Age-related macular degeneration (ARMD) is a wasting away or degeneration of the center if the retina. In ARMD, there are typical spots found in the retina of patients who are diagnosed with macular degeneration, and these spots are called drusen
. Drusen are collections of metabolic byproducts of the retina; they are yellowish spots as seen on exam by the ophthalmologist
which collect underneath the retina. The retina overlying these drusen has the potential to waste away and lose function as well as having leaking of fluid, blood, and/or cholesterol through these spots. Drusen can be a feature of many retinal diseases such as age-related macular degeneration (ARMD), in addition to retinal dystrophies and other retinal degenerations. Along with these drusen or sometimes instead of them, there can be loss of it clumping of retinal pigment that us naturally dispersed throughout the retina.
Patients with ARMD can experience no symptoms at all, a generalized worsening of their central vision or they can experience distortions (such as objects that should be straight that are wavy) and/or scotomas (areas of their vision in which they see nothing).
There is a dry form of ARMD that 90% of those with ARMD have, and a wet form (which 10% of those with ARMD have). Fortunately, of those that lose significant vision, only 10% have the dry form and 90% have the wet form. The bottom-line is the dry form is the better of the two to have and most people with that form don't lose significant vision.
However, it is possible to convert from dry to wet. For that reason there are a few things that can be done to help decrease those chances and to help catch it if it does happen.
The things we know for sure that affect the course of macular degeneration are as follows:
1. Taking an AREDS vitamin supplement is crucial to slowing the progression of vision loss and decreasing the incidence of severe vision loss from ARMD. However, it is important to take the supplement (# of pills and # of times per day) as it states on the supplement bottle; some people take less # of pills or take it less times per day than is recommended, but with an altered regimen, the efficacy of these vitamins may be suspect. Additionally, if you have ever smoked before, it is important to make sure that you're not taking an AREDS supplement with vitamin A or beta-carotene
(those are synonyms) in it; this can increase your risk of lung cancer if you've smoked and are taking this vitamin.
2. Also, smoking increases your risk of worsening ARMD so stopping smoking is an important step.
3. Lastly, protect your eyes from UV exposure by wearing sunglasses
while outside in the sun.
4. It is important to monitor the vision on a regular basis (1-2x/week) with an Amsler grid. The instructions and a copy of the grid can be found online with a simple google search. This will enable you to catch any possible changes to the vision which could herald a conversion from dry to wet ARMD. If this were to happen it would be vital to your vision to see your ophthalmologist right away to get this treated because if it is caught in time, the changes can be stopped and in some cases reversed. However, if these vision changes are ignored for too long then they can scar over and become permanent.
Those are the only things that have been proven to affect the course of ARMD. But eating a well-balanced, healthy diet and exercising regularly provide the best lifestyle protection against age-related macular degeneration (ARMD) worsening.