What is age-related macular degeneration?

Age-related macular degeneration, or AMD, is a disease that blurs the sharp, central vision you need for straight-ahead activities such as reading, sewing, and driving. AMD affects the macula, the part of the eye that allows you to see fine details. AMD does not cause any pain.

Are there different forms of AMD?

Yes. There are two forms of AMD that we treat — wet and dry.

What is wet AMD?

Wet AMD occurs when abnormal blood vessels behind the retina start to grow under the macula. With wet AMD, loss of central vision can occur quickly. Wet AMD is considered to be advanced AMD and is usually more severe than the dry form.

What is dry AMD?

Dry AMD occurs when the light-sensitive cells in the macula slowly break down, gradually blurring central vision in the affected eye. As dry AMD gets worse, you may see a blurred spot in the center of your vision. Over time, as less of the macula functions, central vision in the affected eye can be lost. If you have vision loss from dry AMD in one eye only, you may not notice any changes in your overall vision.

With the other eye seeing clearly, you can still drive, read, and see fine details. You may notice changes in your vision only if AMD affects both eyes. If you experience blurry vision, please call to make an appointment with us here at Perich Eye Center.

What are the stages of dry AMD?

Dry AMD has three stages — early AMD, intermediate AMD, and advanced dry AMD. All of these may occur in one or both eyes.

People with early dry AMD have either several small drusen or a few medium sized drusen. Drusen are yellow deposits under the retina, which often are found in people over age 50. People with early AMD have no symptoms and no vision loss.

If you have intermediate dry AMD you may have either many medium-sized drusen or one or more large drusen. You may also see a blurred spot in the center of their vision, or need more light for reading and other tasks. In addition to drusen, people with advanced dry AMD have a breakdown of light-sensitive cells and supporting tissue in the macula. This breakdown can cause a blurred spot in the center of your vision.

Over time, the blurred spot may get bigger and darker, taking more of your central vision. You may have difficulty reading or recognizing the faces of other people until they are very close to you.

Does Wet AMD have similar stages to Dry AMD?

The stages of wet AMD are different to dry AMD and are considered to be more advanced.

Can Advanced AMD be either wet or dry?

Yes. Both the wet and dry form of AMD are considered advanced AMD. In most cases, only advanced AMD can cause vision loss.

Can the dry form of AMD turn into the wet form?

Yes. All people who have the wet form first had the dry form of AMD. The dry form can advance and cause vision loss without turning into the wet form. The dry form also can suddenly turn into the wet form, even during the early stages of AMD. There is no way to tell if or when the dry form will turn into the wet form.

What are the symptoms of wet AMD?

One of the fist symptoms of wet AMD is seeing straight lines appear wavy. If you notice this condition or other changes to your vision, contact us here at Perich Eye Center at once. We will get you in right away for a comprehensive dilated eye exam.

What are the symptoms of dry AMD?

The most common symptom of dry AMD is slightly blurred vision. You may have difficulty recognizing faces. You may need more light for reading and other tasks. Dry AMD generally affects both eyes, but vision can be lost in one eye while the other eye seems unaffected.

Who is at risk for AMD?

AMD is most common in middle aged and elderly people. The risk for AMD does increase with age. Other risk factors include smoking, obesity, white race, family history of AMD, and female gender.

How is AMD detected?

AMD is detected during a comprehensive eye exam that includes a visual acuity test and dilated eye exam.

The visual acuity test is an eye chart test that measures how well you see at various distances.

In the dilated eye exam, drops are placed in your eyes to widen, or dilate, the pupils. Your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of AMD and other eye problems. After the exam, your close-up vision may remain blurred for several hours.

How will my dry AMD be treated?

Once dry AMD reaches the advanced stage, there is no treatment that will cure the dry AMD. At Perich Eye Center, we can prescribe treatment that can delay and possibly prevent intermediate AMD from progressing to the advanced stage, in which vision loss occurs.

What is the AREDS formulation?

