Did you know macular degeneration is the biggest cause of sight loss in the UK? Every seven minutes of every single day someone in the UK will be diagnosed with this sight-threatening eye condition. As part of National Eye Health Week, the Macular Society has produced this guide to macular disease.
Do you know someone with macular disease? According to a recent Macular Society survey one in three people do – yet awareness of the condition is still low.
Macular disease is the biggest cause of blindness in the UK, one million people are affected by the condition and this is set to double in the next 25 years.
Macular disease affects people of all ages. Age-related macular degeneration (AMD) is the most common type of macular disease, generally affecting people over 50. A group of rare inherited conditions called juvenile macular dystrophies can affect much younger people, including children.
Every day in the UK around 200 people are diagnosed with advanced AMD.
Early diagnosis is key, which is why during National Health Eye Week the Macular Society is encouraging everyone to protect their eyes with a Sight Matters kit.
What is AMD?
AMD occurs as a result of damage to the delicate cells of the macula – the part of the retina responsible for the sharp, central vision required for doing everyday tasks such as reading or driving.
What causes AMD?
We do not know what the exact causes of AMD are however, scientific research has identified a number of factors that can increase your risk of suffering from the condition. The Macular Society’s Sight Matters kit provides further information on how to minimise these risks.
AGE – AMD is an age-related condition that usually develops in people over the age of 50. By the time you reach the age of 75 you have 30% chance of suffering from the condition.
GENDER – Women appear to be at greater risk than men.
FAMILY HISTORY – Studies have found that there are specific genes that can be passed through families which can increase your risk of developing AMD.
SMOKING – Tobacco chemicals can damage the blood vessels behind your eyes, thus increasing your risk of developing AMD.
HIGH BLOOD PRESSURE – research from the Netherlands suggests that hypertension may trigger the development of AMD.
OBESITY – Scientists believe there is a link between obesity and an accelerated progression of AMD to a more advanced stage of the condition.
People with high body mass indexes (BMI) tend to have low macula pigment density and are therefore at greater risk of AMD.
ETHNICITY – Caucasians are at greater risk than other ethnic groups.
EYE COLOUR – AMD is more common in people with blue eyes. This may be related to damage associated with exposure to ultraviolet (UV) light. Blue-eyed people may have less protective pigment in their eyes.
There are two types of AMD:
DRY (atrophic) – the most common form affecting approximately 90% of AMD sufferers it develops gradually over time as small yellow deposits, known as ‘drusen’ build-up under the macula. Loss of vision in patients suffering from dry macular degeneration is directly related to the location and amount of retinal thinning caused by the drusen.
WET (exudative) – affects just 10% of patients, however, it is a much more aggressive form of the condition. It can have a rapid and devastating effect on eyesight, sometimes resulting in complete loss of central vision in a matter of days.
Wet AMD is caused by the growth of new blood vessels under the retina. These vessels can bleed and leak fluid which destroys and distorts the patient’s central vision.
What are the symptoms?
AMD affects people in different ways. Symptoms may develop slowly if you have dry AMD, especially if it’s only in one eye. However, as the condition progresses, your ability to see clearly will change.
- Gaps or dark spots (like a smudge on glasses) may appear in your vision, especially first thing in the morning.
- Objects in front of you might change shape, size or colour or seem to move or disappear.
- Colours can fade.
- You may find bright light glaring and uncomfortable or find it difficult to adapt when moving from dark to light environments.
- Words might disappear when you are reading.
- Straight lines such as door frames and lampposts may appear distorted or bent.
The good news though is that patients normally retain peripheral vision.
Minimising the risks
The Macular Society’s Sight Matters kit gives you the tools you need to protect your sight, including a free eye test voucher. www.macularsociety.org/sightmatters
The kit also gives you information on making changes to your lifestyle to help improve your eye health and reduce your risk of developing AMD.
Studies have shown that repeated exposure to UV light can damage the central part of the retina and contribute to the development of AMD.
Protect your eyes from damaging UV by wearing sunglasses or UV protective lenses.
Always check for a CE, British Standard or UV 400 mark on your sunglasses to ensure they provide adequate UV protection.
Nutrition plays a vital role in preserving your overall eye health. A well-balanced diet containing eye friendly vitamins and nutrients can slow the progression of AMD and even, as some researchers has shown, prevent or delay the onset of the condition.
Quitting smoking, maintaining a healthy BMI (between 18.5 and 24.9) and having a regular eye tests (once every two years, unless advised otherwise by your optometrist) can all help minimise the risk of developing AMD.
You can test for tell-tale signs of macular degeneration at home using an Amsler grid.
Early diagnosis is vital and could save your sight. The Macular Society’s Sight Matters kit includes an Amsler grid so you can monitor your sight, order yours today www.macularsociety.org/sightmatters
If you experience a rapid change in vision, or you have AMD in one eye and suddenly start getting symptoms in the other, you should visit your local A&E department immediately.
Treating macular degeneration
There is currently no treatment for dry AMD, however, wet AMD can be treated, if caught early, using ‘Anti-VEGF’ drugs. VEGF (Vascular Endothelial Growth Factor) is the chemical in the body responsible for the development of healthy blood vessels.
In wet AMD too much VEGF is produced in the eye, causing the growth of unwanted, unhealthy blood vessels. The drugs used, most commonly Lucentis (ranibizumab) and Eylea (aflibercept), block the production of VEGF. Both treatments are given by an injection into the eye, which is much less frightening than it sounds.
Other macular diseases
There are a range of conditions that affect the macular these include diabetic macular oedema, Central serious retinopathy, macular hole, myopic macular degeneration, punctate choroidopathy and retinal vein occlusion.
If you or a loved one is affected by macular disease, the Macular Society is an invaluable resource for information about the condition and its valuable support services. And as always, we are here to answer your questions.
The Macular Society,
PO Box 1870,
Andover SP10 9AD
Find out more about macular disease here.