Foresight - AMD
Age Related Macular Degeneration
AMD is the biggest cause of blindness in the over 50s.
A simple test (enclosed), the Amsler Grid can help you spot the early symptoms of AMD – but for a thorough eye check go to your optician.
If you think you could be experiencing the early symptoms if AMD, go to your optician within the next week. Acting early could reduce further damage to your eyesight.
About this booklet
This booklet is designed to provide you with information about Age-related Macular Degeneration (or AMD for short). It describes what AMD is, as well as how it affects your vision and how to identify the signs and symptoms of the condition. It will also tell you what you should do if you have any concerns, or if you want more detailed information about AMD.
What about AMD?
AMD (Age-related Macular Degeneration) is a condition that can affect your eyes as you get older. In fact, in the over 50s, AMD is the leading cause of sight loss in Ireland, with over 60,000 Irish people suffering from the condition (Source: Fighting Blindness).AMD affects the macula - a small part of the eye responsible for central vision which allows you to see detail. AMD usually starts in one eye and is highly likely to affect the other eye at a later stage.
AMD affects the macula – a small part of the eye responsible for central vision which allows you to see detail. AMD usually starts in one eye and is highly likely to affect the other eye at a later stage. (See diagram opposite)
Remember
Blindness doesn’t usually mean complete loss of sight; there is often some vision but this is so poor that it affects daily activities.
“Wet” and “Dry” AMD
Dry AMD is the most common form of the condition and develops slowly, eventually leading to loss of central vision. Wet AMD is caused by leaky blood vessels inside the eye. It is less common than dry AMD but it can cause more rapid loss of vision.
What causes AMD?
The exact causes of AMD are still unknown. Although there can be a history of the condition in certain families, AMD is still not believed to be genetic, however, if close relatives have suffered with sight loss in the past, then it may be worth getting your eyes checked more regularly.
Studies have shown a definite link between smoking and AMD. Other factors such as high blood pressure and poor diet can also lead to a greater risk of getting AMD. Indeed, recent research (AREDS study) has shown that vitamins (C & E), beta-carotene, copper and zinc supplements in your diet, can help reduce the risk of developing AMD.
How common is AMD?
Today in Ireland, there are thousands of people with AMD. However, less than 1 in 7 of these will have wet AMD, the type of AMD that will cause rapid sight loss. The chances of getting AMD increase as you get older. However, most people develop the dry form, which is currently untreatable. Wet AMD - the type that causes rapid vision loss - can in many cases be treated and sight loss reduced, but early diagnosis is vital. In both cases, help and support is available from low vision services.
There is a simple test for the early symptoms of AMD and this will be explained in the following sections.
Remember
AMD will not cause a total loss of vision. If you have AMD help and support is available to maximise your remaining vision and to help you maintain an active and independent life.
Early detection is important and your optician is the best person to check your eyes.
How does AMD affect vision?
The most obvious symptoms of AMD are distortion and blurring in the centre of vision. The photograph opposite shows how some people with AMD see the world - although the outer part of vision is unaffected the central part becomes obstructed. Consequently, people with AMD have difficulty in recognizing detail and this can show itself when reading, driving and even when trying to identify a familiar face.
Remember
AMD usually starts in one eye and then may affect the other eye at a later date. Significant loss of vision can occur within 3-6 months. Early action is necessary to minimise the damage to your eyesight and to help you adjust to sight loss.
Treatment Options
There are a number of proven treatments for people who have the most severe type of AMD (wet AMD).
They are:
1. Photodynamic Therapy (PDT)
2. Laser Photocoagulation (LPC)
3. Intravitreal Injection
If you are interested in these, ask your doctor, optician or ophthalmologist; they should be able to give you more information and advice. Unfortunately, there are no proven treatments for dry AMD but ongoing research is seeking to provide suitable new therapies. Help and support are available from low vision services and the patient support groups listed in this booklet. If you have experienced recent changes to your vision, you should seek professional advice even if you have visited your optician in the last two years.
Testing for the early symptoms of AMD
The grid below is a quick and simple test, known as The Amsler Grid. It can help to determine whether you are experiencing the early symptoms of AMD, but remember it is not a substitute for an eye test. Please follow these simple instructions now:
Hold the grid around 12 inches (30cm) in front of your eyes (this is the average reading distance)
- If you wear reading glasses leave them on but do not wear varifocals or distance glasses
- Cover one eye with your hand and focus with your other eye on the centre dot
- Check that you can see all four corners of the grid
Remember
If the grid appears in any way abnormal, while you focus on the centre dot, you could be experiencing the early symptoms of AMD and you should seek further help within the next week.
