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It is degenerative changes in the macula, the most sensitive central portion of the retina, reducing central vision. There are two types of AMD:
- The "dry" type occurs where the macular tissue accumulates deposits called drusen. It is a gradual process, affecting 90% of people who have AMD.
- "Wet" AMD occurs when fluids leak from blood vessels beneath the macula. It affects 10% of people who have AMD
There is no definitive cause. The risk factors are: - Most significantly - smoking. Smokers are about 2.5 times more likely to develop AMD than non-smokers
- Being over 50 years
- Having hypertension or cardiovascular disease
- Having a family history of AMD
- Having a strong history of UV light exposure e.g. outdoor work
It is more common in older people and women. In Australia, of those who have some form of AMD: - 9% are over 50 years
- 23% are over 65 years
- 31% are over 80 years
People may not realise they have a problem until their central vision becomes blurred. An optometrist can further investigate the condition using: - The Amsler Grid; People having AMD often report that sections of the regular grid pattern may appear distorted or missing
- Retinal photography
- Visual field testing
- Macular function tests
AMD can be treated but not cured. The retina is nerve tissue and this cannot regenerate so early detection is crucial. Preventive measures for dry AMD include: - stop smoking
- a well balanced diet; high in dark green leafy vegetables and fruit
- dietary supplements containing zinc and anti-oxidant vitamins E, C and beta carotene
- health care practitioners should help determine use of supplements
There are 3 available surgical treatments for wet AMD: - Laser photocoagulation
- Photodynamic therapy (PDT)
- Anti-VEGF(vascular endothelial growth factor)
Vision may decrease after some treatments but it is less severe than the eventual loss of vision if no laser treatment is performed. Multiple treatments may be required to achieve optimal results. People may have problems reading and seeing detail even with spectacles. - Low vision aids are available from optometrists and organisations such as Vision Australia
- Magnifiers, large print books, closed circuit televisions and improved lighting may help significantly
Consultations for detection and treatment of AMD may be claimed through Medicare.
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