What is macular degeneration?
“AMD is a condition in which the macula, a highly sensitive area of the retina responsible for central and detail vision (about the size of this “O”), is damaged. There are two forms of AMD. Both cause loss of central or straightahead vision (as needed for driving a car, reading fine print and recognizing faces) but, fortunately, not side vision,” explains Daniel Ferguson, MD, a partner at Eye Care Specialists, where thousands of AMD patients are diagnosed and treated each year.
“’Dry’ AMD is more common (90% of cases), progresses slowly, and is caused by a thinning of macular tissue. ‘Wet’ AMD is less common, can progress quickly, and is marked by the growth of abnormal new blood vessels under the macula, which can leak fluid and blood. This leakage can create scar tissue which causes blind spots and profound loss of sharp central vision. The earlier it is detected, the better the chances of preserving vision.”
Who is most at risk?
“Age-related macular degeneration is the leading cause of central vision impairment in Americans over age 50. As baby boomers age and life expectancy increases, AMD looms as a growing health and cost concern,” warns Brett Rhode, MD, Head of Ophthalmology at Aurora Sinai Medical Center and private practitioner in Milwaukee and West Allis.
How fast does sight deteriorate?
Dry AMD usually does not result in rapid vision loss, and many patients retain good sight throughout their lives. Some, however, need to use magnifiers and aids. Wet AMD tends to cause a rapid and profound loss of sharp central vision, which may result in legal (less than 20/200 vision), but not total, blindness (because some side vision remains). Without treatment, about 70% of wet AMD patients become legally blind within two years.
What treatments are available?
Rhode explains, “If dry AMD is diagnosed, we may recommend vitamin supplements, healthy omega fatty acid intake, sun protection, and avoidance of smoking, as measures to prevent or slow progression. If wet AMD is diagnosed, we review the risks, benefits and candidacy for injections of a medication called Avastin.” Avastin is a revolutionary drug that inhibits the growth of the abnormal blood vessels that cause “wet” AMD. “Although there are NO guarantees, we have seen remarkable results with Avastin. A few years ago, there wasn’t much we could do. But, with regular injections (about every month or so), we have been able to stop the progression of wet AMD in 90% of our patients, and even had up to 30% gain improvement in vision,” adds Ferguson. (Avastin is also successfully used to treat diabetes-related vision damage.)
What else can be done?
Besides following a treatment plan with your eye specialist, utilize low vision aids (like hand-held and closed circuit TV magnifiers, telescopic devices, talking books, etc.), contact support/transport services, and learn new ways to perform activities. These steps will help you stay independent and productive.
Free educational booklets & information
Eye Care Specialists’ doctors are dedicated to the diagnosis and treatment of AMD, glaucoma, diabetic eye disease, and cataracts. They frequently lecture to the public and fellow physicians and have written their own series of booklets on these conditions. Call 414-321-7035 for FREE copies or to schedule an appointment for a thorough eye screening (usually covered by insurance or Medicare) at their offices on 7th & Wisconsin Avenue, Mayfair Road across from the mall, or 102nd & National. They also offer information at www.eyecarespecialists.net.
Longtime patient maps plan for good vision
For more than 15 years, the doctors and staff of Eye Care Specialists have had the pleasure of caring for patient Ralph Haeselich, 88 and his wife Anneliese. Through bouts with cataracts and now macular degeneration, Haeselich has been diligent about keeping his appointments, often coming in with a smile and a batch of homemade cookies for the office.
Haeselich, a retired US Forest Service worker with a background in cartography (map-making), has definitely “seen” a benefit from the years of office visits. “I’m fortunate enough that, at my age, I can still drive us around,” he notes. There was a time recently however, when Haeselich wasn’t so sure he would have any vision, let alone be able to drive or even look at a map. “I thought I was going blind in my left eye,” he recalls, “I couldn’t see out of the right half of my left eye at all. That’s when Dr. Freedman started the (Avastin) injections.” With laser scan mapping and Avastin treatment, Haeselich’s left eye has been able to maintain 20/30 vision. “Dr. Freedman definitely saved my eyesight,” exclaims Haeselich.
In the years since his retirement, Haeselich and his wife have been very active in their church (volunteering and starting up a clothing and food pantry) as well as keeping up with their growing family that now includes a greatgreat grandchild. To anyone dealing with wet AMD, Haeselich advises, “If you need the injection treatment, get it, try it. It saved my eyesight.” His wife’s face lights up with a smile when she declares, “He can still see me!” She then adds, “We’re so very grateful to Dr. Freedman.”
Are you at risk for AMD?
Although the exact cause is unknown, the following are culprits behind AMD:
- Circulatory problems
- Light eye color
- Race (white ethnicity)
- Smoking (increases risk 3-4 times)
- Gender (being female)
- A diet high in fat and low in vitamins, minerals and antioxidants
- Sun exposure
Warning signs for AMD
AMD usually develops gradually and painlessly, and good vision in one eye can mask problems in the other. As AMD progresses, however, signs may become obvious. If you suddenly notice any of the following symptoms, see an eye care specialist as soon as possible.
- Difficulty reading or doing close-up work
- Faces, clocks and printed words appear blurry
- Distortion of lines, colors, sizes and edges
- Straight lines in a landscape appear wavy
- Blind spots (dark or empty spaces) in the center of vision
“Don’t assume you simply need new glasses and then wait to make an appointment. A comprehensive eye exam is necessary to evaluate the presence, type and severity of AMD and whether or not treatment would be beneficial,” advises Robert Sucher, M.D., co-founder of Eye Care Specialists, one of Wisconsin’s leading ophthalmology practices.
Tips for preventing vision loss “Sight-robbing conditions like AMD, diabetes and glaucoma often develop first in one eye without noticing or showing early warning signs,” explains Dr. Norman Cohen, busy ophthalmologist and continuing education lecturer. “A professional eye exam is the only way to accurately detect eye conditions.” Cohen recommends the following steps to protect vision:
- People age 40-64 should have a thorough dilated eye exam every 2-4 years and every 1-2 years after age 65, especially if you have a parent or sibling with an eye disease, to check for AMD and other conditions. Part of that exam may include an OCT laser scan and an Amsler Grid test (a checkerboard pattern used to detect distortion of lines and dark or missing spots in vision).
- If you notice a problem with your vision (especially straight lines appearing wavy or blind or dark spots) don’t ignore it. Call your eye specialist immediately to see if you should come in for an exam.
- Wear sunglasses and hats with brims. Prolonged or frequent UV-light exposure may be a factor in developing AMD and cataracts.
- Avoid smoking. Smoking can increase the risk of AMD by 3-4 times, as well as raise other eye disease risks. Second-hand smoke is also a threat to vision.
- Proper nutrition and supplements. A high-dose combination of vitamins C and E, beta-carotene and zinc can reduce the risk of developing advanced AMD by about 25% and the risk of related vision loss by about 19% in patients with certain types of AMD. Although these nutrients cannot cure AMD or restore vision, studies show they may be key to protecting existing vision. Ask your eye care specialist if and what kind of supplements may be helpful for you.
- Have a blood sugar test every 3 years to screen for diabetes after age 45. Diabetes can increase the risk of other eye conditions, including cataracts and glaucoma.