Introduction

For age-related macular degeneration, you should see an ophthalmologist (a medical doctor who specializes in eye care and surgery).

In general, people older than 45 years should have a complete eye examination and then follow-up examinations every two to four years.

People with age-related macular degeneration should check their vision daily and promptly notify their ophthalmologist of any changes in their vision.

It should be very rare that a person must go to a hospital for macular degeneration problems. Because of the specialized nature of eye examination equipment, macular degeneration problems are usually handled best in the ophthalmologist's office.

If you notice a sudden decrease in vision in one or both of your eyes and you cannot reach your ophthalmologist, go to the hospital's emergency department. Timely treatment of early wet age-related macular degeneration can prevent further visual loss.

Visual symptoms and/or eye pain may not be symptoms of age-related macular degeneration. You may need prompt diagnosis and treatment of a different eye condition.

Self-Care at Home

In an age-related eye disease study, people with moderate and advanced age-related macular degeneration were shown to have a significant benefit with regard to disease progression by taking dietary supplements containing high-dose antioxidants and zinc.

Smoking cessation is recommended for everyone in order to prevent or slow down progression of retinal disease.

People with advanced age-related macular degeneration may benefit from low-vision aids.

• Handheld magnifiers for reading
• Telescopes to see into the distance
• Talking watches
• Computers that talk or that use large type faces

People should be encouraged to use the remaining peripheral vision that is unaffected by the macular degeneration.

• A useful test that may indicate macular problems or worsening of age-related macular degeneration is the Amsler grid.
• The Amsler grid consists of a square grid with a dark dot in the middle.
• Broken or distorted lines or a blurred or missing area of vision could be one of the first signs of age-related macular degeneration.
• The grid also helps to monitor changes in vision once changes have been detected.
• The Macular Degeneration Partnership offers a self-test online with the Amsler grid.

Follow-up

Because some people with the dry form of macular degeneration may develop the wet form, those with the dry form should monitor their vision daily and notify their ophthalmologist of any changes in their vision.

If you have the wet form of the disease and have had laser treatment, you should test your vision to see if any blind spots grow bigger or if any new blind spots appear. New blood vessels can emerge months or years after you have had successful laser treatment.

If only one eye is affected, your ophthalmologist will perform regular eye examinations on your other eye to discover any sign of new problems.

Prevention

There are no proven preventive medications for age-related macular degeneration.

• The best way to prevent vision loss is to get prompt examination and diagnosis by your ophthalmologist. The earlier you treat it, the better the chance that treatment will help.
• People older than 45 years with a family history of age-related macular degeneration have a greater chance of developing the disease.
• Using the Amsler grid may help detect subtle changes in your vision. You can monitor your vision daily by posting an Amsler grid on your refrigerator.
• Ophthalmologists generally recommend that you stop smoking, eat a balanced diet that includes leafy green vegetables, and protect your eyes from sun exposure with sunglasses that block ultraviolet (UV) sunrays. It is a good preventive measure not to smoke. A literature review found a two- to threefold higher risk for developing age-related macular degeneration in smokers.
• The Age-Related eye Disease Study found that supplementation with antioxidants plus zinc decreased the likelihood of developing advanced age-related macular degeneration in some people.
• Vision exams for those older than 65 years should include age-related macular degeneration screening.

Outlook

Not all people with age-related macular degeneration experience significant vision loss in both eyes. Only 59% of those who lose vision in one eye lose vision in the other eye as well.

People rarely lose all of their vision from macular degeneration. They may have poor central vision, but they are still able to perform many normal daily activities.

The wet form of age-related macular degeneration is a leading cause of irreversible legal blindness. When both eyes are affected, you lose significant quality of life.

The dry form of age-related macular degeneration is much more common and tends to progress more slowly, allowing you to keep most of your vision.