Age Related Macular Degeneration

Age Related Macular Degeneration (ARMD) is an age related disease of the retina, the light sensitive tissue that lines the back of our eye. It affects only the portion of the retina that provides our fine central vision, called the macula. ARMD is the leading cause of blindness in the US for patients over 50 years old. The incidence of ARMD increases with age; 10% of patients 66 to 74 years old have the disease and this increases to 30% of patients over 75. ARMD can run in families and smoking may be a risk factor for its development and progression.

The are two forms of ARMD often referred to as wet and dry. Dry, or atrophic ARMD, is the most common type accounting for 90% of all patients. Dry ARMD often presents as a slow loss of central vision. The is no treatment but frequent monitoring of the vision is important. Patients should follow an Amsler Grid to look for new distortions of their vision or areas that are missing. These changes may represent progression of ARMD from dry to wet and an immediate examination is indicated. Nutritional studies are being carried out to determine if multivitamins can slow the progression of ARMD.

Wet ARMD presents with a sudden change in vision. The vision may become distorted, blurred and may have areas that are missing. Wet ARMD is caused by new blood vessels growing in the eye which are accompanied by blood and/or swelling of the retina. Urgent laser treatment can preserve the vision in some cases by recurrences are common.

All patients with macular degeneration should follow an Amsler Grid regularly and report any changes to their eye care provider as soon as possible. Evaluation of a change in the Amsler Grid is urgent.

A recent study on Age Related Eye Disease (AREDS) by the National Eye Institute* suggests persons older than 55 years of age should have an eye exam to determine their level of risk. Those patients at risk for visual loss due to ARMD (those with extensive intermediate drusen, at least one large drusen, noncentral geographic atrophy, or advanced disease in one eye with visual loss) should consider taking a supplement of antioxidants and zinc. It is important to note that smokers should NOT take the beta-carotene supplements due to an increased risk of lung cancer. See our web page on the ARED study for more detailed information regarding vitamin supplementation and ARMD.