The symptoms of macular degeneration can be difficult to identify. However, this sight-threatening disease is not uncommon – around 1 in 7 Australian adults over the age of 50 are thought to have some stage of age-related macular degeneration. Because early age-related macular degeneration often presents with no noticeable symptoms, diagnosis of this disease can be just an incidental finding during a routine visit with your optometrist or eye doctor. Keep reading to find out more about this condition, including the common symptoms of macular degeneration.
All About Age-Related Macular Degeneration
Age-related macular degeneration is a retinal disease affecting the macula. The macula is the part of the eye responsible for:
- Central sight
- Discrimination of fine detail
- Colour perception
During macular degeneration, the cells of the macula begin to deteriorate, leading to its characteristic symptoms.
Although older age is a significant risk factor for developing macular degeneration, this disease is not considered a normal part of ageing, unlike cataracts.
During age-related macular degeneration, an accumulation of toxic metabolic waste material inhibits the function of the retinal tissues that support the light-sensitive receptor cells. This results in the receptors themselves degenerating and dying, which subsequently impacts your sight.
Exactly why this occurs at all is not fully understood, but your eye doctor will be able to explain several known risk factors, including:
- Genetics and family history
- Tobacco smoking
- Caucasian ethnicity
- Other systemic diseases, such as obesity and cardiovascular disease
During a regular examination, your optometrist or eye doctor will assess your sight and view your retina, including the macula. These two simple tests are enough to alert your eyecare professional that you have macular degeneration. An additional, relatively new diagnostic test is known as optical coherence tomography (OCT), which is a type of imaging that allows your clinician to view all the layers of the retina. OCT imaging has changed the way eyecare professionals are able to detect and monitor age-related macular degeneration as we are now able to see the layers beneath the innermost layer of the retina, as well as more easily and accurately monitor progression.
There are two types of macular degeneration – the dry (or atrophic) form and the wet (or neovascular) form. Dry age-related macular degeneration involves disruption and slow atrophy of the cells of the macula. The wet form is defined by the formation of fragile new blood vessels, which can leak and bleed.
What are the Symptoms of Macular Degeneration?
In the early stages, the symptoms of macular degeneration can be extremely difficult to notice. As this condition tends to progress so slowly, you may not realise your sight is changing over time, and your daily function is not likely to be impacted until the more advanced stages of the disease.
Depending on the severity, the symptoms of macular degeneration can include:
- Distortion to your central sight
- Straight lines appearing wavy or wriggly
- Difficulties with reading small print
- Increasing difficulty discerning other fine detail
- Difficulty recognising faces
- Dark, blurry, or missing areas in the centre of your field of view
- Infrequently, alterations to your colour perception
As the macula comprises only the central part of your retina, your peripheral sight is unaffected by macular degeneration. We rely on peripheral sight for getting around, noticing movement, or seeing in dim lighting.
Dry age-related macular degeneration tends to progress relatively slowly. Conversely, a haemorrhage from the wet form can result in very sudden and profound loss of sight, as the bleed can obscure much of the retina. Wet age-related macular degeneration is an emergency.
Management of Age-Related Macular Degeneration
People with dry macular degeneration can be managed by either an appropriately experienced optometrist or an eye doctor. There is currently no cure for macular degeneration, whether the wet or dry form. In fact, up until recently, there was no treatment for the dry form other than recommending a specific nutritional supplement known as the AREDS2 formulation. However, very recently, an injectable medication has been approved in the USA to slow the progression of retinal atrophy associated with advanced dry age-related macular degeneration. This is not yet available to macular degeneration patients in Australia.
There are other steps that can be useful for supporting the health of your macula, including:
- Ensuring your diet is balanced and high in antioxidants, such as dark green leafy vegetables like kale
- Ensuring you include omega-3 in your diet too, which can be obtained from oily fish such as salmon or nuts and seeds such as chia
- Quitting smoking. Although an ex-smoker still has a higher risk of developing macular degeneration compared to someone who has never smoked, you will be able to lower your risk compared to if you continued smoking
- Managing other health conditions, such as obesity or cardiovascular risk
There is some suggestion in research that high-energy blue wavelength light can contribute to age-related macular degeneration. The strongest source of this type of radiation is the sun, but LED lights, flat-screen TVs, and the screens of other digital devices are also known to emit some degree of blue light. You may want to consider ensuring good sun protection for your eyes when you go outdoors.
If you have dry macular degeneration, your optometrist or eye doctor will want to continue to monitor you closely for deterioration into the wet form. Wet age-related macular degeneration has been treated with eye injections of a drug called anti-VEGF for years. However, this treatment is not a cure. The aim of anti-VEGF medications is to prevent the formation and leakage of the new, abnormal blood vessels in the retina, which can slow or stop the progressive damage to the surrounding cells. Some studies have shown that certain anti-VEGF drugs may be able to restore a small degree of sight loss from wet macular degeneration.
Call us on (03) 9070 5753 today for an eye consultation.
Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
Age-related Macular Degeneration.
Symptoms of Age-Related Macular Degeneration.
Dry macular degeneration.
FDA Approves SYFOVRE™ (pegcetacoplan injection) as the First and Only Treatment for Geographic Atrophy (GA), a Leading Cause of Blindness.