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What is AMD?
Age-related macular degeneration (AMD) is a long-term, degenerative eye disease that gradually affects a person’s sight, often making it blurry or distorted, or causing gaps or dark spots in central vision[i]. There are two types of AMD, known as ‘dry’ and ‘wet’. Dry AMD is a gradual deterioration of the macula, as the retinal cells die off and are not renewed. The term ‘dry’ does not mean the person has dry eyes in terms of their tear production, just that the condition is not wet AMD. Around 10-15% of people with dry AMD also develop wet AMD[i].

Wet AMD affects the macula in different ways often causing more sudden and rapid changes in vision[ii]. This is often experienced as gaps or dark spots in the centre of a person’s vision and objects may seem distorted[ii]. In wet AMD, faulty blood vessels grow, leak fluid and blood in the back of the eye and can permanently scar the macula[ii]. If wet AMD isn’t controlled, it can result in central vision gradually getting worse, leading to difficulty in everyday activities, such as reading, recognising faces and driving[iii].

If you haven’t been diagnosed with AMD but are experiencing any of the above symptoms, get in touch with your local optician or GP as soon as you can.

Diagnosing wet AMD
Initial conversations about your symptoms should take place with your GP or optometrist. GPs have broad knowledge across all types of medical conditions; optometrists are trained eye specialists who examine eyes for visual defects as well as prescribing glasses and contact lenses[iv]. Both your GP and optometrist will usually refer you to an ophthalmologist, a medically trained doctor who specialises in eye care, if they suspect a more severe eye condition such as wet AMD. To learn more about the different healthcare professional roles, click here.

If your GP or optometrist suspects that you have wet AMD, according to national guidelines (e.g. The National Institute for Health and Care Excellence (NICE) AMD guidelines) you should be referred to an eye specialist within one working day and, if confirmed, receive treatment within two weeks. This is because wet AMD can progress quickly[ii], with vision getting worse over a short period of time, sometimes in days or weeks.

"You should be referred to an eye specialist within one working day."

Your eye specialist will conduct an eye exam and to confirm a diagnosis of wet AMD, they may do several other tests. The specialist may use[v]:

  • Examination of the back of your eye: Eye drops to dilate the pupils to see the back of the eye clearly to examine whether there is fluid, blood, or a mottled appearance that’s caused by drusen – yellow deposits that form under the retina. These may make your vision blurred and sensitive to light for a short time so consider taking someone with you.
  • Fluorescein dye angiography: A dye injected into a vein in the arm travels to the eye, highlighting the blood vessels in the retina so they can be photographed. The images will show if you have abnormal blood vessels or retinal changes. The dye will temporarily change the colour of your urine.
  • Optical coherence tomography (OCT): This non-invasive imaging test creates detailed scans displaying cross-sectional images of the retina. It identifies areas of swelling, thickening or thinning, and this test also helps monitor how the retina responds to macular treatments.

Treating wet AMD
Once your eye specialist confirms that you have wet AMD, the next step will be to think about your options. It’s completely normal to feel upset once you’ve been diagnosed and worry about what this might mean for your future. Talk to your friends and family about your feelings or if you feel it would be better to talk to someone outside your close circle, there are organisations such as the Macular Society who have an advice and information service and also offer free telephone counselling.

Although there is no cure for wet AMD[vi], the progressive worsening of vision can be slowed and sometimes even improved with consistent and effective treatment[vii]. Most people are treated with an anti-VEGF that is injected into the eye. Healthcare professionals who are trained to diagnose, treat and practice surgical procedures in the eye will carry out these treatments. To find out more about treatment options for wet AMD and how they work, click here.

In these exceptional times, hospitals and eye professionals are receiving regular guidance from The Royal College of Ophthalmologists as well as Public Health England to ensure everything possible is being done to make sure patients receive their eye injections in a safe environment.

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[i] Macular Society. Dry age-related macular degeneration. Available at: https://www.macularsociety.org/macular-disease/macular-conditions/dry-age-related-macular-degeneration/. Last accessed January 2021.

[ii] Macular Society. Wet age-related macular degeneration. Available at: https://www.macularsociety.org/macular-disease/macular-conditions/wet-age-related-macular-degeneration/. Last accessed January 2021.

[iii] NICE guidance. Age-related macular degeneration. Available at: https://www.nice.org.uk/guidance/ng82/chapter/Context. Last accessed January 2021.

[iv] The Royal College of Ophthalmologists. What is an Ophthalmologist? Available at: https://www.rcophth.ac.uk/about/what-is-ophthalmology/what-is-an-ophthalmologist/. Last accessed January 2021.

[v] Mayo Clinic. Wet Macular Degeneration: Diagnosis. Available at: https://www.mayoclinic.org/diseases-conditions/wet-macular-degeneration/diagnosis-treatment/drc-20351113. Last accessed January 2021.

[vi] All About Vision. Macular degeneration: Prevention and risk factor reduction. Available at: https://www.allaboutvision.com/en-gb/conditions/amd-prevention/. Last accessed January 2021.

[vii] American Academy of Ophthalmology. Anti-VEGF treatments. Available at: https://www.aao.org/eye-health/drugs/anti-vegf-treatments. Last accessed January 2021.

Page-Specific Approval Code UK | February 2021 | 107566