As a practice, it’s important to make sure your patients have all the information they need regarding their eye health. With November being a month to celebrate and spread awareness on men’s health, it’s a perfect opportunity to speak with your patients on the importance of eye health for men. An important aspect to keep them informed about is age-related macular degeneration.

Age-related macular degeneration is the leading cause of severe, irreversible vision loss in people over age 55. It is a progressive eye condition that is characterized by the gradual deterioration of the macula, which is the area of the retina responsible for central vision.[i] Macular degeneration is therefore a condition that causes the center of your vision to blur while the side or peripheral vision remains unaffected.[ii] For older patients, make sure you keep them informed on the facts about age-related macular degeneration and remind them to book an eye exam to make sure their vision is healthy.

TYPES OF MACULAR DEGENERATION

There are two main types of age-related macular degeneration:

DRY FORM:

• Characterized by the presence of yellow deposits, called drusen, in the macula. A few small drusen may be harmless, however, as they grow in size and increase in number, they may distort vision that people find most noticeable when they read.[iii]
• In more advanced stages, the light-sensitive layer of cells in the macula can begin to thin leading to atrophy, or tissue death. During this stage, patients may have blind spots in the center of their vision. In more advanced stages, patients can lose their central vision.[iv]

WET FORM:

• Characterized by the growth of abnormal blood vessels from the choroid underneath the macula. Known as choroidal neovascularization, these blood vessels leak blood and fluid into the retina, causing distortion of vision that makes straight lines look wavy, as well as blind spots and loss of central vision. These abnormal blood vessels and their bleeding eventually form a scar, leading to permanent loss of central vision.[v]

The most common form of age-related macular degeneration is the dry form. Most patients who have it can lose some form of their central vision. The dry form can also lead to the wet form. Only 10% of patients with the dry form will develop the wet form of macular degeneration and they make up the majority of patients who will experience a severe form of vision loss from the disease.[vi]

Once a patient has been diagnosed with the disease, it is very important for them to monitor their eyesight carefully and see their eye doctor on a regular basis. In other words, patients over the age of 55 should have a close relationship with their optometrist in order to stay on top of any vision issues.

Talk to your patients on ways they can monitor their vision at home. Optometrists use a test called the Amsler grid to determine the function of a patient’s central vision. The checkerboard should appear to have straight lines and if the lines begin to bend or show sudden changes, it could be a sign of macular degeneration. Explain to your patients how the grid works and give them a printout of it for them to bring home and monitor their vision.

To help your patients stay on-top of their vision health, here is a breakdown of signs and symptoms they should look out for:

RISK FACTORS FOR MACULAR DEGENERATION

As the term suggests, age-related macular degeneration is much more common in older adults, typically over the age of 55 years old. Macular degeneration may also be hereditary, being passed on from parents to children. Make sure to know your patient’s family history in order to better assess their personal vision issues. The following list can make it easier for your patients to understand their risk of developing macular degeneration.

PREVENTION

Although age-related macular degeneration is mostly present in older adults, there are preventative steps your patients can take to avoid getting the disease. Two big factors for patients to take into consideration is lifelong UV protection and good nutrition.[vii] A healthy lifestyle is thought to be the best way to prevent the possibility of developing macular degeneration later in life. A diet high in antioxidants such as beta-carotene, vitamins C and E, zinc, lutein, selenium and omega-3 fatty acids may help prevent macular degeneration. Most of these antioxidants are found in fruits and leafy vegetables.[viii] Lastly, remind your patients on the importance of booking regular eye exams, this is especially relevant for macular degeneration since an eye exam is the best way to detect its presence and for early detection.[ix]

TREATMENT

For the moment, dry macular degeneration is treated with ocular vitamin supplementation and lifestyle adjustments through exercise, sunglasses to reduce UV radiation and stopping smoking.[x] In cases of wet macular degeneration, some can be treated with medications injected into the eye to stop leaking blood vessels.[xi] However, early detection and timely intervention are crucial to treating wet macular degeneration.

As a practice, if you have patients who are suffering from the symptoms of macular degeneration, there are tools you can offer to help them with their vision. Low vision aids are a great way to help patients see better through their macular degeneration. You can prescribe magnifying devices to enhance both distance and reading vision to help maximize any remaining vision.[xii]

It’s extremely important to keep you patients educated on the various vision issues they may face. The more you get to know your patient, the more you can offer specialized care and advice to assist in their eye health.

[i] https://www.webmd.com/eye-health/macular-degeneration/age-related-macular-degeneration-overview#1

[ii] https://opto.ca/health-library/amd%20and%20low%20vision

[iii] https://www.webmd.com/eye-health/macular-degeneration/age-related-macular-degeneration-overview#1

[iv] https://www.webmd.com/eye-health/macular-degeneration/age-related-macular-degeneration-overview#1

[v] https://www.webmd.com/eye-health/macular-degeneration/age-related-macular-degeneration-overview#1

[vi] https://www.webmd.com/eye-health/macular-degeneration/age-related-macular-degeneration-overview#1

[vii] https://opto.ca/health-library/amd%20and%20low%20vision

[viii] https://opto.ca/health-library/amd%20and%20low%20vision

[ix] https://opto.ca/health-library/amd%20and%20low%20vision

[x] https://opto.ca/health-library/amd%20and%20low%20vision

[xi] https://opto.ca/health-library/amd%20and%20low%20vision

[xii] https://opto.ca/health-library/amd%20and%20low%20vision