By Kimberly Goad, AARP Oct 2022
Whether wet or dry, these symptoms warrant a visit to an eye doctor. You can ward off plenty of health conditions by looking out for early warning signs. But that’s not possible with age-related macular degeneration (AMD), the leading cause of vision loss in people over 50. That’s because there are no warning signs in the early stages.
“Age-related macular degeneration is a disease that can be insidious, often with symptoms coming on slowly over years,” says Michelle Andreoli, M.D., an ophthalmologist at Northwestern Medicine and spokesperson for the American Academy of Ophthalmology. “The slow onset of symptoms can lead to advanced disease before patients are aware of the change.”
AMD, which affects 11 million people in the United States, is a progressive eye disease that affects the central vision and, as a result, the ability to see fine details. If you have advanced AMD, it’s all but impossible to drive, read, watch TV or recognize faces.
There are two types of AMD: dry and wet. The overwhelming majority of people with the disease have dry AMD. With the dry form, parts of the macula — located at the center of the retina, the light-sensitive tissue at the back of your eyes — become thin over time and tiny clumps of protein called drusen grow, gradually blurring your central vision. Any stage of dry AMD can turn into the wet form, but the reverse isn’t true; wet AMD is always late stage.
With wet AMD, abnormal blood vessels grow under the macula, ultimately leading to fluid and blood leakage, causing scarring of the macula.
“Symptoms like the ones described below should prompt patients to see their eye care specialists for an eye exam,” says Akrit Sodhi, M.D., professor of ophthalmology at the Wilmer Eye Institute at Johns Hopkins Medicine. “They could be due to development of advanced AMD, dry or wet.”
Here are three warning signs of AMD.
1. Blurriness
The haziness comes on so gradually you may think the solution to the fuzzy print on the page or your computer screen is a new eyeglass prescription, if not a brighter bulb in the overhead lighting. And it may be. But blurriness is also a hallmark symptom of AMD.
2. Straight lines appear wavy
Imagine looking at lines of text on a page that look bent or curved. Or maybe it’s the window blinds, bathroom tiles or bookshelves that appear that way. When lines that should be straight aren’t, you may have AMD.
3. Blank areas in your central vision
Often, the earliest changes associated with AMD are tiny blind spots in your central vision — as opposed to your peripheral vision — that can slowly enlarge and multiply over time, says Andreoli. “Eventually, these tiny blind spots start to blend together, leading to central vision loss.” And although you may retain some peripheral vision, it’s difficult to read and recognize other people’s faces
.
How to Treat AMD
With AMD, there’s no cure, but there are ways to prevent the disease from progressing. That’s why the American Optometric Association recommends annual eye exams for people over 60. During the exam your doctor will look at the macula for what’s known as drusen, yellow deposits of fats and proteins. Some small drusen are to be expected with age and don’t cause vision loss. But medium-sized or larger ones are a classic sign of AMD. “Regular visits with an ophthalmologist can detect AMD years before patients notice anything is wrong,” says Andreoli. “Early detection of changes can lead to treatments that can slow progression or reverse vision loss in some cases of AMD.”
Vitamins to treat age-related macular degeneration
Research shows that taking certain high-dose vitamins and minerals — specifically, vitamins C and E, zinc, lutein, zeaxanthin, and copper — slows progression of the disease in people with intermediate AMD and those with late-stage AMD in one eye. But that’s not to say you should load up on these vitamins and minerals willy-nilly. Supplements known as AREDS2 are sold over the counter in specific quantities. Talk with your eye doctor about whether such high-dose supplements make sense for you.
“Wet AMD is treated with the same AREDS2 vitamins as dry AMD, but also with injections of medications into the eye to treat the leaking blood vessels,” says Andreoli. These medications help reduce the number of abnormal blood vessels in your retina. They also slow leakage. “Currently, these treatments are focused on stopping progression of disease, but good treatments that reverse damage are still in the works.”
Prevention strategies
Lifestyle also plays a part in treating AMD, adds Sodhi. “Reducing exposure to sunlight by wearing sunglasses, avoiding cigarette smoke, eating a healthy diet and getting annual eye exams can help lower the risk that a patient develops vision loss from AMD as they get older,” he says.
Who’s Most at Risk
You’re at risk for AMD if you are:
Over age 60
As we age, “the cumulative exposure to oxidative stress can affect the health of the retina and, in particular, the macula,” says Sodhi. “The blood flow to the outer retina is reduced, the delivery of oxygen to the retina can be compromised, and the ability of the retina to tolerate the additional burden of oxidative stress declines.”
Regularly exposed to cigarette smoke
Research shows that not only smokers, but also people who are regularly exposed to cigarette smoke, are at greater risk for AMD. That’s because smoking speeds up the deterioration of the macula by increasing the number of damaging chemical compounds and reducing blood and oxygen to the eye. The good news? A study published in the British Journal of Ophthalmology found that stopping smoking can reduce your odds of AMD; the risk in former smokers who hadn’t smoked for over 20 years was comparable to nonsmokers.
Have a family history of AMD
If your parents, siblings or children have AMD, you have a higher risk for getting it too.
Caucasian or Asian
Research shows that white people have 10 times the prevalence of AMD as African Americans. And a review of population studies in Japan, China, Malaysia, India and South Korea found that prevalence of AMD in Asians 40 to 79 years old was almost equal to that of Caucasians, 6.8 percent versus 8.8 percent, respectively.
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