Regular eye exams crucial to identify, treat and slow macular degeneration

Age-related macular degeneration (AMD) is the leading cause of blindness in people 60 and older, and the scary part is there's really nothing that can be done to prevent the condition from developing.

Smokers are at the highest risk of getting AMD, and they are four times more likely to get it than nonsmokers.

AMD is more prevalent in Caucasians, and more common in women than men. Other factors include family history, hypertension, hyper-cholesterol and obesity.

Exposure to harmful UV rays, both UVA and UVB, is also a risk factor, so protective eyewear should always be worn, experts say.

The macula is a spot in the center of the retinae, one that is responsible for the center of central vision.

Woman sitting on bench

"It's the part of your eye responsible for your best vision," says Dr. Jeremey Dohogne, associate optometrist at Leet Eyecare in Cape Girardeau. "I call it the 20/20 spot."

There are two types of AMD: dry and wet.

The dry type causes less profound damage, but it's asymptomatic, making the need for regular eye examinations vital in early detection, experts say.

"Everyone 60 and older should have an eye exam every year, especially if they have a family history of AMD," says Dr. Todd Lumsden, an ophthalmologist who specializes in cataract surgery at Eye Consultants in Cape Girardeau.

Dr. Tatyana Metelitsina, a vitrioretinal surgeon at Eye Care Specialists in Cape Girardeau, agrees. Doctors at Eye Care Specialists have gained a reputation for treatment of AMD, and 60 to 70 percent of patients seen in that office present with AMD, she says.

"We rarely see this disease in people under 55," Metelitsina says.

Halting the progression of dry AMD may avert the condition from advancing to the more damaging, sight-threatening, wet form of AMD, which may happen if left untreated.

Though there is no cure for either form of AMD, the dry type is treated with special vitamins.

"We do not cure this disease," Metelitsina says. "We can only treat it."

Despite the claims on TV about keeping eyes healthy with vitamins, experts say the vitamins are only effective to halt or slow the progression of the condition once it develops.

"They slow down the progression of the disease by some 25 percent," Metelitsina says.

The vitamins do not require a prescription, but people should see their eye doctors for the proper type and recommended dosage.

Patients with this condition are taught how to monitor their visual acuity daily using a chart called the Amsler grid.

"They test one eye at a time, and can pick up the changes. They know to call us immediately," she says.

The chart is available online, so people can test themselves initially at home, but if any vision loss is suspected, they should see an eye doctor immediately.

Wet AMD, the worse of the two conditions, is caused by the leakage or oozing of tiny, abnormal blood vessels in the retinae, Metelitsina explains. The blood's leakage into the retinae destroys its normal anatomy, which can lead to a severe decrease in vision, or in the worst cases, blindness.

Until 10 years ago, there was no real treatment for wet AMD. At that time, a solution was discovered, Vascular Endothelial Growth Factor (VEGF) that, when injected into the eye, can stop the condition from worsening.

"A lot of patients have been saved from going blind and have been able to retain a high level of visual acuity," she says.

The drug is injected into the jellylike substance at the back of the eye, the vitreous. The drug prevents the growth of abnormal blood vessels and leakage.

While an injection in the eye might seem terrifying, Metelitsina says it's really not that bad. The eye is numbed first using analgesic drops. Next, to prevent infection from the injection site, the eye is washed in an antiseptic solution, Betadine. While the Betadine might sting just a bit, Metelitsina says most patients report little pain from the actual injection. The whole process takes only 10 to 15 minutes, and most of that time is spent waiting for the drops to numb the eye. The injection is done in a matter of seconds.

"Usually the next day, or the day after, the patient goes back to normal activities," she says.

The injections are not a one-time thing. The course of treatment calls for repeated injections, once a month, for three to six months, or in some cases, indefinitely.

"If you smoke, quit, and pay attention to your risk factors. Know your family history," she cautions.