Macular Degeneration: What You Should Know

Dear Savvy Senior,

What can you tell me about age-related macular degeneration? My mother had it before she died, and now at age 63, I’m worried I may get it, too. Nearsighted Nancy

Dear Nancy:

Age-related macular degeneration (AMD) is the leading cause of vision loss in older Americans, affecting nearly 2 million people. The good news is, new treatments are now available. Here’s what you should know.

AMD

AMD is a progressive eye disease that gradually diminishes the central (not peripheral) vision you need for straight-ahead activities like reading, driving or watching television. It does not cause total blindness.

There are two forms of AMD–wet and dry. Approximately 85 percent of all people who have AMD have the dry form, while about 15 percent have wet AMD. As the name suggests, age-related macular degeneration is most common in people over the age of 60. Other factors that can increase the risk include smoking, high blood pressure, excessive exposure to sunlight and having a family history of the disease. Women and Caucasians also have a greater chance of getting AMD, as well as do people with lighter colored eyes.

Get Tested

If you’re over the age of 50, it’s a smart idea to get your eyes examined by an ophthalmologist every two years. They can spot early signs of AMD before vision loss occurs. Early symptoms however may include blank, gray, hazy or blurry spots in your central vision making it difficult to read, especially in low lighting. For wet AMD, the classic early symptom is that straight lines appear wavy. A good tool to check your eyes for AMD is the Amsler Grid at www.preventblindness.org–click on “test your eyes”.

Wet AMD Treatments

The treatment of AMD has changed rapidly over the past few years, and new potential treatments continue to be tested and developed. For wet AMD, the most affective treatment is a new drug called Lucentis (www.lucentis.com), which stops vision loss and may even restore it. The downside, however, is it costs more than $1,000 per shot. Medicare typically covers 80 percent. Avastin, a much cheaper drug (about $50 per shot), currently approved for colorectal cancer, is being used by many doctors and may work just as well as Lucentis. The medication is injected into the eye, often once a month over the course of many months. Other treatment options include the drug Macugen, laser surgery and photodynamic therapy.

Dry AMD Treatments

While there’s currently no cure for dry AMD (several treatments are currently being tested in clinical trials), there are some things you can do to slow down and possibly prevent its progression, including:

• Eating healthy: Studies suggest that eating antioxidant-rich foods such as fresh fruits, dark green leafy vegetables and at least one serving of fish a week may delay or reduce the severity of dry AMD.

• Taking vitamins: The AREDS study done by the National Eye Institute found that taking a combination of vitamin supplements each day may slow down the progression of AMD. The AREDS formula includes 25,000 international units (IU) of beta carotene (only recommended for nonsmokers), 500 milligrams (mg) of vitamin C, 400 IU of vitamin E, 80 mg of zinc and two mg of copper. A number of drug stores, supermarkets and health food stores sell this combination in pill form. Other studies suggest that AMD may be slowed by taking lutein and omega-3 fatty acid supplements.

Other Tips

A variety of lifestyle changes can help prevent or delay wet and dry AMD, especially if you’re high risk, including:

• Not smoking. Avoid secondhand smoke, too.

• Exercising. Regular physical activity can help fend off wet AMD.

• Controlling your blood pressure. It’s not just a good idea for your heart; it’s good for your eyes, too.

• Protecting your eyes. Wear sunglasses that block 99 to 100 percent of UVA and UVB rays.

Resources

For more information on AMD, visit the National Eye Institute at www.nei.nih.gov. Also, see www.macular.org or www.amd.org. If you already have vision loss from AMD, vision rehabilitation programs can be very helpful. See www.visionconnection.org or call 800-829-0500 to find services in your area.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior.org. Jim Miller is a contributor to the “NBC Today Show” and author of The Savvy Senior books.