The AREDS formulation is a combination of antioxidants and zinc that is named after a study conducted by The National Eye Institute called the Age-Related Eye Disease Study, or AREDS. This study found that taking a specific high-dose formulation of antioxidants and zinc significantly reduced the risk of advanced AMD and the vision loss that is associated with it. The AREDS formulation helps to slow AMD’s progression from the intermediate stage to the advanced stage where vision loss occurs.

What dosage of the AREDS formulation will I have to take?

We will determine which dosage of the AREDS formula is best for you during an office visit with us. The daily amounts of each supplement used in the research study were 500 milligrams of vitamin C, 400 International Units of vitamin E, 15 milligrams of beta-carotene, 80 milligrams of zinc as zinc oxide, and 2 milligrams of copper as cupric oxide. Copper containing zinc was added to the AREDS formulation to prevent copper deficiency anemia, which is a condition associated with high levels of zinc intake.

The follow up study AREDS II, showed slightly better results. In this study, the beta-carotene was eliminated and lutein 10 mg and Zeaxanthin 2 mg were added in its place.

Can the AREDS formula help me?

We tell our patients who are at high risk for developing advanced AMD that they should consider taking the formulation as part of their total plan of care. You are at high risk for developing advanced AMD if you have either intermediate AMD in one or both eyes OR You have advanced AMD, dry or wet, present in one eye and not the other. Following an appointment with us, we can tell you if you do in fact have AMD, what stage it is in, and if you are at risk for developing the advanced form. Unfortunately, the AREDS formulation is not a cure for AMD, and will not restore vision that has already been lost from the disease. However, it may delay the onset of advanced AMD. It may also help people who are at high risk for developing advanced AMD keep their vision.

If I have early stage AMD. Can I take the AREDS formulation to help prevent the disease from progressing to the intermediate stage?

There is not good data to support those diagnosed with early stage AMD in taking the AREDS formulation. It was not found that the formulation helped those with early stage AMD see any cessation in disease progress. If you have early stage AMD, a comprehensive dilated eye exam every year can help determine if the disease is progressing. If early stage AMD progresses to the intermediate stage, discuss taking the formulation with one of our doctors.

How is wet AMD treated?

Here at Perich Eye Center, we can treat wet AMD with laser surgery, photodynamic therapy, and painless injection of medication into the eye. We want to be clear that while these treatments can slow the progression of wet AMD can not be completely cured. Loss of vision may progress despite treatment.

What can I do if I already have lost some vision from AMD?

If you have lost some sight from AMD, we can help you make the most of your remaining vision.

We can help you find community organizations and agencies that offer information on how to find low vision counseling, training, and other special services for people with visual impairments.

Don’t be afraid to use your eyes for reading, watching TV, and other routine activities. Normal use of your eyes will not cause further damage to your vision.

What is the newest research regarding AMD?

According to scientists at the National Eye Institute, studies are being done to see if transplanting healthy cells into a diseased retina can be accomplished. Genetic and hereditary factors are also being studied. Currently there are initiatory anti-inflammatory treatments being looked at to treat the wet form of AMD.

What can I do to protect my vision?

To protect your vision, we recommend that you have a comprehensive dilated eye exam at least once a year, so that we can monitor your condition and check for other signs of eye disease.

During your visit, it is also possible that we will advise that you take the AREDS supplementation.

During an eye exam, we may ask you to look at an Amsler grid. This is an eye test that involves covering one eye and staring at a black dot in the center of a lined grid.

Signs that are indicative of AMD include seeing some of the lines in the grid as missing and the pattern in the grid appearing wavy.

It is important to know that Dry AMD can become Wet AMD. This is why we at Perich Eye Center recommend you schedule an appointment to come see us for testing in person.

Can my lifestyle make a difference?

Yes, lifestyle changes can help make a difference in not just your overall health but in protecting your vision as well. Here are some tips we recommend to help reduce your risk of developing AMD:

-Refrain from smoking. If you are a current smoker, we recommend that you get the support you need to help you quit

-Eat a healthy diet full of greens, vegetables, fruits and fresh fish - Avoid red meat and pork

-Exercise, do yoga, and meditate

-Maintain a healthy weight

-Develop good strategies to reduce and deal with stress - Monitor your blood pressure.