What to do next if the grid looked perfectly normal
If the Amsler Grid appeared perfectly normal to you then you probably don’t have AMD. However, if you are over 50 and have not been to the optician in the last two years, you should seriously consider making an appointment now. It is also important to keep testing your eyes at home every 2 months using the Amsler Grid.
What to do next if the grid didn’t look normal
If you think you may be experiencing symptoms of AMD after you have used the Amsler Grid on the previous page, then you should visit your doctor or optician within the next week. As well as the Amsler test you performed earlier, your optician, GP or ophthalmologist (eye doctor) will perform other tests, and if necessary, discuss treatment options with you. Advice and support is also available from the organisation listed at the end of this booklet.
Remember
If you think that you could be experiencing symptoms of AMD visit your optician within the next week - acting early could prevent further damage to your eyesight.
The flow diagram on the following page will help you to assess further whether you are likely to be displaying the early symptoms of AMD, and what to do next.
Flow Diagram
If you are experiencing new problems with your eyesight, that your optician, doctor or ophthalmologist are not aware of, then ask yourself the following questions…
Are you experiencing new problems in just one of your eyes?
No: AMD is unlikely. However, you should seek professional advice as a matter of urgency.
If yes then has your vision become distorted and/or blurred?
No: AMD is unlikely. However, you should seek professional advice as a matter of urgency.
If the answer is yes; have you lost some central vision?
No: AMD is unlikely. However, you should seek professional advice as a matter of urgency.
If the answer is yes; has your problem happened in the last 24 hours?
If it has, AMD is unlikely. However, you should seek professional advice as a matter of urgency.
If not, then you should seek professional advice as a matter of urgency.
AMD could be the cause of your symptoms. Please make an appointment to see your doctor or optician during the next week.
Other conditions that affect the eye
There are other conditions that affect your eyesight, particularly as you get older. Your optician will look out for any signs of these during your routine eye test, which is why it is important to get your eyes tested regularly – particularly as some of these conditions do not have any symptoms until after the eye is damaged.
Cataracts
A cataract is where the eye’s lens becomes cloudy, causing impaired vision. Both eyes can be affected and vision is often worst affected in bright sunlight. Cataracts are usually due to the aging process, but they can occur as the result of injury, inflammation or certain drug therapies.
When a cataract causes significant symptoms it can be surgically removed and replaced with an artificial lens.
Glaucoma
This is a disease characterised by an increase in pressure within the eyeball. This causes damage to the delicate nerve cells and loss of visual fields - the ‘all-round’ sight outside of the central vision.
If left untreated, vision gets worse and sufferers often say that their vision is like looking through a tube. Some people may see haloes around lights, especially at night. The commonest form of glaucoma is usually symptom free until there has been a permanent loss of vision.
So early detection by screening is vital
The risk of developing glaucoma increases with age, but may occur earlier if there is a family history of the disease. It is also usually more common in people of African or African-Caribbean origin.
Diabetic Retinopathy (DR)
This is the most serious eye condition in people with diabetes, and affects the retina. People who have had diabetes for a long time may have developed ‘Background Retinopathy’ which does not pose an immediate threat.
Two other forms of DR can however damage eyesight, by causing leakages in the fine blood vessels of the retina. If treated in time, the damage caused by DR can be limited using laser treatment.
A laser beam is carefully focused exactly on to the damaged area and it seals the leaking blood vessels - remember that this will only save any remaining sight and won’t reverse any previous sight loss.
Looking for further help and advice?
The following addresses are for organisations that can offer you advice and support about AMD, other eye conditions, low vision support and other age-related matters.
Fighting Blindness (Ireland)
1 Christchurch Hall, High Street,
Dublin 8
Tel: (01) 873 1004
Web: www.fightingblindness.ie
NCBI
Whitworth Road, Drumcondra, Dublin 9
Tel: 1850 33 43 53
Fax: (01) 8307787
Web: www.ncbi.ie
M.I.S.T
Macular Impairment Support & Togetherness
Ardara, Crostwaithe Park West, Dun Laoghaire, Co. Dublin
Tel: (01) 2809895 / 4947396
Email: beazles@indigo.ie
Age Action Ireland
30/31 Lower Camden Street, Dublin 2
Tel: (01) 475 6989/478 5060
Fax: (01) 475 6011
Email: info@ageaction.ie
Irish Ophthalmic Health Advisory Board
5th Floor, Huguenot House,
35–38 St Stephen’s Green, Dublin 2
Tel: (01) 678 9333
Fax: (01) 661 4408