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Age- related macular degeneration

Age- related macular degeneration 

“I am getting to an age when I can only enjoy the last sport left.  It is called hunting for your spectacles.”
- Edward Grey

Aging brings its own set of troubles. The cartilage (cushion) in your knees gets worn out, your memory gets weaker and so does your eyesight. But sometimes your eyes undergo more degeneration than other old people. This is called Age Related Macular Degeneration.

What is ARMD?

Your macula which is the central part of the retina (the screen at the back of your eye), makes up only a small part of your retina, yet it is much more sensitive to detail than the rest of your retina. Your macula is what allows you read small print and thread a needle. Age- related macular degeneration or ARMD is the degeneration of this macula which is so important for sharp, central vision.

It is of two types:

1. Wet: Also called neovascular type, it leads to more serious vision loss. However, it has been found to occur almost always in people who have dry ARMD. Who will go on to develop wet ARMD cannot be predicted.
2. Dry: This is more common (About 85 – 90 % of all ARMD) (and thankfully) less severe. It is also called the non-neovascular type.

Do I have ARMD? (Signs and Symptoms)   



There is slow painless loss of your central vision. Rarely, the loss of vision can be sudden.

You may notice the following changes:
• You need increasingly brighter light for doing close work
• Increasing haziness of printed words or overall vision
• Decrease in brightness of colors
• An increasing difficulty in adapting to low light levels for eg. When you enter a dimly lit room.
• Visual distortions like straight lines appearing wavy
• Well defined blurry or blind spot in your field of vision
• Hallucinations of animals, people or shapes (this is seen in advanced stages)

What are the causes of ARMD?

The exact cause of dry macular degeneration is not known; the cells that make up your macula break down over a period of time as you age. There is thinning of the tissues of your macula with age. Tiny yellow or white pieces of fatty proteins called drusen are formed under your retina.

As far as wet macular degeneration is concerned, scientists are not clear as to the cause either. There is abnormal growth of new blood vessels beneath your retina. These new blood vessels may leak fluid or blood.

The following factors may put you at a higher risk for developing Macular Degeneration:

• Increasing age
• Family History of macular degeneration
• Smoking
• Being obese
• Being female
• Having high cholesterol
• Having high blood pressure
• Eating less fruits and vegetables

What are the tests for ARMD?   

Your Ophthalmologist may ask you to look at a special piece of paper with vertical and horizontal lines called the Amsler grid.
The following tests or examinations may be done:

• Slit Lamp Examination
• Fluorescein Angiography to create images of the blood vessels in your eye
• Ocular Coherence Tomography to obtain 3D information about your retina

How is ARMD treated?

For dry ARMD, only the use of anti-oxidant medicines has been recommended. There is no other treatment available to reverse dry macular degeneration.
For wet ARMD, the treatment aims at stopping the progress of the disease:

• This can be done using medications which are injected directly into your eye.
• Laser Photocoagulation: This is used to destroy abnormal, leaky blood vessels.
• Photodynamic Therapy: The light from a laser activates a drug (Verteporfin) which is injected in your arm. The drug collects in the abnormal blood vessels and becomes activated under the influence of the laser. This then goes on to damage the abnormal blood vessels.

A surgery may be done in people with advanced macular degeneration wherein a telescopic lens is implanted in one eye. This can improve both close up and distance vision.

How can I prevent ARMD?

• Undergo routine eye exams
• Control other diseases like high blood pressure
• Choose a diet that is rich in fruits and vegetables. Include fish and nuts.
• Maintain a healthy weight
• Quit Smoking