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What is macular degeneration and how to prevent it

By John C. Hagan III, MD

If there is anything that modern medical research confirms it’s that the good and bad choices you make with regard to your lifestyle have a major effect on how long you live, how well you live and even whether your vision will hold up into your golden years.

Eating a healthy diet, exercising regularly, losing weight if you’re overweight, maintaining normal blood pressure and not smoking are all healthy behaviors that do more than keep you lean and healthy – they can save your sight too. These healthy habits can reduce your risk of developing age-related macular degeneration (AMD), the leading cause of vision loss in Americans 60 years of age and older. (They may even help protect against cataracts, not to mention stroke, heart disease and some types of cancers!)

What Is Age-Related Macular Degeneration (AMD)?

AMD is a painless eye disease associated with aging that affects the macula, the part of the eye that allows you to see fine detail. The macula is used for reading, looking at computer screens, driving, recognizing faces and all fine vision. Its structure provides ultra-sharp vision that the peripheral retina cannot produce; however this delicate architecture also predisposes it to the effects of age and disease. (Think of how a pair of blue jeans wears out in the knees first.) AMD gradually destroys sharp, central vision, making it difficult to see common objects clearly.

There are two forms of macular degeneration: “dry” (non-exudative) AMD, and “wet” (exudative), or advanced, AMD. Dry AMD accounts for 90 percent of the total cases of AMD but only 10 percent of cases of legal blindness, while wet AMD occurs only 10 percent of the time but causes 90 percent of the cases of legal blindness. Legal blindness means that the best possible vision, even with glasses, is 20/200 or worse. The peripheral or side vision is not affected by macular degeneration so the eye is not totally blind, but the central field of vision is greatly impaired. 

Wet macular degeneration develops when dry macular degeneration suddenly worsens as tiny blood vessels (“neovascularization”) break through from behind the retina into the macula and leak blood and fluid, causing scar formation. A new form of treatment which uses injectable medicines to stop the bleeding without damage to other eye tissue has dramatically improved prognosis for people with wet macular degeneration. 

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