How to Prevent Macular Degeneration

David, a 60 year old male came into the community pharmacy and complained to the pharmacist about his worsening vision. He mentioned that he recently had symptoms such as increasing difficulty for both eyes to adjust to dim lights, blurry vision, and sometimes difficulty recognising familiar faces. The pharmacist referred him to the ophthalmologist, and he found out that he has macular degeneration. He was devastated and regretted not undergoing eye examination as soon as possible to prevent the disorder from progressing. 

What is macular degeneration? 

Macular degeneration, also known as age-related macular degeneration (AMD or ARMD) is a common eye disorder among people above age 50. AMD prevalence rose from 2% in the 40–44 age group to 46.6% in the 85+ age group. 

AMD is due to the degradation of the inner layers of the macula degrading, which resulted in distorted or diminished central vision. The macula is a component of the retina, providing the eye with sharp vision while looking directly in front of it. The macula's tissue may deteriorate and lose vision-producing cells over time.

How to know if you may have macular degeneration?  

There are 2 types of macular degeneration- dry and wet macular degeneration, with dry macular degeneration being the more common one.  

Symptoms typically appear gradually and painlessly which include: 

• Visual distortions such as the appearance of wavy-looking straight lines 

• Decrease in one's or both eyes' central vision, which is required for close-up work, reading, recognising faces and driving. 

• Requiring brighter light when reading or performing close-up work  

• Difficulty adjusting to dim light conditions such as the cinema 

• Printed words looks blurry 

• Difficulty recognising faces 

• A blind spot or dark, empty area or hazy area in the field of view.

One or both eyes can be affected by dry macular degeneration. It's possible that you won't notice any changes in your eyesight if only one eye is damaged. This is because your healthy eye might make up for your impaired eye. The dry type usually progresses gradually over the years, and may progress to wet macular degeneration. 

Wet macular degeneration is less common and occurs when the blood vessels under the retina swell and leak fluid - hence the name wet AMD. The wet type is more likely to result in a more severe vision loss. 

Who is more likely to have macular degeneration? 

The exact cause is unknown. However, research shows that macular degeneration might be caused by a mix of environmental factors such as smoking, obesity, and food as well as family genes. 

You may be more susceptible to macular degeneration due to: 

• Age over 50 years old 

• Family history and genetics. Research has shown that there are several genes connected to the illness. 

• Race. Macular degeneration is more prevalent among white people. 

• Smoking. Macular degeneration is significantly more likely to occur if you smoke cigarettes or are frequently exposed to tobacco smoke.

• Cardiovascular system and high blood pressure. The risk of macular degeneration may be raised if you have heart or blood vessel disease. 

• Obesity. Obesity may increase the likelihood that early or intermediate macular degeneration will advance to the more severe type of macular degeneration. 

• Diet high in saturated fat. 

Prevention of macular degeneration

Regular eye exams are crucial to detect early signs and symptoms of macular degeneration. You may be able to lower your chance of acquiring dry macular degeneration by following the below measures: 

• Ensure that all your medical conditions are well controlled. If you have high blood pressure or heart diseases, adhere to your medications and follow your doctor’s instructions to control your condition. 

• Avoid smoking as smokers are more likely to have macular degeneration. You may ask your doctors or pharmacists for advice to quit smoking. 

• Keep a healthy optimal weight and exercise regularly. Reducing your consumption of calories and increasing your daily workout can help with weight loss. 

• Diet rich in fruits and vegetables contain vitamins and antioxidants that lower your risk of macular degeneration. 

• Fish contains omega-3 fatty acids, which may lower the incidence of macular degeneration. Omega-3 fatty acids can also be found in nuts like walnuts.

There is no cure for AMD, but there are treatments that may halt or delay the disease's progression. Although age-related macular degeneration seldom results in blindness, it can cause a severe loss of central vision. Reading, driving, and other daily tasks requiring fine central vision may become challenging. On the bright side, patients can rest assured that their peripheral (side) vision is usually not affected by AMD, and are able to move freely without bumping into things. 

This article is written by Rosamund, Bpharm(Hons) (DOC2US), 
reviewed by Dr. Muhamad Syaqir bin Shukri, MBBS

References 

1. Centers for Disease Control and Prevention (CDC). (2022). Age-related Macular Degeneration (AMD). https://www.cdc.gov/visionhealth/vehss/estimates/amd-prevalence.html

2. John Hopkins Medicine. (2022). Age-Related Macular Degeneration (AMD). https://www.hopkinsmedicine.org/health/conditions-and-diseases/agerelated-macular-degeneration-amd

3. Mayo Clinic. (2022). Dry macular degeneration. https://www.mayoclinic.org/diseases-conditions/dry-macular-degeneration/symptoms-causes/syc-20350375

Written by

Rosamund, Bpharm(Hons)DOC2US