen. It is this drusen that can make you lose some vision. Dry AMD usually develops slowly over time, with few symptoms until it reaches an advanced stage.

Some advanced dry AMD symptoms may include:

  • Brighter light needed when doing close work
  • Print appearing more and more blurry
  • Colors appearing less bright
  • Hazy vision
  • A blind spot in the center of your vision

Macular DegenerationWet AMD is a very serious form of AMD-more serious than dry AMD-and it can progress very quickly. Although only 10% of people with dry AMD will get wet AMD, it is a major cause of central vision loss in adults.

Wet AMD occurs with the abnormal growth of blood vessels in the back of the eye. As the blood vessels grow, they can leak blood and fluid, which damage the macula.

Wet AMD is a major cause of central vision loss in Americans aged 55 and older, affecting more than a million men and women.

Wet AMD symptoms may include:

  • Visual distortions, such as:
  • Straight lines or faces appearing wavy
  • Doorways seeming crooked
  • Objects appearing smaller or far away
  • General decrease in central vision
  • A central blurry or blind spot

AMD can occur in 1 eye, or both. If you have AMD in 1 eye, it's important to carefully monitor the other. That's because there's a good chance you will develop AMD in both eyes. Early detection can give you the best chance for success in treating AMD.

What causes AMD? The exact cause of AMD is not known. But there are a number of risk factors that may play a role. These risks include:

  • Age. AMD is a major cause of central vision loss in Americans aged 55 and older
  • Family history/Genetics. If AM D runs in your family or you have a certain abnormal gene, you may have a higher risk
  • Gender. Women are more likely to get macular degeneration
  • Smoking. Cigarette smoking significantly increases the risk of macular degeneration
  • Cardiovascular diseases. High blood pressure, stroke, heart attack, and heart disease with chest pain increase the risk of AMD
  • Obesity. Being severely overweight increases the chance that early or intermediate macular degeneration will progress to the more severe wet form
  • Low levels of nutrients. Low levels of minerals such as zinc and vitamins A, C, and E may increase the risk of AMD
  • Race. Macular degeneration is more common in Whites than any other race

Eye doctors, exams, and tests
When it comes to examining and treating vision, there are a few types of eye doctors. If you have vision problems, you may visit a more specialized eye doctor, like an ophthalmologist or a retina specialist. Below are a few of the different doctors and what they do.

Optometrist - If you wear eyeglasses or contact lenses, it's likely that you've gone to an optometrist (OD). Optometrists are doctors of optometry who perform routine eye exams, prescribe corrective lenses, and help to diagnose vision disorders and eye diseases. When more specialized retina care is needed, as in macular degeneration, an optometrist will likely refer you to an ophthalmologist or retina specialist.

Ophthalmologist - An ophthalmologist is a medical doctor (MD) who specializes in diseases and surgery of the eyes. Ophthalmologists are specially trained to provide a wide range of eye care, from prescribing glasses and contact lenses to complex eye surgery. An ophthalmologist may be the eye doctor that tells you that you have AMD. If you have wet AMD, he or she will likely refer you to a retina specialist for additional exams and possible treatment.

Retina specialist - A retina specialist is an ophthalmologist who has completed additional training with parts of the eye like the retina and other areas in the back of the eye. They commonly treat people with diabetic eye disease and macular degeneration. If you know or think you have wet AMD, it is important to see a retina specialist in order to receive the latest and most appropriate care.

If you've noticed changes in your vision that seem like symptoms of wet AMD, talk to your eye doctor or make an appointment with a retina specialist. He or she will perform 1 or more of the following tests on your eyesight:

  • Visual acuity test- the Snellen eye chart - This chart measures how well each eye can see. The further down you see on the eye chart (the smaller letters), the better your vision
  • Amsler grid - this looks like a checkerboard with a black dot in the middle. Cover 1 eye and stare at the dot. Then repeat with the other eye. If the grid seems blurry or wavy, tell your eye doctor
  • Dilated eye exam - Drops are used to dilate your eyes. Then, using a special lens, your eye doctor looks at the back of your eye for damage
  • Tonometry - First your eye is numbed. Then, a small sensor is placed on the surface of your eye to measure the pressure inside your eye
  • Fluorescein angiography (FA) - For this test, a dye is injected into your arm. Using a special device, your eye doctor can track this dye to locate any abnormal blood vessels in your eye
  • Optical coherence tomography (OCT) - This test uses light waves to make a picture of your retina, allowing your eye doctor to see any abnormal blood vessel growth

Treatment options for AMD
With early diagnosis and proper treatment, the progression of AMD may be delayed. However, for some people, damage caused by AMD can't be reversed. Your retina specialist will determine the course of treatment that is best for you.

Available treatments include:

  • Injections given into the eye. These are commonly called intravitreal injections. Your eye will be numbed prior to the injection. Then you may feel some pressure when receiving the injection. These injections target the abnormal growth of blood vessels in the eye that cause wet AMD
  • Hot laser treatment. A hot laser is beamed into the eye to burn away the abnormal blood vessels
  • Photodynamic therapy (PDT). A combination of a light- sensitive drug and a cold laser to "shut off" abnormal blood vessels
  • Preventative measures. Studies have shown that a daily supplement, such as vitamins A, C, E and beta-carotene, zinc, and copper, may reduce some risks of developing severe AMD. Talk to your doctor before taking any supplements

Tips for living with AMD There are ways to cope with AMD. Ask your eye doctor if there is a low-vision center in your area. A few simple changes can help you cope with low vision.

For general AMD information:
AMD Alliance International
Toll-free: 1-877-AMD-7171
Web: www.amdalliance.org
Alliance for Aging Research
Phone: 1-202-293-2856
Web: www.agingresearch.org
For detailed information on AMD, treatment options, and support:
EyeCare America
Toll-free: 1-800-222-EYES
Web: www.eyecareamerica.org
Lighthouse international
Toll-free: 1-800-334-5497
Web: www.lighthouse.org
Macular Degeneration Partnership
Toll-free: 1-888-430-9898
Web: www.amd.org
Foundation Fighting Blindness
Toll-free: 1-888-394-3937
Web: www.blindness.org
Macular Degeneration Support
Phone: 1-816-761-7080
Web: www.mdsupport.org
For information for caregivers, family, and friends:
National Alliance for Caregiving
Web: www.caregiving.org
National Family Caregivers Association
Toll-free: 1-800-896-3650
Web: www.thefamilycaregiver.org
National Council on Aging
Phone: 1-202-479-1200
Web: www.ncoa.org
Blinded Veterans Association
Toll-free: 1-800-669-7079
Web: www.bva.org
Prevent Blindness America
Toll-free: 1-800-331-2020
Web: www.preventblindness.org