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AMD Awareness Could Save Your Vision

It’s that time of the year again. Each February, the optometric community bands together to create awareness about age-related macular degeneration (AMD). AMD is a leading cause of vision loss for people 50 years and older; early detection plays a key role in the outcome of the disease. That’s why bringing awareness to the disease and its risk factors is so important. 

Macular degeneration is a disease that damages the macula, which is a small area in the center of the retina responsible for sharp, clear central vision. The disease comes in two forms, wet AMD and dry AMD. The most common form, dry AMD, which affects around 80% of AMD patients, is when the macula gradually thins, and small clusters of protein called drusen begin to grow. Drusen result from cells in the macula that cannot rid themselves of metabolic waste called lipofuscin. The lipofuscin accumulates as drusen which causes a gradual vision decline. 

Dry AMD can turn into wet AMD when abnormal new blood vessels grow through breaks in a membrane layer of the thinning macula. The fragile blood vessels leak fluid into the macula, causing rapid decrease in central vision.The wet form is less common, yet it can cause a faster and more drastic vision loss. If a person has dry AMD which turns into wet AMD, this should be treated as soon as possible, as within days this can cause permanent scarring. Fortunately, there is effective treatment for wet AMD if detected before scarring arises. 

Both forms of AMD result in a loss of central vision, while peripheral vision stays intact. Symptoms can present as difficulty focusing on objects in front of you, or a blurred or dulled area in the central visual field which leads to having trouble reading, doing close work, driving or even recognizing faces. With time, the size of the blurred area can grow and eventually develop into black spots in central vision. Oftentimes patients don’t even notice symptoms until a significant amount of damage has been done. This is why regular eye exams are critical, especially if you are at risk. 

While AMD alone won’t cause complete blindness, it can cause a permanent, total loss of central vision if not treated. Vision loss can lead to a condition called low vision which can have a very serious impact on daily living and require a lot of assistance both by vision devices and the help of others. 

Are You at Risk? 

As it is an age-related disease, age is a significant risk factor for AMD, specifically once you reach 60. However, age is not the only risk factor. While some risk factors for AMD cannot be controlled there are lifestyle factors that you can change to prevent AMD.

Other than age, risk factors include:

  • Family history: If you have a family history of AMD, you are more at risk. Research has identified at least 20 genes that are associated with AMD, showing there is a genetic factor.
  • Race: Caucasian descent is a higher risk factor for AMD, and in fact, Caucasians with light irises have an increased risk from age 50.
  • Smoking: Smoking doubles your risk of developing AMD. 
  • Overweight/Obesity: Research shows that being overweight is a risk factor for AMD.
  • Having heart disease, high blood pressure and high cholesterol increase your risks.
  • Diet: An unhealthy diet rich in saturated fats is a significant risk factor.
  • Early exposure to UV light and blue hazard light (especially with the younger generation having increased exposure to digital devices) can cause early onset AMD. 

Here are some lifestyle steps you can take to reduce your risk of AMD:

  • Stop smoking
  • Eat a healthy diet rich in omega 3 fatty acids, (from fatty fish or flax seeds), leafy greens and colorful fruits and vegetables. 
  • Know your family history.
  • Exercise regularly.
  • Protect your eyes using UV protection and blue blocker coatings on eyeglasses.
  • Get regular eye exams.

In addition to a comprehensive eye exam, your doctor may be able to test for certain risk factors. For example, there is now technology available that can test for lutein levels via technology such as QuantifEye and Macuscope, (low lutein can indicate increased risk). In addition, genetic testing is also now available through a simple cheek swab to determine an individual’s risk for developing AMD. 

Treatment

There is no known cure for AMD, however there are treatments available that may slow the progression of the disease. For dry AMD, studies (AREDS and AREDS2) have concluded that a particular high-dose combination of nutritional supplements taken daily can slow the disease. The combo includes vitamins C and E, Lutein, Zeaxanthin, Zinc and Copper. For wet AMD, the goal is to reduce the growth of abnormal blood vessels and the leakage that takes place and this is done through certain medications called anti-VEGFs which are injected into the eye or with laser surgery. 

Untreated macular degeneration can have devastating effects on your independence and quality of life. If you are 50 or over, speak to your eye doctor about your risk factors and what you can do to prevent AMD. 

Handheld devices for low vision

Handheld Devices For Low Vision In New York

Traditionally any patient with a visual impairment from AMD, Glaucoma, Inoperable Cataracts, Retinitis Pigmentosa and the many other eye diseases that cause low vision, would choose a handheld telescope monocular for distance and a handheld magnifier for near vision.

The handheld telescopes are optical devices that magnify objects that are at a distance. These are used by low vision patients who perform a lot of activities that involve viewing objects at a distance.

