What is age-related macular degeneration (AMD)?
"AMD is a condition in which the macula, a highly sensitive area of the retina responsible for central and detail vision (about the size of this "O"), is damaged. There are two forms of AMD. Both cause loss of central or straight-ahead vision (as needed for driving a car, reading fine print and recognizing faces) but, fortunately, not side vision," explains Daniel Ferguson, MD, a partner at Eye Care Specialists, where thousands of AMD patients are diagnosed and treated each year. "'Dry' AMD is more common (90% of cases), progresses slowly, and is caused by a thinning of macular tissue. 'Wet' AMD is less common, can progress quickly, and is marked by the growth of abnormal new blood vessels under the macula, which can leak fluid and blood. This leakage can create scar tissue which causes blind spots and profound loss of sharp central vision. The earlier it is detected, the better the chances of preserving vision."
Who is most at risk?
"AMD is the leading cause of central vision impairment in Americans over age 50. As baby boomers age and life expectancy increases, AMD looms as a growing health and cost concern," warns Brett Rhode, MD, Head of Ophthalmology at Aurora Sinai Medical Center and private practitioner in Milwaukee and West Allis.
How fast does sight deteriorate?
Dry AMD usually does not result in rapid vision loss, and many patients retain good sight throughout their lives. Some, however, need to use magnifiers and aids. Wet AMD tends to cause a rapid and profound loss of sharp central vision, which may result in legal (less than 20/200 vision), but not total, blindness (because some side vision remains). Without treatment, about 70% of wet AMD patients become legally blind within two years.
What treatments are available?
Rhode explains, “If dry AMD is diagnosed, we may recommend vitamin supplements, healthy omega fatty acid intake, sun protection, and avoidance of smoking, as measures to prevent or slow progression. If wet AMD is diagnosed, we review the risks, benefits and candidacy for injections of a medication called Avastin.” Avastin is a revolutionary drug that inhibits the growth of the abnormal blood vessels that cause “wet” AMD. “Although there are NO guarantees, we have seen remarkable results with Avastin. With regular injections (about every month or so), we have been able to stop the progression of wet AMD in 90% of our patients, and even had up to 30% gain improvement in vision," adds Ferguson. (Avastin is also successfully used to treat diabetes-related vision damage.)
What else can be done?
Besides following a treatment plan, you can stay independent and productive by utilizing low vision aids (like hand-held and closed circuit TV magnifiers, telescopic devices, talking books, etc.), contacting support/transport services, and learning new ways to perform activities.
Personal Story: Longtime patient maps plan for good vision
For more than 15 years, the doctors and staff of Eye Care Specialists have had the pleasure of caring for patient Ralph Haeselich, 88 and his wife Anneliese. Through bouts with cataracts and now macular degeneration, Haeselich has been diligent about keeping his appointments, often coming in with a smile and a batch of homemade cookies for the office.
Haeselich, a retired US Forest Service worker with a background in cartography (map-making), has definitely “seen” a benefit from the years of office visits. "I'm fortunate enough that, at my age, I can still drive us around," he notes. There was a time recently however, when Haeselich wasn't so sure he would have any vision, let alone be able to drive or even look at a map. "I thought I was going blind in my left eye," he recalls, "I couldn't see out of the right half of my left eye at all. That's when Dr. Freedman started the (Avastin) injections." With laser scan mapping and Avastin treatment, Haeselich’s left eye has been able to maintain 20/30 vision. "Dr. Freedman definitely saved my eyesight," exclaims Haeselich.
In the years since his retirement, Haeselich and his wife have been very active in their church (volunteering and starting up a clothing and food pantry) as well as keeping up with their growing family that now includes a great-great grandchild. To anyone dealing with wet AMD, Haeselich advises, "If you need the injection treatment, get it, try it. It saved my eyesight.” His wife’s face lights up with a smile when she declares, “He can still see me!” She then adds, “We’re so very grateful to Dr. Freedman.”
Are you at risk for AMD?
Although the exact cause is unknown, the following are culprits behind AMD:
* Race (white ethnicity)
* Gender (being female)
* Smoking (increases risk 3-4 times)
* A diet high in fat and low in vitamins, minerals and antioxidants
* Sun exposure
* Circulatory problems
* Light eye color
Warning signs for AMD
AMD usually develops gradually and painlessly, and good vision in one eye can mask problems in the other. As AMD progresses, however, signs may become obvious. If you suddenly notice any of the following symptoms, schedule an eye exam ASAP,” advises Robert Sucher, M.D., co-founder of Eye Care Specialists, one of Wisconsin’s leading ophthalmology practices.
* Difficulty reading or doing close-up work
* Faces, clocks and printed words appear blurry
* Distortion of lines, colors, sizes and edges
* Straight lines in a landscape appear wavy
* Blind spots (dark or empty spaces) in the center of vision
Free educational booklets & information
Eye Care Specialists’ doctors are dedicated to the diagnosis and treatment of AMD, glaucoma, diabetic eye disease, and cataracts. They frequently lecture to the public and fellow physicians and have written their own series of booklets on these conditions. Call 414-321-7035 for FREE copies or to schedule an appointment (usually covered by insurance or Medicare) at their offices on 7th & Wisconsin Avenue, Mayfair Road across from the mall, or 102nd & National. They also offer information at www.eyecarespecialists.net.
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