Macular degeneration

Introduction

Macular degeneration, or as its more commonly known as Age-related macular degeneration(AMD). It is one of the cause of irreversible blindness among people who are in their golden years (Waugh et al, 2018). There are 2 types of AMD which are Dry AMD and Wet AMD. Dry AMD being characterized by the atrophy of certain areas of the retina, in layman terms, certain parts of the nerves in your eyes are dying or have stopped working (Waugh et al, 2018). Wet AMD would be characterized by abnormal new blood vessels growing in the retina, causing swelling mainly in the central part of the retina, causing vision loss (Waugh et al, 2018)  

left : normal vision , right : permanent dark spot that blocks the vision for AMD patient

Signs and symptoms

Most patients don’t get any obvious symptoms in the early stages of the diseases. An optometric examination will take place to detect AMDs. In dry AMD patients, they typically report that the central vision is slowly deteriorating. However, the deterioration happens much more rapidly in wet AMD, sometimes in the matter of days (Horton & Guly, 2017). Hence, when checked with the amsler grid, which is a grid with many small squares, the patient will have to focus on a black dot in the middle of the grid and describe what they see. Usually the patient would report that the lines on the amsler grid is not straight or the squares look distorted or blur.  

Treatment

For dry AMD, there’s very limited amount of treatment options. Usually, suggestion for treatment is that to go on a specific vitamin regiment and live a generally healthier lifestyle. Besides, patient will also be asked to quit smoking if they do smoke (Horton & Guly, 2017). For wet AMD, the one and only treatment available so far is the injection of anti-vascular endothelial growth factors (Anti-VEGF).

The administration of these drugs can stop the production of abnormal blood vessels and improve the visual acuity of the patient (Horton & Guly, 2017). The anti-VEGF are administered through an intraocular injection which means that a syringe will be inserted into the eyeball and the drug is administered straight into the eye. There has been a recent study on improving the vision of AMD patients by treatment with a corneal elastic modulus-altering procedure. This procedure basically alters the geography of the corneal to let the light hit the good parts of the retina instead of the bad parts, therefore, improving vision. However. this procedure is still being tested (Serdarevic et al, 2017).  

Prevention

AMD does have a genetic disposition. However, recent studies have found that prolonged exposure to high energy blue light can also damage the retina. Therefore, causing AMD to occur earlier in life (Zhao et al, 2018). To cut down on one preventable cause of AMD, we implore our readers who are digital natives to start using blue filter lenses. This is to protect your eyes, provided that your job does not entail very accurate colour discrimination. This is due to blue filter lenses tend to have a faint yellow tint which may affect colour perception.

References

Horton, S., & Guly, C. (2017). Prevention and treatment of age‐related macular degeneration. Prescriber, 28(1), 37-41. Serdarevic, O., Tasindi, E., Dekaris, I., & Berry, M. (2017). Vision improvement in dry and wet Age‐Related Macular Degeneration (AMD) patients after treatment with new corneal CPV procedure for light redirections onto the retina. Acta Ophthalmologica, 95. Waugh, N., Loveman, E., Colquitt, J., Royle, P., Yeong, J. L., Hoad, G., & Lois, N. (2018). Introduction to age-related macular degeneration. In Treatments for dry age-related macular degeneration and Stargardt disease: a systematic review. NIHR Journals Library. Zhao, Z. C., Zhou, Y., Tan, G., & Li, J. (2018). Research progress about the effect and prevention of blue light on eyes. International journal of ophthalmology, 11(12), 1999.