Macular Degeneration at 60 and Above

Macular degeneration at 60 is an eye disorder that slowly destroys sharp, central vision. This makes it difficult to see fine details and read. Age-related macular degeneration (AMD) is a gradual, progressive, painless deterioration of the macula, the small area in the center of the retina

Macular Degeneration at 60 and Above

Macular degeneration at 60 is an eye disorder that slowly destroys sharp, central vision. This makes it difficult to see fine details and read. Age-related macular degeneration (AMD) is a gradual, progressive, painless deterioration of the macula, the small area in the center of the retina

Macular degeneration is the leading cause of severe, irreversible vision loss in people over 60 years of age. It occurs when the small central portion of the retina, known as the macula, deteriorates. The retina is the light-sensing nerve tissue at the back of the eye. Because the disease develops as a person ages, it is often referred to as age-related macular degeneration (AMD). Although macular degeneration is almost never a totally blinding condition, it can be a source of significant visual disability.

Macular degeneration is a group of eye diseases that affects central vision. It is the leading cause of severe vision loss among people age 60 and older, especially among Caucasians. The disease tends to occur more often in women than in men. Although AMD can occur in middle age, the people age 60 and older are at greatest risk for developing AMD.

Some forms of macular degeneration can occur in children. One is juvenile macular degeneration, or Stargardt's disease, which affects one in 10,000 children. It usually appears between the ages of six and 20 and is inherited.

What is Macular degeneration?

Macular degeneration at 60 is an eye disorder that slowly destroys sharp, central vision. This makes it difficult to see fine details and read. Age-related macular degeneration (AMD) is a gradual, progressive, painless deterioration of the macula, the small area in the center of the retina.

The retina is like the film in a camera; it lines the inside of our eyeball and records what we see. The retina is different from the film, however, in that it has only one area that sees details perfectly clearly; that is its center point, the macula.

Damage to that area called the macula affects our detail vision and reduces the clarity of whatever we are looking directly at. This is the vision we use to read, drive, see the television, and do detailed work such as threading a needle, sewing, or crafts.

It also reduces contrast sensitivity i.e. our ability to see objects that are the same tone as their background, so identifying faces and seeing curbs and steps may be difficult. Our peripheral vision, the wide area that includes everything that we are not looking directly at, remains intact so individuals with age-related macular degeneration can see all around.

Types of Macular degeneration (AMD)

  • Dry form - The dry form of macular degeneration is defined by the presence of yellow deposits, called drusen, in the macula. A few small drusen may not cause changes in vision. However, as they grow in size and increase in number, they may lead to a dimming or distortion of vision that people find most noticeable when they read. In more advanced stages of dry macular degeneration, there is also a thinning of the light-sensitive layer of cells in the macula leading to atrophy, or tissue death. In the atrophic form of dry macular degeneration, patients may have blind spots in the center of their vision. In the advanced stages, patients lose central vision.
  • Wet form. The wet form of macular degeneration is defined by the growth of abnormal blood vessels from the choroid underneath the macula. This is called choroidal neovascularization. These blood vessels leak blood and fluid into the retina, causing distortion of vision that makes straight lines look wavy, as well as blind spots and loss of central vision. These abnormal blood vessels and their bleeding eventually form a scar, leading to permanent loss of central vision.

Most patients with macular degeneration (AMD) have the dry form of the disease and can lose some form of central vision. However, the dry form of macular degeneration can lead to the wet form. Although only about 10% of people with macular degeneration at 60 develop the wet form, they become majority of those who experience serious vision loss from the disease. It is very important for people with macular degeneration to monitor their eyesight carefully and see their eye doctor on a regular basis.

