Age-related macular degeneration (ARMD)

ARMD is caused by hardening of the arteries that nourish the macula. This deprives the sensitive retinal tissue of oxygen and nutrients and that very important part of the retina dies. As a result, the central vision deteriorates. Macular Degeneration is the most common cause of visual impairment in old age - it is sometimes referred to as 'wear and tear' in the eye.

The macula is the part of the retina responsible for seeing fine detail in the centre of the field of vision. Whenever a person is looking directly at an object, it is the macula that receives the image. When macular degeneration occurs, it is detailed central vision that suffers. Peripheral vision i.e. the outer field of vision, is unaffected. This means the person will often see best 'out of the corner of the eye', rather than by looking straight at the object of interest.

Macular Degeneration varies widely in severity. In the worst cases, it causes a complete loss of central vision, making reading or driving impossible. For others, it may only cause a slight distortion in central vision. Straight lines then appear curved and objects are generally distorted centrally. Fortunately, macular degeneration does not cause total blindness since it does not affect peripheral vision.  The person always retains his peripheral vision. The main practical difficulties are likely to be in seeing fine details such as reading, writing, seeing people's features, sewing and crossing roads.

There are two main types, Dry and Wet Macular Degeneration. The dry type is generally mild, very slow to worsen and not as disabling as the wet type. It does not respond to any active treatment and is best managed by better lighting and magnifying aids. The wet type starts with central distortion of sight and can progress catastrophically to loss of all central vision in the affected eye. Strangely it seems to represent an attempt by the body to repair the damage and it does sometimes respond to prompt treatment: sudden or rapid loss of central vision is an emergency and should lead to immediate further investigation. Children and young people can also suffer from an inherited form of macular degeneration called macular dystrophy.

Causes of Macular Degeneration
Macular Degeneration may be caused by variety of factors. Genetics, age, nutrition, smoking, and sunlight exposure may all play a role.

Signs and Symptoms

• Loss of central vision. This may be gradual for those with the dry type. Patients with the wet type may experience a sudden decrease of the central vision.
• Difficulty reading or performing tasks that require the ability to see detail
• Distorted vision (Straight lines such as a doorway or the edge of a window may appear wavy or bent.)

Detection and Diagnosis

ARMD is usually diagnosed following an eye  examination by an ophthalmologist or optometrist. The eye examination is most usually carried out after the person notices a deterioration in visual acuity or distortion un the central vision. Vision testing, Amsler Grid test, ophthalmoscopy and fundus photography are tests that are commonly used in a routine eye examination to detect ARMD. Fluorescein angiogram is used as a confirmation test.

Nutrition and Macular Degeneration

Several recent studies have indicated a strong link between nutrition and the development of macular degeneration. It has been scientifically demonstrated that people with diets high in fruits and vegetables (especially leafy green vegetables) have a lower incidence of macular degeneration. More studies are needed to determine conclusively if nutritional supplements can prevent or slow down progression in patients with existing disease. But many eye practitioners are already recommending food supplements to their patients suffering from ARMD. Examples of food supplements available locally are Eye Vit from HealthAid laboratories and I-Caps from Alcon laboratories.

Disclaimer of Medical Liability

Whilst we have taken great care to gather correct information and to keep it current, we cannot guarantee its accuracy and completeness.

The information provided should never be considered a substitute for professional health care by a qualified doctor or other health care professional, which will be tailored to the patient's individual circumstances. We cannot take responsibility if you rely on this information alone.