AMD ?

Age related macular degeneration (ARMD) is the leading cause of central vision loss. It is due to age related changes in the central part of retina which is important for reading, writing and recognizing faces. Consider eye as a camera, the front part of the eye is the lens of the camera. If this lens is not working properly that means you have a cataract where we remove the lens and put another lens. Now, In ARMD the lens of the camera is fine but the film of the camera (retina) at the back is damaged. Therefore the light enters the eye but the image is not formed on the film (retina)

Age is the most common cause for ARMD. As we cannot reverse ageing so completely preventing this disease is not possible. Genetic link also plays an important role which means if your parents have ARMD then the chances of you developing it in the future are higher as compared to general population. We cannot alter age or genetic link but one important risk factor to develop ARMD which we can stop is SMOKING. Smoking doubles the risk of ARMD. Hypertension and obesity are also associated with ARMD.

Age is the most common cause for ARMD. As we cannot reverse ageing so completely preventing this disease is not possible. Genetic link also plays an important role which means if your parents have ARMD then the chances of you developing it in the future are higher as compared to general population. We cannot alter age or genetic link but one important risk factor to develop ARMD which we can stop is SMOKING. Smoking doubles the risk of ARMD. Hypertension and obesity are also associated with ARMD.

Age is the most common cause for ARMD. As we cannot reverse ageing so completely preventing this disease is not possible. Genetic link also plays an important role which means if your parents have ARMD then the chances of you developing it in the future are higher as compared to general population. We cannot alter age or genetic link but one important risk factor to develop ARMD which we can stop is SMOKING. Smoking doubles the risk of ARMD. Hypertension and obesity are also associated with ARMD.

ARMD generally starts after 55 years of age. However, it may start earlier in patients who have other risk factors like genetic predisposition, smoking, obesity.

The most common cause for ARMD is age. Old age is not reversible/curable so similarly the disease is not reversible or completely curable. We should try to control other risk factors like smoking, obesity, hypertension. We can delay the progression and limit the loss of vision or even regain meaningful vision back if diagnosed early and treated appropriately. It is therefore important to get regular retina checkup done for patients who are at risk of ARMD.

The most common cause for ARMD is age. Old age is not reversible/curable so similarly the disease is not reversible or completely curable. We should try to control other risk factors like smoking, obesity, hypertension. We can delay the progression and limit the loss of vision or even regain meaningful vision back if diagnosed early and treated appropriately. It is therefore important to get regular retina checkup done for patients who are at risk of ARMD.

The most common cause for ARMD is age. Old age is not reversible/curable so similarly the disease is not reversible or completely curable. We should try to control other risk factors like smoking, obesity, hypertension. We can delay the progression and limit the loss of vision or even regain meaningful vision back if diagnosed early and treated appropriately. It is therefore important to get regular retina checkup done for patients who are at risk of ARMD.

This question is most commonly asked by patients who have lost significant central vision already in one eye. The answer to this question is unfortunately YES. The risk of developing ARMD if one eye is already affected is 50 % in next 5 years. We cannot stop the disease completely as of now but it is important we diagnose it early so we can limit vision loss in this eye and prevent damage to the extent possible.

We have 2 types of vision – central vision (important for reading, writing, recognizing faces) and peripheral vision (Crossing road, walking). ARMD affects only central vision and therefore it creates problem in reading and recognizing faces. Patients generally complain of straight lines appearing wavy to them. (Image of patients view with AMD)

This is the question most asked by patients in the clinics as soon as they are diagnosed with ARMD. This question has immense implications on the psyche of patient and is often the only information they are seeking. I cannon emphasize enough that no ARMD WILL NOT CAUSE COMPLETE BLINDNESS. Even if the disease progresses, it affects only central vision. Patient will not have problem while walking in the house or going to washroom. They will have difficulty in watching TV or focusing on objects but will not be completely dependent on others for their daily activities.

This is the question most asked by patients in the clinics as soon as they are diagnosed with ARMD. This question has immense implications on the psyche of patient and is often the only information they are seeking. I cannon emphasize enough that no ARMD WILL NOT CAUSE COMPLETE BLINDNESS. Even if the disease progresses, it affects only central vision. Patient will not have problem while walking in the house or going to washroom. They will have difficulty in watching TV or focusing on objects but will not be completely dependent on others for their daily activities.

ARMD is broadly divided in two types wet and dry. To put it in simple terms, Wet AMD is associated with edema and/or bleeding and needs treatment in the form of intravitreal injections. Dry ARMD is associated with irreversible damage to cells and does not need aggressive treatment.

The initial diagnosis of ARMD is based on clinical evaluation. The diagnosis is confirmed with tests like OCT, OCT angio, FFA. The detail features of these are beyond the scope of this document. The most common test done is OCT which allows us to assess the presence of edema in the retina and plays an important role in deciding treatment / re treatment.

To answer the first question there is no fixed number of injections that are required. Each patient responds differently and the number of injections depends on how the eye responds to treatment. I generally give an estimate of 3-4 injections as most patients need 3-4 injections to stabilize. However, some patient may need less injections and some may need more. The injections are usually given at 1 month intervals. The injection is given inside the white part of the eye and is not painful. You can resume your daily activities immediately following the injection with no additional restrictions post injection, no admission required.

To answer the second question, the aim of treatment is not complete visual recovery as that is not possible in most cases. The aim of treatment is to prevent further visual loss and try to regain some meaningful vision back. The disease is age related and will progress eventually but with treatment we slow down the progress or in some patients we are even able to halt the progress.