AMD: Top vision loss cause among elderly

MANILA, Philippines – If you are 60 years old and above and have recently been experiencing changes in your central vision — like blurring, blind spot in the middle of your field of vision or straight lines appearing crooked — then you should see your eye doctor just to make sure it’s not Age-related Macular Degeneration (AMD), the leading cause of visual loss among the elderly.

AMD is a disease affecting elderly patients over 60 years old that gradually destroys sharp, central vision. 

Without the central vision, people would have a hard time performing daily activities such as preparing meals, reading, writing, driving or even recognizing people.

AMD affects the macula, the part of the eye that is utilized when one is reading, aiming, following moving objects or any other activity where clear and sharp vision is required. Macula is located at the center of the retina.

Although AMD causes no pain to the patient, it will result in visual loss and legal blindness among the elderly if left untreated.

There are two types of AMD: the dry type and the wet type. In the dry type, the retina becomes weaker, there is slight blurring which may eventually lead to blind spot in the middle of their field of vision, and difficulty in reading or recognizing faces. 

In the wet type, initially, there is distortion of vision like straight lines appearing crooked, abnormal blood vessels grow under the retina, and leak fluid and blood. This leakage can result in swelling of the retina and lead to permanent loss of vision in two years.

Dr. Arnold Salud, retina and vitreous specialist at the American Eye Center, said in a recent lecture that AMD is the leading cause of visual loss among people aged 60 and above, and one of the top 10 causes of disability among the elderly worldwide. There are around 500,000 new cases of AMD every year, he said.

Although studies show that age is the main risk factor for AMD, Salud said other risk factors include smoking, obesity, high blood pressure, diet that is low in antioxidants and high in unsaturated fats, pollution, and excessive sunlight exposure.

But with a little lifestyle modification, Salud said these risk factors could be mitigated.

• Quit smoking. Salud said a recent study showed that current smokers have fourfold higher risk of developing AMD than never or past smokers. They develop AMD 10 years earlier than non-smokers.

• Limit exposure to sun, or if it cannot be avoided, use hats or sunglasses.

• Get the right nutrients for the eyes. Eat green leafy vegetables and fish, and increase dietary intake of carotenoids, vitamin E and zinc. Studies show that high intake of vitamins C and E, betacarotene and zinc reduces the risk of AMD by 35 percent.

Salud said there are several drugs available in the market today that aim to delay the progression of AMD, if not improve the vision of AMD sufferers. 

But like all drugs, there are pros and cons to using them. He advises the public to be more prudent before agreeing to use the prescribed drug and inquire about its side effects on the Internet.

“Some doctors have the tendency to prescribe drugs that are least expensive to their patients, without fully informing them of the bad side effects,” Salud said.

Take, for example, the drug commonly prescribed to patients suffering from the wet type AMD. It targets the growth of abnormal blood vessels behind the retina, but it may also have an untoward effect on the growth of normal blood vessels in other parts of our body.

“What’s the use of giving your patient affordable drugs if it would do more harm than good? When it comes to decision-making on their well-being, patients must be informed and must have a say on which kind of drug to use,” Salud said.

For more information on AMD and its treatment, visit the American Eye Center at Shangri-La Plaza Mall, EDSA corner Shaw Boulevard, Mandaluyong City, or call (02) 636-0762 or 0917-LASERME.