Macular degeneration
Age-related macular degeneration, or AMD, is the most common cause of sight loss in people over 60 in Ireland. It affects the macula, the small central part of the retina that you use for reading, recognising faces and driving.
AMD affects central vision only. It does not cause total blindness, and you keep the side vision you use to move around.
The two types
Dry AMD is the common form, around nine in ten cases. Deposits called drusen build up under the retina and the cells above them slowly thin. It develops over years, and many people never lose meaningful vision from it.
Wet AMD is less common but more serious. Abnormal blood vessels grow under the retina and leak fluid into the macula. It moves over weeks, not years, and it is very treatable if caught early.
What to look out for
Contact the clinic or your optometrist straight away, without waiting for your next appointment, if you notice:
- Straight lines looking bent, wavy or kinked, such as a door frame or the lines on a page
- A new blurred, grey or missing patch in the centre of your vision
- A sudden drop in vision in one eye
These can be signs of wet AMD, and the sooner treatment starts the better the result.
Slower changes that are worth mentioning at your appointment include needing more light to read, difficulty in dim light, trouble recognising faces, and letters dropping out of words.
Check each eye on its own
Your good eye covers for the other so well that a real change can go unnoticed for months. Once a day, with your glasses on, cover one eye and look at something with straight lines, then swap. It takes ten seconds. An Amsler grid on the fridge does the same job.
How it is diagnosed
An OCT scan gives a cross-section of the retina in a few seconds, with no dye and no needles, and shows fluid directly. The scan is available at both clinics, so diagnosis and the decision to treat usually happen in the same visit.
Treatment
Dry AMD. There is no injection or tablet that reverses it. What helps is stopping smoking, a diet rich in green leafy vegetables and oily fish, and for people with intermediate disease an AREDS2 vitamin supplement, which reduces the risk of progression. Regular monitoring picks up any change early.
Wet AMD. Anti-VEGF injections into the eye stop the leaking vessels and dry the retina out. The eye is numbed with drops first, and most people find the injection far easier than they expected. Treatment starts monthly and the gap is then extended, guided by your scan each visit. Most treated patients keep their vision, and many improve.
Reducing your risk
Age and family history are the main factors and cannot be changed. Smoking is the biggest risk you can control, and stopping is the single most useful step. Keeping blood pressure under control, staying a healthy weight and wearing sunglasses in bright light all help.
What to do next
Patients: contact the clinic to arrange an appointment. Bon Secours Limerick 086 034 8727, Eyes, Lids & Face Clinic Ennis 065 672 4160.
GPs and optometrists: refer directly to Limerick or Ennis, including by Healthmail. Details are on the clinic page.