People rarely lose all their vision from age-related macular degeneration and it doesn’t always affect both eyes. The peripheral areas of the visual field remain unaffected so to a degree, this allows patients to adapt to the condition.
The sufferer may have poor central vision but even in advanced stages of the disease you will still be able to use peripheral vision to compensate by looking to the side of the visual field rather than making use of the direct line of sight.
Treatment for AMD should be sought as soon as a problem is recognised as this will reduce the risk of further deterioration of sight.
Dry macular degeneration tends to develop gradually and causes no pain. While no one knows exactly what causes the condition, it has been linked to heredity and environmental factors, like diet and smoking. In some cases, dry macular degeneration can progress into wet macular degeneration. Unfortunately, there is still no treatment for dry macular degeneration although we would recommend regular check ups to monitor progress.
Wet macular degeneration is caused by the growth of abnormal blood vessels within the retina, leading to a build-up of fluid, bleeding and scarring. Wet AMD can cause serious visual loss in a much shorter space of time than dry AMD, sometimes within a few months.
The cause of the condition isn’t known but there are some commonly identified risk factors. Smoking, high blood pressure, obesity and genetic factors all play a part in AMD both in its presentation and development.
The physiological cause of the disease differs between wet and dry AMD.
Dry AMD is caused by a build up of a fatty substance on the back of an eye. Onset of the condition is slow as the fatty residue increases. There is usually no treatment available for dry AMD, however, visual aids are available to manage the impact of dry AMD on life such as magnifying glasses, bold print books and special lighting.
Wet AMD is caused by the growth of abnormal blood vessels on the back of the eye. Onset is much quicker, a matter of days or weeks. In Wet AMD, treatment is possible to reduce the worsening of vision.
If you suddenly develop blurred vision or distortion in your vision you could be suffering from MD.
Anti-angiogenic injections are given directly into the eyes to stop vision getting worse. The most common and effective treatment for wet macular degeneration is known as anti-VEGF (vascular endothelial growth factor) theory. This is an injection of a drug into the eye that controls the build-up of fluid under the retina. In normal patients, VEGF is a healthy molecule which promotes the growth of blood vessels.
However, when the VEGF works less effectively, new blood vessels in the choroid layer (behind the retina) are weaker and so leak into the retinal layers.
The injections prevent new blood vessels from forming and blocks leaking that occurs from already formed abnormal blood vessels. Injections are effective on 90% of people and causes an improvement in vision for 30% of people.
At Vision Scotland, anaesthetic drops are administered before the eye is injected. These drops number the eye so treatment is painless and without discomfort. There are a few side effects associated with these injections such as bleeding, irritation and redness. Injections are usually given every few months for as long as they are helping.
Photodynamic therapy involves a light being shined at the back of the eye to destroy abnormal blood vessels that cause wet AMD. It may be recommended alongside eye injections. Photodynamic therapy can be repeated every few months and side effects can include temporary vision problems, eye and skin sensitivity and sensitivity to light for a few days or weeks.
Without treatment, vision will gradually get worse. The type of AMD one has (wet AMD or dry AMD) affects the speed of onset of the condition. With wet AMD, deterioration can occur relatively quickly, whereas the changes are usually more gradual in dry AMD.