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AMD: a preventable form of vision loss

Age-related macular degeneration (AMD) can be stopped or slowed if caught early enough. Regular eye exams are crucial.

Age-related macular degeneration (AMD), a common cause of vision loss in later life, damages the part of the eye (the macula) that provides clear central vision. Being aware of AMD’s earliest symptoms and having regular eye exams may catch the disease in its early stages, allowing treatment in some cases and lifestyle modification in others.

“Regular exercise, quitting smoking, and eating a nutritious diet rich in green, leafy vegetables are good not only for your eyes, but for your overall health status,” explains Dr. Jeffrey Heier, clinical instructor in ophthalmology at the Harvard-affiliated Massachusetts Eye and Ear Infirmary and director of the Retina Service at Ophthalmic Consultants of Boston.

Prevalence of AMD by age


% with AMD









The two forms of AMD

Most people with AMD (90%) develop the “dry” form of the condition, which erodes and thins the retina—the light-sensing portion of the eye. The earliest symptoms of AMD are distortion and central blurring, and it can range from mild to severe.

Doctors can’t predict whose disease will worsen or how quickly, but one in 10 people with dry AMD progresses to “wet” AMD, marked by abnormal and leaky blood vessels in the retina. “Most people will never reach the wet stage, but they are the ones you often hear about,” Dr. Heier says.

Though less prevalent, wet AMD is the leading cause of vision loss in the elderly.

How age-related macular degeneration (AMD) affects vision

How age-related macular degeneration (AMD) affects vision

The macula is the part of the eye that provides clear, central vision. When
the macula is damaged, people may first experience blurred or distorted vision and see straight lines as wavy. With further damage, people may start to see a black or dark space at the center of their visual field.

Dilated eye exams

In a dilated exam, the doctor puts drops in your eye that expand (dilate) the iris and allow a clear view inside. The doctor will be looking for yellowish spots under the retina, called drusen, and other abnormal changes. In the intermediate stage of AMD, the changes start to noticeably affect vision. Many people begin having exams in their 40s as part of an evaluation for eyeglasses. This provides a baseline for future comparisons. The American Academy of Ophthalmology recommends that people over 65 get dilated eye exams every one to two years. Depending on the findings, the doctor will recommend when you should return for another look.

Eye vitamins for dry AMD

Caught at the intermediate stage, dry AMD may be slowed or stopped with a cocktail of high-dose “eye vitamins.” The recipe includes vitamins A, C, and E, plus zinc and copper. “Eye vitamins will help to slow or prevent progression in about 25% of people,” Dr. Heier says. “The exam can determine if you will benefit from vitamins.”

Should you start taking eye vitamins even if you don’t have intermediate AMD? Dr. Heier advises against it. There’s no strong proof that eye vitamins prevent AMD in healthy eyes. And in recent years, evidence has emerged that high doses of certain vitamins, like vitamin E, may actually cause harm.

Instead, enrich your diet. Green leafy vegetables like spinach, collard greens, and kale are good sources of eye-healthy nutrients. Don’t forget exercise, and stop smoking if you are a smoker; it is a major risk factor for AMD. “There is no downside to spinach, and no downsides to exercise as long as it’s approved by your primary care doctor,” Dr. Heier says.

Drug therapy for wet AMD

Drugs for wet AMD called VEGF inhibitors “have revolutionized how we treat AMD,” Dr. Heier says. “Roughly 80% of patients do not lose additional vision and a third recover significant vision.”

VEGF drugs must be injected into the eye at least monthly. The injections come with a small risk of infection. Some research suggests that VEGF treatment may raise the risk for stroke slightly, but whether and how much is still uncertain. Still, presented with the choice of the uncertain risks of treatment or the real possibility of vision loss, most people choose the medication.

Posted by: Dr.Health

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