In this blog, we will look at some of the handheld options available, as well as the pros and cons of handheld versus wearable low vision devices.

Hand-held telescopes –

This device is used with one eye and one eyepiece. Thus, it is also known as a telescopic monocular. Usually, it is used for just short viewing periods. Examples of where these can be used are reading signs on the street, house numbers, restaurant menus, prices at the grocery store, and aisle numbers at a store.Some advantages of using hand-held telescopes are:

Hand Held Magnifiers

These devices use magnification and many times built-in lighting to help with reading, sewing, painting, and other near vision tasks. Today there are also digital versions of the handheld magnifiers that not only offer crystal clear picture but also include many other advanced features such as contrast control.

Some of the advantages of handheld devices are.

  • They are portable and can be carried in your pocket using a cord.
  • They can be used for viewing distant items and objects that are fairly close.
  • They are inexpensive, although the higher quality digital devices are more expensive.
  • You can choose from a range of magnification powers.

Some disadvantages of these are:

  • Field of view is small
  • Not enough illumination for seeing bright images
  • Walking with it not recommended due to depth perception being affected
  • Need to be held with perfectly still hands, a near impossibility over time, making them only fit for short-term use.
  • They require carrying extra devices with you at all times.

What other options are there for a low vision patient?

Today there are innovations in low vision optics and technology all the time. From advanced digital glasses like Esight, OrCam to implantable telescopes like CentraSight, and telescopic or bioptic glasses, there are so many great options for a patient with impaired vision. If you are a low vision patient in New York City Or Long Island, speak to Dr. Schoenbart for a free phone consultation, where he will explain the many options available for a patient with vision loss.

 

Preventing Age-related Macular Degeneration

dad riding bike with daughter

February is AMD and Low Vision Awareness Month in the United States, and it’s White Cane Week in Canada. Age-related Macular Degeneration (AMD) is a leading cause of vision loss in adults aged 50 and older. Awareness about the disease, the risk factors and prevention are critical, even for younger generations because taking care of your eyes while you are young will help to reduce the risks later on in life.

Understanding AMD

AMD is a disease that damages the macula, which is the center of the retina responsible for sharp visual acuity in the central field of vision.  The breakdown of the macula eventually results in the loss of central vision and can occur in one eye or both eyes simultaneously. While AMD doesn’t result in complete blindness, the quality of vision is severely compromised leading to what we refer to as “low vision”.

The loss of central vision can interfere with the performance of everyday tasks such as driving, reading, writing, cooking, or even recognizing faces of friends and family.  The good news is, there are many low vision aides on the market now that can assist in helping you to perform these tasks. 

There are two types of AMD, wet and dry.

Dry AMD is the most common form of the disease. It is characterized by blurred central vision or blind spots, as the macula begins to deteriorate. Dry AMD is less severe than the wet form, but can progress to wet AMD rapidly.

Wet AMD is when abnormal blood vessels begin to grow under the retina and leak fluid and blood into the macula, causing distortions in vision. Wet AMD can cause permanent scarring if not treated quickly, so any sudden blur in vision should be assessed immediately, especially if one is aware that they have AMD.

Are You at Risk?

The biggest risk factor for AMD is age. Individuals over 60 are most likely to develop the disease however it can occur earlier.  Additional risk factors include:

  • Smoking: According to research smoking can double the risk of AMD.
  • Genetics and Family History: If AMD runs in your family you are at a higher risk. Scientists have also identified a number of particular genes that are associated with the disease.
  • Race: Caucasians are more likely to have AMD than those from Hispanic or African-American descent.
  • Lifestyle: Obesity, high cholesterol or blood pressure, poor nutrition and inactivity all contribute to the likelihood of getting AMD. 

Prevention of AMD:

If you have risk factors, here is what you can do to prevent or slow the progression of AMD:

  • Regular eye exams; once a year especially if you are 50 or over.
  • Stop smoking.
  • Know your family history and inform your eye doctor.
  • Proper nutrition and regular exercise: Research indicates that a healthy diet rich in “Eyefoods” with key nutrients for the eyes such as orange peppers, kale and spinach as well as regular exercise may reduce your risks or slow the progression of AMD.
  • Maintain healthy cholesterol levels and blood pressure. 
  • Dietary supplements: Studies by the National Eye Institute called AREDs and ARED2 indicated that a high dosage of supplements of zinc, vitamin C, vitamin E and lutein may slow the progression of advanced dry AMD (it is not recommended for those without AMD or early AMD).  Speak to a doctor before taking these supplements because there may be associated risks involved. 
  • Wear 99% -100% UV-blocking sunglasses.

The first step to eye health is awareness. Help us to spread the word about this debilitating disease and the importance of choosing a healthy lifestyle.