Age related macular degeneration (ARMD) is the major cause of central vision loss in Americans aged 55 and older. ARMD is a deterioration or breakdown of the macula. The macula is a small area at the center of the retina in the back of the eye that allows us to see fine details clearly and perform activities such as reading and driving.
The visual symptoms of ARMD involve loss of central vision. While peripheral (side) vision is unaffected, one loses the sharp, straight-ahead vision necessary for driving, reading, recognizing faces, and looking at detail.
Although the specific cause is unknown, ARMD seems to be part of aging. While age is the most significant risk factor for developing AMD, heredity, blue eyes, high blood pressure, cardiovascular disease, and smoking have also been identified as risk factors. AMD accounts for 90 percent of new legal blindness in the US.
Nine out of 10 people who have ARMD have the dry form (called atrophic), which results in thinning of the macula. Dry ARMD occurs when cells under the macula break down and create deposits called drusen. It is drusen that can make you lose some vision. Dry ARMD usually develops slowly over time, with few symptoms until it reaches an advanced stage. This advanced stage is commonly refered to as Wet ARMD. Currently there is no treatment for the dry form of ARMD.
The wet form of ARMD (called exudative) is less common (occurring in one out of 10 people with ARMD), but is more serious. In the wet form of ARMD, abnormal blood vessels may grow in a layer beneath the retina, leaking fluid and blood and creating distortion or a large blind spot in the center of your vision. To visualize this, imagine the roots of a tree growing and spreading until they actually uproot a sidewalk. Then imagine rainwater seeping up through the cracks. These abnormal blood vessles (the "roots") tend to be very fragile. They often grow, and leak or bleed, causing scarring of the macula. This damage to the macula results in rapid central vision loss. If the blood vessels are not growing directly beneath the macula, laser surgery is the only proven effective treatment, to date, for wet ARMD. The procedure usually does not improve vision but prevents further loss of vision. For those wet ARMD patients whose blood vessels are growing directly under the center of the macula, Lucentis® has become the preferred treatment.
Promising ARMD research is being done on many fronts. In the meantime, high-intensity reading lamps, magnifiers and other low-vision aids help people with ARMD make the most of their remaining vision.
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