Macular Degeneration

About
Symptoms
Diagnosis
Treatment

What is Age Related Macular Degeneration?

Age-related macular degeneration is a disease which affects the macula – the area of the retina that is responsible for 95% of your central vision.

Risk factor for getting ARMD:

  • Age > 75 yrs
  • Family history
  • Smoking history

Types of ARMD

There are two main types of macular degeneration: wet and dry.

Dry ARMD happens when the macula thins, and scars due to waste products that are unable to be removed by eye.  This often happens very slowly.  Treatment of this is commonly supportive and vitamin supplements can be suggested.

Wet ARMD happens when abnormal blood vessels grow under the retina.  These new blood vessels have weak walls and can leak and bleed into the macula.  Treatment for Wet ARMD is injection of medication into the eye which aims to stop these blood vessels forming and leaking.

Age-related macular degeneration - Coastal Eye Surgeons
OCT: Dry ARMD
Age-related macular degeneration - Coastal Eye Surgeons
OCT: Wet ARMD

Symptoms of ARMD

The macula is the part of the retina used for central vision. When it starts to deteriorate, you will likely notice changes in your central vision first. These may include:

  • Central blur, for example: inability to see people's faces when looking at them 
  • Distorted vision: straight lines, such as door frames aren't straight and have a "kink" in them
  • Difficulty reading, which is not improved with glasses
  • Difficulty seeing in the dark
  • Changes in colours (reduced brightness)
  • Taking longer to adjust to changes in light

If you suffer from wet Age-related macular degeneration, you may also notice distortion of straight lines and printed words. If this is the case, it’s important to speak to your ophthalmologist immediately.

Healthy Vision ARMD Vision

Healthy vision versus ARMD-affected vision.

How is ARMD diagnosed?

ARMD can only be diagnosed by an eye care professional, such as an optometrist or ophthalmologist. Regular eye check-ups are important, especially if your doctor has told you are at risk for ARMD.

ARMD is often diagnosed as part of a routine eye exam. Your eye doctor will usually perform the following tests:

Dilated eye exam
Your doctor may put drops in your eyes that cause your pupils to relax and dilate. This lets them see a magnified view of the macula. They will check for abnormalities such as blood vessel changes or yellowish deposits (called drusen).

Optical coherence tomography (OCT)
This scan allows the ten layers of the retina and macula to be visualised. It uses light waves to take a cross-section image of the back of your eye. It can identify areas that are thinning or thickening due to ARMD, as well as the current activity of the underlying blood vessel which cause bleeding or fluid leakage.

Fluorescein angiography
A special dye is injected into your bloodstream which makes the blood vessels more visible, allowing them to be photographed with a specialised camera.

Amsler Grid
This test is done at home and can help monitor the progression of wet ARMD. Your eye doctor may provide you with a printed copy, or you can download one below.

If your test results indicate macular degeneration, you will usually be referred to an ophthalmologist for further treatment. If this happens, you can ask for a referral to Coastal Eye Surgeons for expert eye treatment.

What’s an Amsler grid and how do I use one?

The Amsler grid is a simple self-monitoring tool that you can use at home. It was invented by an
ophthalmologist named Marc Amsler in 1945. If you are at risk for developing ARMD, your
ophthalmologist may advise you to monitor your vision using an Amsler grid.

An Amsler grid should be used once a day, in good lighting, and while wearing whatever glasses you
usually use to read. To use the grid:

  1. Hold the grid 30-40cm away from your face and cover one eye
  2. Focus your uncovered eye on the dot in the centre of the grid
  3. Without moving your focus from the spot, take note of any abnormalities in the grid. If you see blurry, wavy, dark, or blank patches, contact your ophthalmologist immediately.
  4. Follow the same steps with the other eye.

Some people find it helps to stick an Amsler grid at eye level on the fridge, on the outside of the shower,
or on a door where they see it every day. Making the test an easy part of your daily routine can help you
remember to use it regularly.

Download Amsler grid free

Treatment for ARMD

Since vision loss from ARMD cannot be restored, treatment aims to prevent further progression of the disease and help sufferers continue living normally with reduced vision.

Dry AMD can’t be treated, but lifestyle modifications may help slow its progression. Maintaining a healthy diet and quitting smoking can help prevent further damage.  Vitamin supplements maybe recommended.

Wet ARMD is treated with intravitreal (eye) injections. These are repeated every 4 weeks until the condition is under control, with further injections being performed at an extended interval as appropriate. At Coastal Eye Surgeons, we perform these in our clinic without need to go to a hospital.

Conservative and supportive aids such as magnifiers, reading lights, or changed settings on your phone and computer can improve the quality of your resultant vision. Your eye specialist can provide recommendations for these and help you set them up.

Age-related macular degeneration - Coastal Eye Surgeons

Additional Resources

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