How you can avoid losing vision by macular degeneration as you get older
During routine eye check-ups, it is common for older patients to complain of dark shadows in the centre of their vision.
Most of them put it down to the ageing process and are prepared to accept it as a fact of life. But the fact is that these symptoms may be early signs of age-related macular degeneration (AMD).
Perhaps you have just learned that you or a loved one has the condition. But many people haven't even heard of AMD and don't understand exactly what is going on inside their eyes.
Millions of people worldwide have AMD. It's a leading cause of vision impairment among older people in the developed world.
It has few symptoms in the early stages, so it's important to have your eyes examined regularly. The condition can interfere with everyday activities, such as your ability to see faces, drive, read or write. However, the peripheral vision you retain can be used very effectively.
While there is no cure, eye-care specialists can treat AMD and considerably improve sufferers' quality of life.
There are many types of macular degeneration, but AMD is the most common. It's also known as a common vision killer for older people. According to statistics, it's most common among those over 60, but there are signs that younger people can also be affected, with some patients as young as 40.
It affects your central vision. Patients will experience blurred vision and see objects that are distorted.
AMD is divided into two categories, dry and wet, both of which need treatment to control deterioration of the condition. neither form is painful.
Those with early dry AMD will experience slightly blurred and slightly distorted vision. When this happens, patients must be closely monitored to prevent the condition progressing into wet AMD.
The vision of wet AMD sufferers will deteriorate much faster. Central vision will see a blank spot, be extremely blurry or see objects blocked by shadow. With wet AMD, symptoms could start in one eye and progress to the other.
Detection is possible only with a proper eye examination.
During the process, your eye care professional will look for signs of yellow deposits beneath the retina. These deposits are known as drusen. The presence of many and large drusen deposits may indicate that you have AMD.
Pigment changes under the retina are another AMD pointer. Your eye-care specialist will check for signs of specific degenerative changes.
The dry type of AMD could progress into the wet type, but once diagnosed, patients are usually treated with vitamin supplements to control the condition, effectively reducing the chances of it developing into the wet type by 20 per cent to 30 per cent. These vitamins should be prescribed only by your eye doctor to avoid over-medicating.
For wet AMD, common treatments include photodynamic therapy or the use of anti-VEGF (vascular endothelial growth factor) agents to suppress any advancement of the condition.
Anti-VEGF medicines are injected into the eye by a eye-care professional to slow the loss of vision by acting against the VEGF protein, which is one cause of abnormal blood vessels developing under the retina.
So it's comforting to know that vision loss and permanent damage can be avoided if AMD is detected and treated early.
But it's important to remember that even after successful treatment, patients aren't in the clear. They'll need to monitor their vision with regular check-ups because AMD could recur after full recovery.
People of all ages should seek regular eye check-ups; it's definitely the best way to protect your vision.
Dr Ernie Lo is a Hong Kong-based ophthalmologist