How to Spot the Early Stages of AMD

from IPN 2023 February

IPN 2023 February

Written by: Konstantina Danai Karagkiozeli, MSc, Science Communications Executive at Fighting Blindness (research@fightingblindness.ie ) And the ophthalmologists: Dr Matthew O’Riordan, Royal Victoria Eye and Ear Hospital Research Foundation, Dublin, Ireland - Mr Mark Cahill, Consultant Ophthalmologist, Progressive Vision Research, Dublin, Ireland

Age-related macular degeneration is a painless eye condition often referred to as AMD or macular degeneration. It is a progressive eye disease that affects up to 10% of adults over 65 years of age and is a leading cause of severe vision impairment and blindness in this age group.

window frames or door posts. If they see any distortion or realise sudden changes to their vision it is important to visit their doctor as soon as possible.

Independently of the above, to detect the earliest signs of AMD, it is recommended that everyone has an eye examination every one or two years by an optometrist or an eye doctor. This is particularly encouraged for people over 50 years of age, or who have a family history of AMD or both.

AMD causes the gradual loss of sight due to blurring or loss of central vision however the peripheral vision (vision to the side) is usually not affected. AMD is a chronic disease – it cannot be cured and in many patients sight cannot be restored after it is lost. However certain forms of the disease can be treated. Early detection is important to potentially stop the worsening of the disease and to protect an individual’s sight. Some changes in the vision that could be early signs to spot the development of AMD include:

• Straight lines such as door frames or steps appearing wavy or distorted.

• Smudge, shadow or gaps appearing in the field of vision.

• A glare in bright light or decreased levels of vision in low lighting or darkness.

• Challenges in reading small print, even with glasses, and in recognising colours or find that colours begin to fade.

• Printed words seem very blurry

• Difficulty in recognising or distinguishing faces and may notice everyday activities such as driving or watching TV can become seriously affected over time.

If anyone is having any of the above symptoms, we strongly recommend they visit an eye care professional as soon as possible as early detection can help avoid further eyesight damage.

Additionally, a useful test for spotting the early signs of AMD is the Amsler Grid. It is an at-home test where if an individual sees that the lines appear missing or wavy, they may have AMD and should contact their eye doctor immediately. Full instructions on how to use the Amsler Grid can be found on the Fighting Blindness website https://www. fightingblindness.ie/living-with- sight-loss/eye-conditions/agerelated-macular-degenerationamd/ Please note that even if the grid looks normal, people should still attend regular eye exams for early detection of AMD. Also, frequent self-check-ups can catch the progression of the eye condition while in the early stages of AMD. People can monitor their sight and do a self-check up by closing one eye and look at https://www.fightingblindness.ie/living-with-sight-loss/eye-conditions/age-related-maculardegeneration-amd/ Please note that even if the grid looks normal, people should still attend regular eye exams for early detection of AMD.

General eye check-ups are very important for people with AMD, as these individuals may still be at risk of developing other kinds of eye problems that affect the general population, some of which may be treatable. It is important to note if AMD is left untreated, serious sight loss can occur within 3-6 months so it is highly recommended to act fast in order to save as much as vision is left.

There are two forms of AMD, Early and Late. Only an eye care professional can tell which form an individual may have. In Early AMD the signs that the retina is being damaged are only visible to an eye care practitioner (optometrist or eye doctor). At this stage the damage does not affect sight and people are unaware of the condition. This highlights the importance of regular eye examinations to detect AMD in its early stages.

Some people progress from Early to Late AMD, where the condition causes loss of vision. There are two main types of Late AMD that can affect sight – Wet AMD and Dry AMD. The Dry form represents around 85-90% of all AMD cases, it causes gradual deterioration in your sight.

Wet AMD is a less common form of AMD but can develop more quickly and cause a rapid loss of vision. Wet AMD occurs when cells within the macula stop working and your body starts growing new blood vessels to fix the problem. The eye doctors may refer to this as neo-vascularisation.

Amsler Grid (Image Source: American Macular Degeneration Foundation)

Also, frequent self-check-ups can catch the progression of the eye condition while in the early stages of AMD. People can monitor their sight and do a self-check up by closing one eye and look at window frames or door posts. If they see any distortion or realise sudden changes to their vision it is important to visit their doctor as soon as possible.

It is important to note that AMD doesn’t cause a total loss of vision and, also, that it usually starts in one eye affecting the other only at a later stage.