Macular Degeneration

Macular degeneration usually affects people over 50 years of age, and is known as Age-related Macular Degeneration (ARMD or AMD).

There are other forms of macular disease which affect younger people, which are often termed 'macular dystrophy' and may run in families - however, this type of macular degeneration is rare. Macular degeneration can also be caused by eye injury, infection or inflammation. Diabetes can also cause macular disease (known as diabetic retinopathy).

AMD alone does not result in total blindness. Only the central (reading) vision is affected and the surrounding vision remains normal. Useful side vision that allows you to see to get around is retained in both forms of AMD.

There are two forms, wet and dry. In the wet form, if abnormalities are detected early, and depending on the location of the abnormal vessels under the retina, laser treatment may be effective in arresting AMD in a minority of patients. Other forms of therapy for the wet form include a form of cold laser called photodynamic therapy and also the use of injections into the eye. There is no known effective therapy for the dry form.

If you come to Moorfields Private service you can be assured that all these options will be available to you, and the best and most appropriate course of action will be taken.  Macular degeneration affects the macula at the back of the eye, impairing central vision.

The macula is a small area in the centre of the retina. It is the centre-most part of the retina where the light comes to a focus when you are looking at an object, and is where detailed vision takes place and is responsible for sight in the centre of the field of vision.

Macular degeneration is not a painful condition. In fact, some people do not even realise that they have the condition until their symptoms become more severe.

The main symptom of macular degeneration is blurring of your central vision. Your peripheral vision (outer vision) is not affected.

If you have macular degeneration, your central vision will still be blurred, even when you wear glasses.

Dry age-related macular degeneration

If you have dry age-related macular degeneration (AMD), it may take between five and 10 years before you find that your symptoms are significantly affecting your daily life.

Sometimes, if only one of your eyes is affected by dry AMD, your healthy eye will compensate for any blurring or loss of vision, which means that it will take longer before your symptoms become more noticeable.

You may have dry AMD if you find that:

• you need brighter light than normal when reading,
• it is difficult to read printed or written text (because it appears blurry),
• colours appear less vibrant,
• you have difficulty recognising people's faces, or
• your vision seems hazy, or less well defined.

If you are experiencing any of these symptoms, you should make an appointment with your GP or optometrist (a health professional who specialises in diagnosing vision problems and eye conditions).

Wet age-related macular degeneration (AMD)

If you have wet age-related macular degeneration (AMD), you may also experience other symptoms as well as blurred central vision. In wet AMD, the symptoms appear more suddenly than they do in dry AMD.

The typical symptoms of wet AMD are described below.

• Visual distortions - for example, straight lines may start to appear wavy or crooked. This is known as metamorphopsia.
• Blind spot - this usually appears in the middle of your visual field. The longer a blind spot is left untreated, the larger it will become. This is known as a central scotoma.

You should seek immediate medical assistance if you, or someone that you know, experiences any sudden changes in their vision, such as those described above.

It may be a sign you have wet AMD, which needs to be treated as soon as possible.

If you require immediate medical attention, you will either need to book an emergency appointment with an optometrist, or visit your local hospital's accident and emergency (A&E) department. It is very important for you to seek medical attention as soon as possible to reduce the risk of the condition causing any permanent damage to your vision.

The retina and macula rest on another layer at the back of the eye (the choroid), which provides oxygen and nutrition to the retina and is responsible for clearing waste products. Between the retina and choroid there is a thin membrane (Bruch's membrane) through which the nutrients and waste products pass. Abnormalities in Bruch's membrane cause macular degeneration either by blocking nutrition or causing blood vessels of the choroid to grow under the retina; these blood vessels destroy structures around them as they grow. If the cells in the macula deteriorate then the central part of your field of vision (what you can see) becomes blurred.

What is seen around the blurred area is relatively clear because the peripheral retina works normally. This means you will retain enough peripheral sight to see to get around, but activities which need close sight, such as reading, get more difficult.

You do not need a GP’s written referral letter to see a Moorfields Private consultant. If you know which consultant you would like to see, please contact their private secretary to make an appointment or receive further information, alternatively, email us at enquiries@moorfields-private.co.uk