Risk factors for Macular degeneration

Macular degeneration may be hereditary, meaning it can be passed on from parents to children. If someone in your family has or had the condition you may be at higher risk for developing macular degeneration. Talk to your eye doctor about your individual risk. Smoking, high blood pressure, high cholesterol, obesity, and being light skinned, female, and having a light eye color are also risk factors for macular degeneration. Few more risk factors are:

  • Obesity - Being overweight doubles the risk of developing advanced macular degeneration.
  • Caucasian ethnicity
  • being female
  • A family history of the condition - Studies indicate that your chances of developing age-related macular degeneration are three to four times higher if you have a parent, child, or sibling with macular degeneration.
  • Smoking - Current smokers have a two-to-three times higher risk for developing age-related macular degeneration than people have who never smoked.
  • high blood cholesterol levels
  • cardiovascular disease
  • Hypertension – A study has proved that persons with hypertension are 1.5 times more likely to develop wet macular degeneration than persons without hypertension.
  • Sunlight - It is the blue wavelengths from the sun that damage the macula, not the ultraviolet (UV) rays.

Symptoms of Macular degeneration

In its early stages, macular degeneration may not have symptoms and may be unrecognized until it progresses or affects both eyes. The first sign of macular degeneration is usually blurred vision with a dim, blurry spot in the middle of your vision. This spot may get bigger or darker over time.

Symptoms of macular degeneration at 60 include:

  • Decreased quality/resolution of vision with blurriness and difficulty with reading fine print, driving, etc.
  • Dark, blurry areas in the center of vision
  • Diminished or changed color perception
  • Dry AMD - Objects in the center part of your vision often look distorted and dim, and colors look faded. One may have trouble reading print or seeing other details. But the person can see well enough to walk and do most daily activities. As dry AMD gets worse, person may need more light to read or do everyday tasks. A blurred spot in the center of vision gradually gets larger and darker. In the later stages of dry AMD, you may not be able to recognize faces until they are close.
  • In Wet AMD, straight lines look distorted and wavy. There may be a small dark spot in the center of your vision that gets larger over time. With both types of AMD, central vision loss can occur quickly. If this happens, you will need to be seen right away by an ophthalmologist. Make sure this eye doctor has experience in treating problems with the retina.

Causes of Macular degeneration

Though macular degeneration is associated with aging, there also is a genetic component to the disease. Several researchers have related a strong association between development of AMD and presence of a variant of a gene known as complement factor H (CFH). This gene deficiency is associated with almost half of all potentially blinding cases of macular degeneration.

Other research has shown that oxygen-deprived cells in the retina produce a type of protein called vascular endothelial growth factor (VEGF), which triggers the growth of new blood vessels in the retina. The normal function of VEGF is to create new blood vessels during embryonic development, after an injury or to bypass blocked blood vessels. But too much VEGF in the eye causes the development of unwanted blood vessels in the retina that easily break open and bleed, damaging the macula and surrounding retina.

Treatment for Macular degeneration

There is currently no cure for macular degeneration, but treatments may prevent severe vision loss or slow the progression of the disease. Several options are available, like:

  • Anti-angiogenesis drugs - These medications (Aflibercept, Avastin, Eyelea, Lucentis, Macugen) block the development of new blood vessels and leakage from the abnormal vessels within the eye that cause wet macular degeneration. This treatment has been a major change in the treatment of this condition and many patients have actually regained vision that was lost.
  • Laser therapy – High energy laser light can sometimes be used to destroy actively growing abnormal blood vessels that occur in macular degeneration.
  • Photodynamic laser therapy - A two-step treatment in which a light-sensitive drug (Visudyne) is used to damage the abnormal blood vessels. A doctor injects the drug into the bloodstream to be absorbed by the abnormal blood vessels in the eye. The doctor then shines a cold laser into the eye to activate the drug, damaging the abnormal blood vessels.
  • Low vision aids - Devices that have special lenses or electronic systems that produce enlarged images of nearby objects. They help people who have vision loss from macular degeneration make the most of their remaining vision.

Preventive measures for Macular degeneration

Although there is no known way to prevent macular degeneration, leading a healthy lifestyle can reduce your risk of developing AMD:

  • Do not smoke
  • Maintain a healthy diet that is high in fruits and vegetables and low in animal fat
  • Exercise regularly
  • Maintain a healthy weight
  • See your eye care professional regularly for dilated eye exams.

Allie Leon, Chief Fun Officer

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