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Age-related macular degeneration

Age-related macular degeneration (ARMD) is the leading cause of vision loss in Americans age 60 and over. Its causes are multifactorial as well as genetic. The disease blurs the sharp, central vision needed for "straight-ahead" activities such as reading, sewing, and driving. ARMD affects the macula, the part of the eye that allows seeing fine details. In some cases, ARMD progresses so slowly that people note little change in their vision. In other cases, the progression is rapid and can result in loss of vision in both eyes. The course of the disease is not aggravated by visually demanding activities such as reading small print or sewing.

ARMD occurs in two forms: wet and dry.

What is wet ARMD?

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Wet ARMD occurs when abnormal blood vessels behind the retina start to grow under the macula. These new blood vessels tend to be very fragile and often leak blood and fluid, which raise the macula from its normal position at the back of the eye. Damage to the macula occurs rapidly.

With wet ARMD, loss of central vision can occur quickly over a few days. Wet ARMD is considered to be advanced ARMD and is more severe than the dry form.

An early symptom of wet ARMD is that straight lines appear wavy. If you notice this condition or other changes to your vision, contact your eye care professional at once. It is crucial to undergo a comprehensive dilated eye exam.

Treatment of the wet form is usually by intravitreal injection of a medical substance that prevents growth of the abnormal blood vessels that cause ARMD. For more information, see under “Retinal disease treatment”.

What is dry ARMD?

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Dry ARMD occurs when the light-sensitive cells in the macula slowly break down, gradually blurring central vision in the affected eye. As dry ARMD gets worse, a blurred spot may appear in the centre of your vision. Over time, as less of the macula functions, central vision in the affected eye can be lost gradually.

The most frequent symptom of dry ARMD is blurred vision. You may have difficulty recognizing faces. You may need more light for reading and other tasks. Dry ARMD generally affects both eyes, but vision can be lost in one eye while the other eye seems unaffected. Treatment and management of ARMD usually involves taking eye vitamins (rich in antioxidants and zinc), undergoing an annual comprehensive dilated eye exam, eating a healthy diet rich in green vegetables and fish, maintaining an appropriate weight level, keeping fit through regular exercise, quitting smoking, and wearing sunglasses to protect your eyes.

Dry ARMD can progress and cause vision loss without transforming into the wet form. However, the dry form can turn into the wet form in short order, even in the earliest stages of ARMD. If and when this will occur is hard to predict, though.

Therefore, it is important to have your eyes examined under dilation by your eye care professional and to be attentive to your vision in order to detect any problems early on. Optical coherence tomography (OCT) has proven a very useful diagnostic tool in detecting and monitoring ARMD with a high degree of accuracy.

Dr. Louis-Pierre Gauvin Meunier

Dr. Louis-Pierre Gauvin Meunier

Dr Gauvin Meunier graduated from the University of Montreal in ophthalmology. He joined the team from Institut de l'oeil des Laurentides in 2014.

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