No one knows what causes age-related macular degeneration, but obesity and high blood pressure are risk factors. Learn how to prevent it.
What is age-related macular degeneration?
Early on, the symptoms of macular degeneration can be subtle. The most you may notice are slight distortions in your central vision — your ability to see what’s right in front of you. Straight lines may appear wavy, or written words may seem to be missing letters. Nearly 90 percent of all cases are “dry” macular degeneration, which begins in this way, and may never end in serious vision loss.
However, from 14 to 20 percent of dry maculation degeneration cases progress to the “wet” form, when abnormal blood vessels leak fluid into the retina. Once that happens, if you don’t get treatment, you may develop a large dark area in your central vision and ultimately become blind.
What causes macular degeneration?
No one knows. You don’t have to be elderly, but the chances of getting it go up as you age. Women are more likely to develop age-related macular degeneration than men. People with white skin and blue eyes are more vulnerable.
How to prevent macular degeneration
The best thing you can do is get regular eye exams, a baseline exam at around 40 and an exam every year or two after age 65. If you see any slowly progressing vision changes, see an ophthalmologist. If you have a sudden loss of vision, go the same day if possible.
How to slow macular degeneration
If you are diagnosed with dry macular degeneration, you need to improve your health habits overall. Quit smoking, get low-intensity exercise at least an hour a day, preferably outside; eat more green leafy vegetables (which contain lutein and zexanthin) and eat fatty fish at least twice a week, and you can slow the progression of the condition, studies suggest.
As the American Optometric Association reports, two large clinical trials have found evidence that a combination of supplements — now available in pharmacies — also can slow the progression of age-related macular degeneration. Talk to your doctor about how these supplements might interact with other medications you may be using. If you used to smoke or still are, don’t take beta-carotene, which is linked to lung cancer; take lutein and zexanthin instead. But supplements are not a substitute for a healthful diet.
Your eye doctor can take an optical coherence tomography scan to detect any abnormal blood vessels.
A few times a week, you can do a quick test yourself using an Amsler grid you might tape up near the toilet or phone. Cupping your hand over one eye, examine the grid with the other. Do any of the lines in the grid appear wavy, blurred, or distorted? Are there any holes or dark areas in the grid? If the answer is “Yes” to either question, speak to your eye doctor. Do all the boxes in the grid look square and the same size? Can you see all corners and sides of the grid while keeping your eye on a central dot? If the answer is “No,” then you also need to see a doctor.
In the past, people who had developed wet macular degeneration would lose two or three lines in the vision chart within two years or so, Gupta notes. But a new kind of medication can stabilize or improve vision for about half of all patients. Your ophthalmologist can inject medication directly in your eye in the office, giving you local anesthesia. You might need to receive the shots monthly, at least for a while. There are risks associated with the shots, and you may be able to taper down or stop receiving them. If your condition worsens, you can go back for more treatments, Gupta notes.
March 25, 2020
Christopher Nystuen, MD, MBA