Macular degeneration is an eye condition that
attacks the macula, the region of the retina
responsible for central, detailed vision. Although
it does not cause complete blindness, it robs the
individual of their central, straight-ahead vision,
resulting in what is often referred to as a central
vision “blind spot”. It does not affect the outer
circle of peripheral vision, so a person will always
be able to see things to the side, but this vision
is too low resolution (blurry) to make up for lost
For many people, the first sign of AMD is
something they notice themselves. Straight lines
like doorways or telephone wires may appear wavy or
disconnected. When they look at a person, their face
may be blurred while the rest of them are in focus.
Lines of print may be blurred in the center or the
lines may be crooked.
What is End-Stage (or Advanced) AMD?
- More than 15 million Americans are affected
by some form of macular degeneration, a
progressive disease which can lead to severe
vision loss in the most advanced form, end-stage
AMD. Approximately 2 million Americans have
advanced forms of AMD with associated vision
- End-stage macular degeneration is the most
advanced form of age-related macular
degeneration and the leading cause of
irreversible vision loss and legal blindness in
individuals over the age of 60.
- Despite the availability of new drug
treatments that slow, but not stop, the
progression of AMD, the number of people with
end-stage AMD is expected to double by the year
How is AMD Diagnosed?
As the National Eye Institute
explains, the early and intermediate stages of
AMD usually start without symptoms. Only a
comprehensive dilated eye exam can detect AMD. The
eye exam may include the following:
- Visual acuity test.
This eye chart measures how well
you see at distances.
- Dilated eye exam.
This provides a better view
of the back of your eye.
- Amsler grid test.
This checks whether you are seeing
unusual wavy lines.
- Fluorescein angiogram.
This test makes it possible
to see leaking blood vessels, which occur in a
severe, rapidly progressive type of AMD.
- Optical coherence tomography.
Like an ultrasound,
OCT can achieve very high-resolution images of any
tissues that can be penetrated by light—such as the
During the exam, your doctor is looking for drusen,
which are yellow deposits beneath the retina. Most
people develop some very small drusen as a normal
part of aging. The presence of medium-to-large
drusen may indicate that you have AMD. Another sign
of AMD is the appearance of pigmentary changes under
What are Wet AMD and Dry AMD?
Dry AMD, also called atrophic AMD, is the most
common form of age-related macular degeneration.
Macular Degeneration Partnership explains that it
occurs when the there is a “breakdown or thinning of
the layer of pigment epithelial cells (RPE) in the
macula. These RPE cells support the light sensitive
photoreceptor cells that are so critical to vision.”
As these cells die and drusen (a yellow deposit)
build up as a result, the macula is damaged,
reducing central vision.
Wet AMD, also called neovascular AMD, is only
diagnosed in about 10 percent of patients, according
to the National Institutes of Health. Vision
loss associated with wet AMD occurs when abnormal or
very fragile blood vessels grow under the macular
and then leak blood and fluid. This damages
the macula. Typically, patients who develop
wet AMD often are diagnosed with dry AMD, first.
How is AMD Treated?
Early AMD – Currently, there is no treatment, but it
should be monitored annually by an ophthalmologist
There are many service providers who can educate AMD
patients and their caregivers about vision assistive
devices such as reading glasses with high-powered
lenses, video magnifiers, computer aids and many
more. Ask your physician for a referral to a
low vision occupational therapist.
Intermediate AMD – There are several treatments that
may slow progression, but will not cure AMD.
- Vitamin therapy (AREDS2 formulation)
- Anti-VEGF injection - A few different anti-VEGF
drugs are available (e.g., Lucentis) and vary in
cost and how they are injected.
- Photodynamic therapy - This technique involves laser
treatment of select areas of the retina.
- Laser surgery – Used with only certain cases of
neovascular (wet) AMD, it involves aiming an intense
“hot” laser at the abnormal blood vessels in your
eyes to destroy them.
End-Stage (Advanced AMD): The CentraSight treatment
program uses a tiny telescope, an FDA-approved
medical device, which is implanted inside the eye to
improve vision and quality of life for individuals
affected by End-Stage AMD. It is the only surgical
treatment option for AMD.
It is also a Medicare eligible, out-patient
procedure. Learn more by calling 877-99-SIGHT
(74448) or at
The telescope implant is not a cure for End-Stage
AMD. It will not restore your vision to the level it
was before you had AMD, and it will not completely
correct your vision loss. Patients with this level
of AMD have had to cease driving due to their
vision; after the telescope procedure, although near
and distance vision may improve, driving will not be
possible because the implant does not restore normal
How is AMD Prevented?
Common risk factors for AMD are:
Research shows that smoking doubles the
risk of AMD.
AMD is more common among Caucasians than among
African-Americans or Hispanics/Latinos.
- Family history.
People with a family history of AMD
are at higher risk.
To reduce your risk, avoid
smoking, exercise regularly, maintain normal blood
pressure and cholesterol levels and eat a healthy
diet with green leafy vegetables and fish.