How to manage and treat age-related macular degeneration

Age-related macular degeneration (AMD) is a common condition in older people, affecting almost one in 20 over the age of 65 in the UK. Around 600,000 people across the UK currently live with AMD.

Understanding what AMD is, how you can spot the warning signs and what you can do to slow its progression is key. While there is no cure for AMD, early diagnosis could help you keep your vision healthy for as long as possible.

What is age-related macular degeneration?

AMD is a condition that affects the macula, the central part of your retina — a layer of tissue that detects light and sends this information to your brain. Much like other areas of your body, ageing can affect the health of your macula. Over time, changes in the blood supply and structure of your macula can cause vision problems. 

Changes to your macula specifically cause issues with your central vision. Your central vision refers to when you are looking straight ahead at something, such as when you’re driving or reading. AMD can cause blurred or distorted vision, and eventually, as the disease progresses, blind spots. 

AMD doesn’t affect your peripheral vision, so even in advanced cases, it doesn’t result in a total loss of sight. 

AMD can come on slowly or quite suddenly, depending on which of the two types you have. 

Dry age-related macular degeneration

Dry AMD is the most common type of AMD and develops slowly. Often, people with dry AMD in just one eye won’t notice any changes to their eyesight for a while as their healthy eye will compensate for the change. This is why testing and regular eye examinations are important. 

Dry AMD is caused when cells in the macula become damaged. This can be caused by disturbances in cells in the macula that contain pigment and the build-up of yellow, fatty deposits in the macula called drusen. 

Symptoms include:  

• A blurry or blind spot
• Decreased brightness of colours
• Difficulty recognising faces
• Difficulty adapting to low light levels
• The need for brighter light when reading
• Visual distortions, such as straight lines looking bent

Dry AMD progresses slowly, usually over several years, and has very few early symptoms. The Amsler Grid test can help you spot any irregularities in your sight, which is key to an early diagnosis.

Wet age-related macular degeneration

Wet AMD tends to affect vision faster than dry AMD but is less common. It is a more severe form of AMD and can cause a sudden and drastic change in your eyesight.

It’s caused by blood vessels growing into the macula and leaking blood or fluid. This distorts your vision, which can cause sudden blurriness or blind spots in your central vision.

What are the risk factors for AMD?

There are several risk factors that may increase your chances of developing AMD. Some can be avoided with lifestyle changes.

Risk factors include:

• Age — AMD is most common in those aged over 60
• Being overweight
• Family history — AMD can run in families
• Heart disease — diseases that affect your heart and blood vessels can increase your risk
• Smoking 

How do you diagnose AMD?

While you can use the Amsler Grid Test to see if there are any issues with your eyesight that could be caused by AMD, you will need to see an ophthalmologist (a doctor specialising in eye health) or an optometrist for a definitive diagnosis. 

Testing for AMD is painless and non-invasive. A retinal angiogram, where a picture is taken of the blood vessels and other structures of your retina, and a 3D retinal scan will provide a comprehensive view of your retina. Your ophthalmologist can therefore see if your macula has been damaged or if there is another eye disease that needs to be treated. 

How do you treat AMD?

While there is no cure for AMD, there are ways that you can slow its progression so you can preserve your vision for longer. 

For dry AMD, lifestyle changes can help. Make sure you: 

• Eat a balanced diet
• Get other eye conditions treated
• Have regular eye tests
• Maintain a healthy weight and exercise regularly
• Protect your eyes from the sun
• Stop smoking

There is some evidence that certain health supplements, specifically antioxidant vitamins and minerals, could help slow down the progression of AMD.

When it comes to treating wet AMD, lifestyle changes are still a good idea, but you will also need medical treatment. This form of AMD requires drugs to be injected into the affected eye every four to six weeks to slow down the disease and preserve your vision for as long as possible. 

Living with AMD

Being diagnosed with AMD doesn’t mean that you can’t carry on doing the things you love. With regular treatment and/or lifestyle changes, you can preserve your vision for years to come. 

There are support networks available to help you cope with AMD and improve your overall wellbeing.