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World-class Macular Degeneration care – right on your doorstep

What is Age-Related Macular Degeneration (AMD)

Age-Related Macular Degeneration (AMD) is a sight-threatening disease associated with ageing, which gradually destroys sharp central vision. AMD affects the photoreceptor cells in the macular, which is the central area of the retina, allowing for the ability to see in fine detail.

AMD is broadly classified into two main forms: Wet and Dry AMD

  • Dry AMD shows changes in the pigment layer, as the light-sensitive cells in the macular slowly break down, gradually blurring central vision in the affected eye. Over time, as less of the macular functions, central vision capabilities diminish in the affected eye.
  • Wet AMD may include similar changes to the above description of Dry AMD. Furthermore, in wet AMD, abnormal blood vessels behind the retina start to grow under the macular. These new blood vessels tend to be very fragile and often leak fluid. This, in turn, will alter the position of the macular from its normal position at the rear of the eye. Damage to the macular occurs swiftly, leading to a more rapid loss of central vision.

Who is at risk

Although AMD may occur at middle age, it most often affects the ageing population, and is a leading cause of vision loss in people 60 years of age and older. Other individuals at increased risk include:

  • Smokers
  • Those with circulatory conditions, including high blood pressure
  • The overweight and obese
  • Those suffering from a poor diet - especially one that is deficient in carotenoid rich vegetables such as spinach, peas, tomatoes and curly kale.

How Age-Related Macular Degeneration (AMD) effects our vision

Age-Related Macular Degeneration is not painful. At its earlier stages, central vision might become blurred or distorted. A feature of Wet AMD, in particular, is that straight lines may also appear wavy or crooked. As AMD becomes more severe a blank patch or dark spot might appear in the central vision. This makes reading, writing and recognising small objects difficult.

AMD affects only the central retina, whilst the side (peripheral) vision remains efficient;

The condition generally affects both eyes, although the rate of decline between each eye may vary considerably.

How Age related Macular Degeneration (AMD) is treated

Your eye surgeon will undertake a careful investigation of both eyes, using eye drops to dilate the pupils. Detailed tests are used to image the macular, and may include photography and retinal scans.

You may also be asked to focus on an Amsler Grid; the pattern of this grid resembles a draughtsboard. You will cover one eye and stare at a black dot in the centre of the grid. While staring at the dot, you may notice that the straight lines in the pattern appear wavy or that some of the lines are missing.

These examinations will enable your consultant to make an accurate diagnosis and prognosis for the effects of the condition on your central vision, and to propose an appropriate treatment plan to you.

In many cases the changes in sight will be mild and patients retain useful central vision for many years. Treatment for patients with Dry AMD is therefore largely supportive and aimed at helping those affected to maximise their central vision through the provision of spectacles and magnifiers.

New treatments available for Wet AMD are increasingly providing more positive outcomes, whilst research is ongoing. These treatments include laser surgery to seal leaking blood vessels and medication injected into the eye under local anaesthetic that prevents leaking from blood vessels beneath the retina.

In addition, some CESP consultants are performing surgery which enables the damaged retina to be replaced with an adjacent piece of healthy retina.

In the U.K. an important network of support services are available for those whose central vision is lost, including support at home through social services and locally based charities. A certificate of visual impairment may allow access to these services and, if appropriate, can be arranged by your consultant.

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