Merck Manuals Answers Common Questions About Age-Related Macular Degeneration
And while it typically does not lead to total vision loss, AMD can cause serious visual impairment, which can affect a person's ability to drive, read, and even recognize faces, says
Mehta answers some of the most common questions surrounding AMD in a new editorial from MerckManuals.com.
What is AMD?
If we think of the eye like a camera, the retina is like film where light is converted to electrical signals that are sent to the brain, says Mehta. The macula is the central and most vital area of the retina. As people get older, they can develop spots on the macula known as drusen, which are similar to age spots on the skin. As a result, central vision becomes washed out and loses detail, and straight lines may appear wavy.
What is the difference between dry and wet AMD?
There are 2 types of AMD: dry and wet. All AMD starts as the dry type, says Mehta. In dry AMD, which is characterized by the drusen deposits, the tissues of the macula become thin as cells disappear.
In dry AMD, the loss of central vision occurs slowly and painlessly over years. As the disease progresses, central blind spots (scotomas) usually occur and can sometimes severely impair vision.
Wet AMD develops when abnormal blood vessels grow under the damaged macula and leak fluid and blood (hence the description as "wet").
What causes AMD?
There's no single known cause of AMD, says Mehta. It is a degenerative condition that develops over time, most often in people over the age of 50. It can run in families, although having a family history does not mean someone will definitely develop it.
Several risk factors can increase the likelihood of AMD, including smoking, poor nutrition, high blood pressure, and cardiovascular disease, says Mehta.
Can AMD be prevented?
The best ways to lower the risk of AMD, says Mehta, include avoiding smoking, controlling blood pressure, staying physically active, and eating a healthy diet, especially one rich in omega-3 fatty acids found in fish and dark, leafy green vegetables.
How is AMD treated?
For people with intermediate or advanced AMD in at least one eye, certain dietary supplements are recommended to help slow disease progression, says Mehta.
In the wet form of AMD, medications can be injected directly into the eye (intravitreal injections) to stop abnormal blood vessels from leaking. These treatments significantly reduce the risk of vision loss and can even improve reading vision in about one-third of patients.
For people with severe vision loss from AMD, doctors may also:
- Give additional injections in the back of the eye
- Use laser or light-based treatments to seal abnormal blood vessels
- Recommend low-vision tools, such as magnifiers, special reading glasses, or electronic devices
- In select cases, implant a miniature telescope inside the eye to improve central vision
Can people with AMD still drive?
It is very common for people with AMD to worry about losing the ability to drive, and understandably so, says Mehta. AMD is a progressive condition, so regular monitoring for any vision changes is important.
Beyond driving, AMD can affect many daily activities, but there are excellent low vision tools and resources available to support both near and distance vision. The first step is to meet with an ophthalmologist, who can recommend the right aids or specialty care based on the individual's current vision.
To read more of Mehta's insights on AMD, visit the editorial on MerckManuals.com.
About The Merck Manuals and MSD Manuals
First published in 1899 as a pocket-sized reference for physicians and pharmacists, The Merck Manual has evolved into one of the world's most trusted and widely-used medical resources. Today, it serves professionals and consumers alike with expert-authored, regularly updated medical content. Available in 16 languages and reaching nearly 250 countries, The Manuals offer far more than text. The website and mobile apps feature an ever-growing collection of videos, podcasts, infographics, and interactive 3D models designed for medical professionals, students, veterinarians, and curious consumers. For over a century, The Merck Manual has been fully committed to making reliable medical knowledge accessible to everyone, everywhere. Access The Manuals online in
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