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Macular disease is the biggest cause of sight loss in the UK and age-related macular degeneration (AMD) is the most common type[i]. 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[ii].

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[iii].

"Around 10-15% of people with dry AMD also develop wet AMD."

Currently wet AMD is the only form of the condition which is treatable. Approximately 39,800 people in the UK develop wet AMD each year[iv].

Managing your disease progression with your eye specialist
Wet AMD can develop quickly and worsen over time[v]. To help slow down the progression of the disease, your eye specialist may recommend a so-called anti–vascular endothelial growth factor, or anti-VEGF, treatment[vi]. Every person responds differently to treatment, and therefore it’s important to monitor for any changes in your vision. It is also important to make the most of the time you get with your eye care team, so take this quick questionnaire and download your appointment guide.

1. Attend regular eye check-ups. Your eye specialist will regularly monitor the progression of your wet AMD during appointments and may use an optical coherence tomography (OCT) scan to take pictures of the back of your eye. The OCT is a common, non-invasive technique that produces images of the back of the eye and helps your eye specialist monitor changes in your condition, including the presence and build-up of fluid[vii].

Regular appointments will help your eye specialist decide the best treatment option and dosing schedule for you, adjusting them over time as needed. For more information on treatment for wet AMD, see here.

OCT image of an eye with wet macular degenration
OCT image of an eye with wet macular degeneration

OCT image of an eye with wet macular degeneration (top)
OCT image of a healthy eye (bottom)
 

Eye appointments during the COVID-19 pandemic
During this exceptional time, many people may understandably feel anxious about going to public places, including the eye clinic. However, to effectively manage the progression of wet AMD, it is extremely important to continue to attend eye appointments for injections and monitoring.

In the UK, hospitals and eye care 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 people receive their eye injections in a safe environment. Speak to your eye care team about any concerns you may have and how to prepare for your next visit. They will be able to explain how the current situation and possible social distancing rules may affect your appointment.

2. Monitor progression at home. Your eye specialist may also ask you to keep track of your vision at home by using a tool such as an “Amsler grid”, used to detect and monitor changes in vision caused by damage to the macula. A healthy eye will usually see the lines as straight, while to someone with wet AMD the lines can appear distorted or blurry, or be blocked out by an empty gap or dark spots in the centre of the vision.

You can order an Amsler grid by visiting macularsociety.org for more information or by calling 0300 3030 111. Once you have received it, you can follow the steps below:

  1. Go to the room in your home where you do most of your reading and carry out other close-up tasks, and use the light you would normally use for these activities
  2. Place or hold the Amsler grid at your arm’s length, approximately 30-38 centimetres or 12-15 inches from your eyes
  3. Test each eye individually by covering one eye while testing the other
  4. Keep your eye focused on the dot in the centre of the grid and answer these questions:
    • Do any of the lines in the grid appear wavy, blurred or distorted?
    • Do all the boxes in the grid look square and the same size?
    • Are there any "gaps" (missing areas) or dark areas on the grid?
    • Can you see all the corners and sides of the grid, while keeping your eye on the central dot?
  5. Switch to the other eye and repeat.

Aim to test your eyes with an Amsler grid once a week and make sure to report any irregularities to your eye specialist immediately. To help you and your eye specialist understand how your condition is progressing, mark any areas of the Amsler grid that you're not seeing properly and bring the grid with you on your next visit.

Healthy living for healthy vision
While the exact cause of AMD is unknown, there are many risk factors believed to be linked to the disease[v]. Lifestyle changes you can make today can have a positive effect on your health overall, your eye health, and help you maintain your independence for longer. 

From a healthy diet to regular exercise, there are a number of ways you can protect your eyes[viii]. For more information on lifestyle changes you can make today, click here.

Related Articles

Doctor and patient during appointment

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[i] Quartilho, A et al. Leading causes of certifiable visual loss in England and Wales during the year ending 31 March 2013. Eye vol. 30(4), 602-607. 2016.

[ii] NHS. Symptoms: Age-related macular degeneration (AMD). Available: https://www.nhs.uk/conditions/age-related-macular-degeneration-amd/symptoms/. Last accessed January 2021.

[iii] 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.

[iv] Owen CG, Jarrar Z, Wormald R, et al. The estimated prevalence and incidence of late stage age related macular degeneration in the UK. Br J Ophthalmol 2012;96:752-756.

[v] NHS. What is AMD? Available at: https://www.nhs.uk/conditions/age-related-macular-degeneration-amd/. Last accessed January 2021. 

[vi] Macular Society. Treatments. Available at: https://www.macularsociety.org/diagnosis-treatment/treatments/. Last accessed January 2021.

[vii] Ursula Schmidt-Erfurth, Victor Chong, Anat Loewenstein et al. Guidelines for the management of neovascular age-related macular degeneration by the European Society of Retina Specialists (EURETINA). Br J Ophthalmol. 2014; 98(9): 1144-1167.

[viii] 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.

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