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Age-related Macular Degeneration

macular degeneration


Age-related macular degeneration (ARMD) is the most common cause of vision loss in those aged over 50. It causes a gradual loss of central whichis needed for detailed work and reading and driving, recognizing people's faces and doing other fine tasks. The disease does not lead to complete blindness. Visual loss can occur within months, or over many years,. There are two main types of ARMD - 'wet' and 'dry'. 'Wet' ARMD is most severe but more treatable. Visual loss caused by ARMD cannot normally be reversed. New drugs are an exciting development for wet ARMD as they may halt or delay the progression of visual loss.

Understanding the back of the eye

When you look at an object, light from the object passes through the cornea, then the lens, and then hits the retina at the back of the eye. The light from the object focuses on the macula. You need a healthy macula for detailed central vision.

The two types of age-related macular degeneration

  • Dry ARMD
    • This is the most common form. Typically, dry ARMD is a very gradual process . It usually takes several years for vision to become seriously affected. Many people with dry ARMD do not totally lose their reading vision.
  • Wet ARMD
    • Wet ARMD may also be called neovascular or exudative ARMD. It is likely to cause severe visual loss over quite a short time - sometimes just months. Very occasionally, this visual loss can occur suddenly, within hours or days. loss.

Both wet and dry ARMD are further classified according to severity. Early, intermediate or advanced types refer to the degree of damage to the macula. 6 in 10 cases of intermediate/advanced ARMD are due to wet ARMD.

What causes age-related macular degeneration?

In people with ARMD the cells of the retina do not work so well with advancing age. They gradually degenerate. This is the dry type of ARMD.The exact reason why cells of the retina stop working properly is not known. In other cases, something also triggers new blood vessels to develop the wet form of ARMD. The trigger is not known.

Certain risk factors increase the risk of developing ARMD include:

  • Smoking tobacco.
  • Possibly, high blood pressure
  • A family history of ARMD.
  • Sunlight(inconclusive evidence)
  • ARMD seems to be more common in people from Caucasian (white) racial backgrounds than from other racial groups.

What are the symptoms of age-related macular degeneration?

  • If the vision of one eye only is affected, you may not notice any symptoms, as the other good eye often compensates. When both eyes are affected you are more likely to notice symptoms.
  • The main early symptom is blurring of central vision despite using your usual glasses.
  • You need brighter light to read by. Words in a book or newspaper may become blurred.
  • Colours appear less bright.
  • You have difficulty recognising faces.
  • One specific early symptom is visual distortion. Typically, straight lines appear wavy or crooked.
  • Visual hallucinations . People see different images, from simple patterns to more detailed pictures.
  • ARMD is painless.

Always see a aneye specialist (ophthalmologist) promptly if you develop visual loss or visual distortion.. Older people should have regular eye checks to check each eye separately for early ARMD (and to check for other eye conditions such as glaucoma).

Is there any treatment for ARMD
For the more common dry ARMD, there is no specific treatment yet. There are, however, certain things that can be done to maximize the sight you do have and to improve your eye health such as stopping smoking and protecting the eyes from the sun's rays by wearing sunglasses. A healthy balanced diet rich in antioxidants, with vitamin and mineral supplements may be beneficial.

For the less common wet ARMD, treatment may halt or delay the progression of visual loss in some people. Newer treatments may even be able to reverse some of the visual loss. Treatments which may be considered include treatment with anti-vascular endothelial growth factor (anti-VEGF) drugs, photodynamic therapy and laser photocoagulation.

 


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