Keep Those Old Eyes Seeing It All

February is Low Vision Awareness Month

/ Author:  / Reviewed by: Joseph V. Madia, MD

Following what was no doubt a successful campaign last month to raise awareness for glaucoma, the organization Prevent Blindness America continues to work for healthy eyes by promoting February as Age-related Macular Degeneration and Low Vision Awareness month.

Age-related macular degeneration (AMD) is one of the leading causes of blindness in the United States with over 1.5 million adults over age 50 suffering vision loss due to AMD. As the nation grows older it is anticipated that over 17 million people will have moderate to severe AMD by the time the next decade arrives.

The macula is a small area of the retina that allows us to focus with high acuity on the object we are looking at. When the macula is damaged, there is difficulty with central vision, while peripheral vision is spared. This can make it extremely difficult for AMD sufferers to read, recognize faces, and focus on specific objects, not to mention making driving dangerous. This can cause great distress and disability. Unfortunately, AMD is a painless condition which has noticeable symptoms only after permanent damage has occurred.

Age-related macular degeneration (AMD) is categorized into two conditions, dry and wet. In dry AMD, the photoreceptor cells in the macula slowly degenerate and cause central-vision blurring. A characteristic symptom that is seen by doctors in an eye exam is called drusen, which is the debris from the cellular breakdown of the macular cells. Drusen will appear as yellow spots on the eye. Dry AMD can be broken down into early, intermediate, and late stages, with the early stage not having any noticeable vision loss.

In wet AMD, however, the process is different and small blood vessels start to overgrow underneath the macula. The fragility of the small blood vessels can cause them to break or leak, and the displaced blood causes the macular cells to move from their optimal position. This can happen very quickly, and vision can be damaged rapidly. While 85% of all AMD patients have dry AMD, all patients who have developed wet AMD had dry AMD first, which illustrates the importance of eye exams and taking care of AMD early.

Who is at risk for AMD? Those fortunate enough to enjoy their golden years also are unfortunately the ones who are most at risk, as advanced age is the primary risk factor for AMD. However, there are many other risk factors that can contribute to developing AMD. As with any multitude of health problems, smoking and obesity are both major contributors to developing AMD. Other factors that can't change are race, gender and family history. Caucasians are much more likely to develop AMD, which is contrary to cataracts, which African-Americans are twice as likely to suffer from. Women are also more likely to suffer from AMD than men, and people who have a family history of AMD are also at greater risk.

So to the point of Prevent Blindness' goal this month, what can you do to prevent AMD? The key is regular eye exams and awareness of the fact that as you age, the greater risk you're at.

The American Academy of Ophthalmology recommends a baseline eye exam starting at age 40, when the first signs of impending vision loss may begin. Dr. Christopher J. Quinn, of Omni Eye Services remarks "After the age of 40, most asymptomatic patients not otherwise at risk (such as diabetics, patients with glaucoma, or taking systemic medications with ocular side effects) should follow the recommendation of their eye doctor regarding frequency of examination. I recommend an examination every 2 years. Since the incidence of age related eye disease increases substantially after the age of sixty, I recommend asymptomatic patients over the age of sixty have an annual eye examination with dilation of the pupil by an optometrist or ophthalmologist."

As with any good health advice, avoid tobacco, maintain a healthy weight, and aggressively treat hypertension and high cholesterol. If you've grown old enough to be at risk for AMD, make sure you take the steps to enjoy the old age you've earned by seeing everything the world has to offer.

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Review Date: 
February 22, 2011