When thinking about our five senses, almost everyone will say that they are all essential to fully appreciate life. But if you are to ask me what is the most important among the five, I would probably say the sense of sight. If you lose your sense of smell, you can still appreciate your food if you can see it. You can make yourself feel and stay safe if you see where you are going, even without speaking or hearing anything. So, I can just imagine how difficult it is to have a vision problem, like age-related macular degeneration. What is this disease affecting the eye, and what can we do to treat and prevent age-related macular degeneration? Even though some diseases might be hereditary, this one seems to be related to the age.
Age-related macular degeneration: How do we see?
Before knowing what age-related macular degeneration is, we have to understand how our eyes process what we see. Our sense of sight starts with light passing through a part of our eye called the cornea acting as the windows of our eyes. Another part of the eye controls how much light enters, and this is called the pupil. As light passes, the lens behind the pupil and iris (the colored part of the eye surrounding the pupil) bends and sends the image we are looking at to the retina, a light-sensitive tissue at the back of the eye. The retina then transmits the light and converts it into signals that should be passed to the brain for processing. This cycle goes on and on.
What is age-related macular degeneration?
In age-related macular degeneration (AMD), the macula or a small part at the center of the retina begins to wear down as we age, hence the name. The macula is responsible for the narrow angle of our sight, allowing us to see the specific points of a picture, like a face, the letters to a book, the flower in the garden, etc. Once this part of the retina is damaged, the images we perceive becomes distorted or blurry, making it difficult for us to appreciate what we see fully.
People over the age of 50 have a very high possibility of developing this eye disease. In fact, its potential to develop increases as you age. Studies show that one out of five people aged 50 and one out of four people aged 60 and above have signs and symptoms of age-related macular degeneration (AMD).
Kinds of age-related macular degeneration
Dry age-related macular degeneration (Dry AMD) is when parts of the macula get thinner with age, and tiny yellow clumps of protein deposits called drusen start to grow. As these deposits grow more prominent with time, you slowly lose central vision because the light-sensitive cells in the macula die. The dry form is the more common type of AMD.
Wet age-related macular degeneration (Wet AMD) is when instead of the development of protein deposits, blood from the vessels that are situated at the back of the macula burst and floods your retina. The presence of blood interrupts the light passage, distorting the image you need to transmit to the brain. The worst part of this is when the bleeding starts to develop scarring in the retina, causing an irreversible and permanent vision loss.
How do I know I have age-related macular degeneration (AMD)?
AMD is a progressive vision problem and the leading cause of vision loss. During its first appearance, it is difficult for a patient to decipher any symptom as your vision can still feel and look normal. But as the macula starts ‘degenerating’, you would notice some dark, blurry parts of your vision suddenly appearing, faces or details of a picture looks distorted, and reading may be more difficult than before.
How to diagnose and treat AMD
Ophthalmologists are the eye disease expert doctors who use several tests to determine the type and stage of macular degeneration a patient has.
Amsler grid. This procedure uses a piece of paper with grid patterns forming small equal squares with a single black dot in the middle. A patient with AMD may notice that if he focuses his sight on the dot, some lines of the squares become wavy or curved.
Fluorescein angiography. This test uses a yellow dye injected into a vein, which is expected to travel along the vessels around the body. Using a special camera, the doctor takes pictures of the retina, and the blood vessels surrounding it to figure out is abnormal blood vessels are developing near the macula, which may create the blockage.
Optical coherence tomography (OCT). Another way to visualize the retina and macula to determine if bleeding or protein deposits are present that may signal AMD.
Treatment of AMD
There is no definite way to treat AMD. However, based on the type of AMD you may have, your ophthalmologist may prescribe taking supplements so that the degeneration slows down, and the symptoms would not progress at an alarming rate.
Dry AMD. Patients with protein deposits as the cause of AMD may be recommended to increase their intake of Vitamins A, C, E, Minerals like zinc and copper, as well as lutein and zeaxanthin.
Wet AMD. Eye specialists who discover that abnormal blood vessels surrounding the retina cause AMD would recommend patients to take anti- Vascular endothelial growth factor (VEGF), a drug that prevents the development of new blood vessels. They can also recommend undergoing laser surgery that reduces the blood vessels that leak on your macula.