information Age-related macular degeneration Eye Clinic Salisbury NHS Foundation Trust

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1 information Age-related macular degeneration Author: Renee Tyers and Rama Jay Date written: July 2007 Last reviewed: October 2014 Review date: September 2017 Version: 2.1 Code: PI1231 If you need this information in another language or medium (audio, large print, etc) please contact the Customer Care Team on uk. Eye Clinic You are entitled to a copy of any letter we write about you. Please ask if you want one when you come to the hospital. The evidence used in the preparation of this leafl et is available on request. Please patient.information@salisbury.nhs.uk if you would like a reference list. Salisbury NHS Foundation Trust Salisbury District Hospital, Salisbury, Wiltshire SP2 8BJ Salisbury NHS Foundation Trust

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3 Further advice and help Wessex Sight Centre Salisbury NHS Foundation Trust (01722) Wiltshire Blind Association 1 Commercial Road Devizes Wiltshire SN10 1EH (01380) Macular Disease Society 13a Bridge Street Andover SP10 1BC Royal National Institute for the Blind (RNIB) Contents The Macula 4 Types of ARMD 5 Possible causes 5 How do I know if I develop ARMD? 6 Treatments for Wet Macular Degeneration 7 Vitamin supplements 8 Low vision aids 8 What can I do? 9 Will I go blind? 9 Further advice and help Judd Street London WC1H 9NE Helpline: or

4 Age Related Macular Degeneration (ARMD) is a common condition that affects the central vision by damage to the central retina, called the macula. It occurs most often later in life and is the most common cause for visual impairment in people over 60 years of age in the UK and in the developed world. The Macula The retina is a light sensitive layer of cells at the back of the eye which is responsible for our vision. The centre of the retina is called the macula. The macula allows us to see fine detail and colours. What can I do? Stop smoking! Have a healthy diet See your optician if you develop sudden symptoms or your vision changes. Will I go blind? ARMD does NOT lead to blindness; peripheral vision is maintained and people continue to be able to get around and perform daily activities such as cooking and dressing. If you eyesight is badly affected you may benefit from being registered visually impaired, which allows you to claim certain benefits. 4 9

5 Vitamin supplements A large research trial, called AREDS (Age Related Eye Study) found that a combination of vitamins C and E, copper, zinc, lutein and zeaxanthin can slow down the progression of Macular Degeneration once it has developed (AREDS 2 formula ). Your ophthalmologist may recommend you to take these. As the dosages are high, it is very important to consult your doctor before taking any supplements. Low vision aids People with both types of Macular Degeneration benefit from advice on magnification and lighting to help with difficulties. Apart from magnifiers, training can be given on how to make the most of your remaining sight. The Eye Clinic can arrange a referral for you to the Wessex Sight Centre. Types of ARMD Dry ARMD occurs when the macula starts wearing out with age and is working less well. This may affect reading and fine detailed vision. Dry Macular Degeneration often involves both eyes, but one may be affected long before the other. There is currently no effective treatment for this condition. In Wet ARMD, abnormal blood vessels develop in the retina. These can leak fluid or bleed and eventually cause scarring. This can happen very quickly, and lead to rapid loss of vision. There are now treatments that are effective in the early stages of Wet ARMD. Possible causes The exact for Age Related Macular Degeneration is not known, but a number of risk factors have been identified. 8 5

6 Age; is an important factor. Smoking; increases the risk of getting Macular Degeneration probably by three to four fold. Genes; there is evidence that the condition can occur in families. Diet; there is evidence that supplements with vitamins and lutein can slow down the progression. 6 How do I know if I develop ARMD? In the early stages the central vision may become blurred or a dark or black patch can occur in the centre. Straight lines may look wavy or fuzzy. In Dry Macular Degeneration these symptoms develop very slowly over months or years, but in Wet Macular Degeneration this happens more quickly over days or weeks. Occasionally shapes and colours are seen that are not actually there this is called Charles Bonnet Syndrome. If you notice any of these changes you should see your optician for a referral to an eye specialist. The eye specialist will examine your eyes. This includes administration of eye drops to dilate your pupils, so the back of your eye can be examined. You may also need a have a Fluorescein Angiogram, a special series of photographs, which can help decide what type of Macular Degeneration you have. This involves a small injection of dye in the arm, so that the blood vessels at the back of the eye can be seen. Treatments for Wet Macular Degeneration Wet ARMD can now be controlled by injections into the eye. There are several different drugs in use, your doctor will discuss the different options with you. These drugs will have to be given repeatedly to maintain their benefit. 7