Living Well

Are You at Risk of Going Blind?

Losing my eyesight as I get older is one of my biggest fears...

Without good vision, I could lose the ability to drive, read, and even recognize the faces of my loved ones.

For folks over the age of 65, the leading cause of vision loss is "age-related macular degeneration" (AMD). About 15 million Americans have some form of macular degeneration – and in many cases, it results in blindness.

AMD is an eye disease that damages the macula – the part of the eye that provides central vision. It's the part of the eye that gives you the ability to read and drive. It's located in the back wall of your eye... in the center of the retina.

There are two types of AMD – "wet" and "dry" macular degeneration. They can damage eyesight in one or both of your eyes.

Wet macular degeneration is the more severe – and thankfully, less common – form. Blood and fluid build up between the retina and the macula... causing the macula to lift from its normally flat position. This is what distorts your vision. The onset of wet macular degeneration is rapid and often happens in people who already suffer from dry macular degeneration. However, the cause isn't clear.

Dry macular degeneration represents about 85%-90% of AMD cases. It gets its name because the macula dries out, causing the loss of vision. Unlike wet macular degeneration, there is no swelling or blood leaking involved.

But as I mentioned, dry macular degeneration can become wet macular degeneration. And the symptoms are similar... including needing brighter light to see clearly, blurriness while reading, a blind spot in the central field of vision, straight lines appearing wavy, and seeing a decreased intensity of colors.

There are three stages of dry macular degeneration: early, intermediate, and advanced.

Early AMD involves getting small deposits in the eye (called drusen). And there may not be any other symptoms or vision loss.

People in the intermediate stage could have medium-sized or a few large drusen in the eye. While there still may not be any symptoms, some people might experience blurriness in their central vision or need more light to read.

Once people are in the advanced stage of dry macular degeneration, the drusen are large. There will also be a big dark spot in your central vision that can grow and darken over time.

Like many other diseases, there are several risk factors that make you more likely to develop AMD:

  • Age – Most people with AMD are 60 and over
  • Smoking
  • Race – Caucasians have a higher risk of AMD than other races
  • Family history
  • Obesity
  • High blood pressure
  • Gender – Women are more likely to develop AMD.

Your eye doctor has several ways to test you for AMD.

One is by examining the back of your eye. Your doctor dilates your eye to see the back part, looking for yellow drusen deposits. He can also test your central vision using various grids. You could have AMD if any of the lines on the grid are faded, broken, or distorted.

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Another test is an angiogram that uses a colored dye to highlight abnormalities in the blood vessels in your eye. There's also optical coherence tomography (OCT). This imaging test can find thinning or thickening of areas around the retina – which can indicate either wet or dry macular degeneration.

If you have these sorts of symptoms, you should see your doctor. And if they came on rapidly, you may have wet AMD... make an urgent appointment.

Currently, there's no cure for wet or dry AMD. But there are treatments to slow the progression...

Medications injected into your eye shrink blood vessels, allowing the fluid to re-absorb. This can help the retina heal and improve some vision loss. Laser light therapy and photodynamic therapy use light to destroy the leaky blood vessels. These treatments stop the disease's progression.

There's also an implant called an implantable miniature telescope that magnifies images to reduce the size of the blind spot. This is intended for folks who haven't responded to other treatments.

There are treatment options for dry macular degeneration, as well. The National Eye Institute recommends a combination of nutrients to improve vision for people in the intermediate stage of AMD. Interestingly, the randomized controlled trial using supplements for AMD is one of the few trials that has shown any benefit using supplements in human diseases.

The nutrients that slow progression are vitamins C and A, beta carotene, and zinc. Longtime readers known I'm usually skeptical of taking large doses of any one vitamin... But for AMD, this works. And the doses are relatively small.

So... how can you prevent AMD? Do what I do...

  • Have a routine eye exam with an ophthalmologist (an eye doctor) after you turn 55 years old to check for any signs. They have M.D. after their names. (Optometrists do not.)
  • Exercise regularly (three to four times a week, even if it's just walking for 20-30 minutes).
  • Eat fruits and dark-colored vegetables... Carrots, broccoli, berries, and leafy greens all contain eye-healthy nutrients.
  • Eat foods with tons of omega-3s (like fish and nuts).

Follow these four steps to give your eyes the best care possible. And if you already have AMD, ask your doctor about these treatment options.

What We're Reading...