Macular Degeneration (ARMD)
How's your macula?
The Macular Degeneration Foundation has recently launched it's latest awareness campaign (click here to view). Since it's launch, the staff at Visual Eyes Optometry have seen a significant increase in patient awareness of the macula's role in vision, and the importance of checking and maintaining it's health. As such, we have dedicated this page to the macula. You can also visit the Macular Degeneration site for more information and links, or make a donation to this non for profit organisation.
If it has been a while, or you have never had your macular checked - you should.
Make an appointment now over the phone or complete our contact form and request specifically to have your macular checked in detail.
What is Age-Related Macular Degeneration?
Age-Related Macular Degeneration (ARMD), also known as age-related maculopathy, involves the damage or breakdown of the the light-sensitive tissue at the macula. The macula is a very small part of the retina, which is responsible for our fine-tuned, detailed central vision .
ARMD mainly affects older people: about four per cent of those more than 40 years old, nine per cent of those over 50 years, 23 per cent of those over 65 years and 31 per cent of those aged 80 years or more. Men and women are equally affected. ARMD accounts for up to 45 per cent of legal blindness and up to 70 per cent of seriously impaired vision in people over the age of 70 years.
How does ARMD affect vision?
As ARMD damages the part of the retina responsible for central vision and for seeing fine detail, it becomes difficult to see small details of objects. If both eyes are affected, reading and other tasks requiring fine vision generally become very difficult. However, because side vision is mostly unaffected, people often maintain the vision needed for the detection of movement and recognition of gross detail.
Some of the layers of the retina thicken and waste material which is usually removed from the retina forms deposits, distorting the retina. This distortion can cause damage to the other layers of the retina. In about 10 per cent of cases, new blood vessels grow into the macula from beneath. These newly-formed vessels are fragile and often leak blood into the retina where the blood causes scar tissue to form. The scarring blocks out central vision to a severe degree. There are also some other forms of macular degeneration which are inherited and not associated with ageing.
How is ARMD detected and diagnosed?
People with ARMD may notice that their vision has deteriorated, but many patients do not realise that they have a problem until their vision becomes blurred. During the course of a comprehensive eye examination, a Visual Eyes Optometry Optometrist will perform a number of tests to detect the presence of ARMD. It is highly recommended that each time we take high resolution digital photos of both retinas. This not only enables a higher level of scrutiny to be placed on the integrity of the macula, but also provides a more detailed "baseline" for future reference when looking for changes in the structure of the macula such as accumulations of waste material or the formation of new blood vessels.
Another test that may be used is a grid pattern known as an Amsler chart. This is a regular grid that looks like a piece of graph paper. Patients with ARMD often report that sections of the grid appear to be distorted or missing. To print your own copy of an Amsler Grid Chart click here.
At Visual Eyes Optometry, we will always refer patients whom we suspect have ARMD to an ophthalmologist (eye surgeon) for confirmation of the diagnosis. The ophthalmologist may perform a test called fluorescein angiography. In this test a fluorescent dye is injected into the patient's bloodstream and the ophthalmologist observes the progress of the dye through the blood vessels in the retina. This reveals any leaking blood vessels.
Can ARMD be treated?
When most body tissues such a muscle, skin or bone are damaged, the cells of that tissue have the capacity to regrow and repair the damage. Because nerve cells cannot regenerate, damage to nerve tissue, such as the retina, is usually permanent and irreversible. This is why the vision loss in ARMD is so difficult to treat, compared with other vision disorders. For example, it is possible to remove and replace the eye's lens in a person with cataract but it is not possible to replace or even repair the retina of a person with ARMD - yet.
Where new blood vessels have appeared in the macula area, laser surgery may be used. In this treatment a focused, intense beam of laser light is used to seal off leaking blood vessels and to prevent new vessels growing. This treatment is most effective when it is applied in the very early stages of the disease, before extensive damage has been done.
While there is little that can be done to prevent or cure ARMD, people with the disease can be helped to continue functioning normally. Many patients with ARMD will eventually come under the classification of being a low vision patient. Special help in the form of low vision devices is available from optometrists and specialist low vision clinics. Low vision devices enable patients to make the most of their vision and include items such as miniature telescopes, high-powered reading spectacles, hand-held and stand magnifiers, closed circuit televisions and other simpler aids such as large-print books.
For any treatment of ARMD to be effective, it must be diagnosed as early as possible. Regular eye examinations are the key to early detection of retinal changes and other signs of disease. If you notice any change in the quality of your vision, make an appointment to have your eyes examined immediately. Regular examinations are particularly important for people over the age of 50 years, smokers, and people whose families have a history of eye problems - especially ARMD.