Age-Related Macular Degeneration
(from the National Eye Institute)

Age-related macular degeneration (AMD) is a disease that affects your central vision. It is a common cause of vision loss among people over age of 60. Because only the center of your vision is usually affected, people rarely go blind from the disease.

However, AMD can sometimes make it difficult to read, drive, or perform other daily activities that require fine, central vision.

What is the macula?

The macula is in the center of the retina, the light-sensitive layer of tissue at the back of the eye. As you read, light is focused onto your macula. There, millions of cells change the light into nerve signals that tell the brain what you are seeing. This is called your central vision. With it, you are able to read, drive, and perform other activities that require fine, sharp, straight-ahead vision.

How does AMD damage vision?

AMD occurs in two forms:

Dry AMD affects about 90 percent of those with the disease. Its cause is unknown. Slowly, the light sensitive cells in the macula break down. With less of the macula working, you may start to lose central vision in the affected eye as the years go by.

Dry AMD often occurs in just one eye at first. You may get the disease later in the other eye. Doctors have no way of knowing if or when both eyes may be affected.

Wet AMD--Although only 10 percent of all people with AMD have this type, it accounts for 90 percent of all severe vision loss from the disease. It occurs when new blood vessels behind the retina start to grow toward the macula. Because these new blood vessels tend to be very fragile, they will often leak blood and fluid under the macula. This causes rapid damage to the macula that can lead to the loss of central vision in a short period of time.

Who is at risk for AMD?

Although AMD can occur during middle age, the risk increases as a person gets older. Results of a large study show that people in their 50s have about a two percent chance of getting AMD. This risk rises to nearly 30 percent in those over age 75.

Besides age, other AMD risk factors include:

Gender--Women may be at greater risk than men, according to some studies.

Smoking--Smoking may increase the risk of AMD.

Family History--People with a family history of AMD may be at higher risk of getting the disease.

Cholesterol--People with elevated levels of blood cholesterol may be at higher risk for wet AMD.

What are the symptoms of AMD?

Neither dry nor wet AMD causes any pain. The most common symptom of dry AMD is slightly blurred vision. You may need more light for reading and other tasks.

Also, you may find it hard to recognize faces until you are very close to them. As dry AMD gets worse, you may see a blurred spot in the center of your vision. This spot occurs because a group of cells in the macula have stopped working properly.

Over time, the blurred spot may get bigger and darker, taking more of your central vision. People with dry AMD in one eye often do not notice any changes in their vision. With one eye seeing clearly, they can still drive, read, and see fine details. Some people may notice changes in their vision only if AMD affects both of their eyes. An early symptom of wet AMD is that straight lines appear wavy.

This happens because the newly formed blood vessels leak fluid under the macula. The fluid raises the macula from its normal place at the back of the eye and distorts your vision. Another sign that you may have wet AMD is rapid loss of your central vision. This is different from dry AMD in which loss of central vision occurs slowly.

As in dry AMD, you may also notice a blind spot.

How is AMD treated?

Dry AMD currently cannot be treated. But this does not mean that you will lose your sight. Fortunately, dry AMD develops very slowly. You may lose some of your central vision over the years.

However, most people are able to lead normal, active lives--especially if AMD affects only one eye. Some cases of wet AMD can be treated with laser surgery. The treatment involves aiming a high energy beam of light directly onto the leaking blood vessels.

Laser treatment is more effective if the leaky blood vessels have developed away from the fovea--the central part of the macula. But even if the blood vessels are growing right behind the fovea, the treatment can be of some value in stopping further vision loss.

How is laser surgery preformed?

Laser surgery is performed in your eye care professional's office or eye clinic. Before the surgery, he or she will: (1) dilate your pupil and (2) apply drops to numb the eye.

In some cases, he or she also may numb the area behind the eye to prevent any discomfort. The lights in the office will be dim. As you sit facing the laser machine, your eye care professional will hold a special lens to your eye. You may see flashes of light.

You can leave the office once the treatment is done, but you will need someone to drive you home. Because your pupils will stay dilated for a few hours, you also should bring a pair of sunglasses. For the rest of the day, your vision may be a little blurry. Your eye may also hurt a bit. This is easily controlled with drugs that your eye care professional can suggest.

You will need to make frequent follow-up visits. During each exam, you may have fluorescein angiography to make sure that the blood vessels are not still leaking, or that new blood vessels have not developed. If the vessels continue to leak, you might need some more laser surgery.

It is important to realize that laser surgery is not a cure for AMD. It is only a treatment to help stop further vision loss. The risk of new blood vessels growing back after laser treatment is relatively high.

Click here to watch RealVideo of a Healthy Living story on laser surgery for macular degeneration.

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