What is age-related macular degeneration?
The macula is a small area at the centre of the retina which is responsible for what we see straight in front of us, allowing us to see fine detail for activities such as reading and writing, as well as our ability to see colour.
Vision can be severely affected if the cells of the macula are damaged and stop working – this is known as age-related macular degeneration (AMD). Symptoms include blurred vision or distortion (with straight lines appearing wavy and objects appearing to be an unusual size or shape). In more advanced cases, sufferers develop a blank patch or dark spot in the centre of their sight which makes reading, writing and recognising some objects difficult.
Age-related macular degeneration (AMD) is a common condition affecting older people. About one in 100 people aged 65-75, and about one in eight people aged over 85 have AMD that is severe enough to cause serious visual loss.
There are two types of AMD:
“Dry” macular degeneration occurs when the cells within the macula stop working. This normally happens slowly and it may take several years for vision to be severely affected. Dry macular degeneration is the most common form of AMD and accounts for 90% of all cases “Wet” macular degeneration is caused by the growth of abnormal blood vessels within the retina, leading to a build-up of fluid, bleeding and scarring. Wet AMD can cause serious visual loss in a much shorter space of time than dry AMD, sometimes within a few months.
The treatment options for dry AMD are very limited. Not smoking and eating a healthy diet is recommended as this may help slow down visual loss. However, one new treatment that has shown some promising early results is IOL VIP (Intraocular Lens for Visually-Impaired People).
During IOL VIP two lenses are inserted into the eye under local anaesthesia. These lenses help to magnify the images we see in front of us and can also be used to direct them to a less damaged part of the macula, with the aim of improving vision in the treated eye.
IOL VIP is generally performed as a day-case procedure, with no overnight stay in hospital. The procedure itself takes about 20 minutes but, at the moment, it's too early to say how successful this treatment will be in the future.
One possible treatment for wet AMD is the injection of a drug that controls the build up of fluid under the retina. The drugs are known as VEGF inhibitors. The injections are not a cure for AMD but they may stop it from getting worse and in some cases, may improve sight providing treatment is started at an early stage.
The injections are carried out as a day-case or out-patient procedure, with no overnight stay in hospital. They are usually performed under local anaesthesia, which means that you will be awake during the procedure.
Your consultant will discuss the benefits and associated risks of injections for wet AMD together with any alternatives to the treatment.
About the injections for Wet AMD
Before the injection you will be given local anaesthetic eye drops and the area around your eye will be cleaned with an antiseptic. Once the anaesthetic has taken affect, your consultant will inject the drug through the wall of the eye.
The injection takes a few minutes and you will usually be able to go home about an hour later.
You may need regular repeat injections for the treatment to be successful – please ask your consultant for further advice.
Injection for wet AMD is a relatively new treatment. Like all medical procedures, there are risks as well as benefits.
Although a rise in pressure within the eye is expected immediately after the injection, occasionally an incision is required to release fluid from the eye.
In rare cases the inside of the eye can become infected. This can be serious and can lead to permanent loss of vision - antibiotic eye drops are used to reduce the risk of infection.
Also in rare cases, the retina can become detached, which may require surgery.
The chance of complications depends on the exact type of injection you are having and other factors such as your general health. You should ask your consultant how any risks apply to you.