Macular Degeneration... are you at risk?
Macular degeneration is one of the most common causes of poor vision or vision loss in Canadians (it accounts for 90% of new cases of legal blindness in Canada)
What is Macular Degeneration (ARMD)?
Macular degeneration is one of the most common causes of poor vision or vision loss in Canadians (it accounts for 90% of new cases of legal blindness in Canada). The macula is a small area at the centre of the retina in the back of the eye that lets us see fine details clearly. We need this area of our eyes for reading text, driving a car, watching TV and even recognizing faces and looking at anything in detail. While our side vision is not effected in macular degeneration, end stage of the disease results in complete loss of the central area of our vision (like a large black or grey blind spot straight ahead).
Macular degeneration (also known as Age-Related-Macular-Degeneration or ARMD, since age is the most common risk factor in this disease) has many risk factors which include increasing age, heredity (if someone else in the family had ARMD), blue eyes, high blood pressure, cardiovascular disease and smoking.
Healthy Eye - Eye with Age-Relation Macular Degeneration
There are different types of ARMD
There are two different types of ARMD; wet and dry.
Nine out of ten people have Dry ARMD which results in a thinning of the macula. Dry ARMD takes years to develop and is treated with a specific vitamin regimen based on the AREDS (Age Related Eye Disease Study).
Wet ARMD is less common but is much more serious. In the wet form, abnormal blood vessels grow in a layer beneath the macula and leak fluid and blood, causing much more substantial vision loss. Treatment for this form includes injections of anti-vascular agents right into the eyeball. This new treatment has been shown to preserve vision in 95% of patients.
Macula with Dry Amd and Macula with Wet AMD
How do I know if I am at risk for AMRD?
Routine annual eye exams with examination of the macula by an optometrist will show any evidence of changes in the macula. In addition, OCT scans (Optical Coherence Tomography) will scan layers of the retina that are not visible in a regular eye exam. These scans can help with early detection of changes and point out where treatment is needed.
How can I prevent getting ARMD?
1) Annual eye exams – make sure you are being scanned yearly for signs of macular change.
2) Sun Protection - We know that sun or UV exposure is also a huge risk factor in the development of ARMD. Wearing sunglasses that protect from 100% UVA and UVB exposure is essential in the protection against macular damage. Not all sunglasses have 100% protection. It is important to start protecting our children’s eyes early on as much sun damage is done before the age of 18 years. Ask your optometrist about optimal protection.
3) Eating well. Choosing a healthy diet can help prevent ARMD. The antioxidant vitamins in fruit and vegetables contribute to eye health. Kale, spinach and other dark green, leafy vegetables have high levels of antioxidants. Foods that are high in lutein and zeaxanthin benefit people with macular degeneration.
4) Managing other medical conditions. If you have other medical conditions such as high blood pressure, heart disease or diabetes, for example, take your mediation and follow doctor’s instructions to keep these conditions under control. Quitting smoking will also help reduce ARMD risk.
5) Vitamin supplements – if there is a family history of ARMD, supplementing with lutein and zeaxanthin may help in the prevention of ARMD onset. Please ask your eye doctor for a recommendation as not all vitamins are good for every person and not all vitamins are absorbed properly in the body. Some vitamins (for example high levels of zinc) can actually be harmful for ARMD patients.
6) Blue light protection. Many of our devices (including computers, tablets, smart phones, video games) emit a low level of visible blue light. This light is thought to be damaging to the macula long term. We can protect ourselves by reducing the amount of time of these devices or by wearing glasses that have blue light filters. Many of the new, high quality lenses can be ordered specifically for blue light protection. It is healthier to wear these glasses while on our devices than wear nothing at all. Again, please ask your eye doctor about which filter would be right for you. Not all blue light is bad. Blue light filters are especially important for children who spend time on the computer or ipads. Children have larger pupils than adults and more blue light reaches their maculae. We should try to protect our children’s eyes at an early age.
7) Genetic testing. If there is a strong family history or if there are early signs of ARMD, genetic testing can be done to determine the risk of vision loss and the type of vitamins that should be used to prevent further damage. There are genetic markers that can show which supplement would be best for each patient and if one would actually be harmful. This can be done in the optometrist office with a simple mouth swab.
Macular degeneration can be detected early and prevented. We must take time out of our busy schedules to have routine eye exams and OCT scans. We must also protect our children’s eyes at an early age with eye exams, sunglasses and a healthy lifestyle. Please see your optometrist with any questions you might have regarding ARMD. Please visit our website here.
Detecting Age-Related Macular Degeneration