Macular diseases - Age-related macular degeneration (AMD)

There are many risks that cannot be influenced, such as age and especially predisposition. For early detection, everyone should visit the ophthalmologist at least once after the age of 60.

Macular degeneration (AMD) is the most common cause of visual impairment in old age

The macula is located in the center of the retina. It contains the "point of sharpest vision" and, with its 6-7 million color-sensitive sensory cells called cones, is responsible for the high resolution of our color detail vision. A variety of diseases impair this complex process of our sharp daytime vision.

By far the most common form is age-related macular degeneration (AMD). AMD is the main cause of blindness in people over the age of fifty in industrialized countries. Since macular degeneration is not curable so far, the disease should be prevented.

Examples of macular degeneration

Macular degeneration Without impairment

Macular degeneration

Causes of Macular Degeneration - AMD

AMD is a chronic disease. Deposition products of the metabolism settle in the macula and damage the cells up to cell death. We distinguish between two forms of AMD.

Dry AMD

Dry age-related macular degeneration accounts for at least 75% of cases. In the early stages, the deposit products appear yellowish under the retina. Affected persons may notice slight visual impairment, e.g. when reading. In the late stage, the retinal cells die, which can significantly reduce central, sharp vision.

Symptoms of macular degeneration

  • Decrease in visual acuity and thus in reading ability
  • Distorted vision - straight lines appear bent
  • Decreased contrast vision - colors appear pale and washed out
  • Decrease in the ability to adapt to changing light conditions (adaptation)
  • Central visual deficits - gray spot in the central visual field

Moist AMD

Wet age-related macular degeneration is a more aggressive form and often progresses rapidly. Deposition products of the metabolism lead to a reduced supply of oxygen and nutrients to the blood vessels, which eventually results in excessive pathological vessel growth under the macula. Fluid leaks from the newly formed, diseased and leaking vessels and lifts the pigment layer. The retina swells, producing distorted, low-contrast images and, in the final stage, complete loss of central vision due to extensive cell death and scarring.

Early detection with self-test

For early detection, everyone should visit the ophthalmologist once at the latest from the age of 60. Older people can use the test with the Amsler grid regularly. This gives them an indication of whether they suddenly see straight lines crookedly.

Eye test with the Amsler grid

  • With the Amsler grid you can perform a first self-test at home.
  • One eye is covered with the hand and the other eye is used to view the grating at a distance of about 40cm.
  • If you see dark spots or bent lines, you should make an appointment with your eye doctor

Therapy of the Macular Degeneration

There is as yet no recognized effective therapy for blind AMD. However, studies show that a high-dose nutrient combination of antioxidant vitamins and lutein as a dietary supplement can slow the progression of the disease.

Avoidance of nicotine and alcohol are even more important. In the wet form, action must be taken quickly because it progresses rapidly. A drug is injected into the eye to contain the diseased, leaky vessels that sprout into the macula. This is to prevent the progression of the disease.

These so-called VEGF (vascular endothelial growth factor) inhibitors are injected into the eye with a very fine needle. Thanks to the local anesthetic, you hardly notice anything and are allowed to go home immediately after the injection. How often and at what intervals this procedure needs to be repeated is assessed on an individual basis.

Prophylaxis

There are many risks that cannot be influenced, such as age and especially predisposition.

If the parents or grandparents suffer from AMD, it increases the risk of developing AMD themselves. In addition, there are also a number of negative influences that must be avoided.

Smoking multiplies the risk of AMD and the disease appears earlier in life. Make sure you eat a balanced diet, with plenty of vegetables and fish.

Protect yourself from UV rays and wear good sunglasses in bright light. Check blood pressure and blood sugar levels. All this reduces the risk.

Eye test with the Amsler grid

Blackbird grid

Blackbird grid test passed without complaint.

Blackbird grid

Distorted image as an indication for age-related macular degeneration (AMD)

Instruction:

You can easily perform the test on your computer screen. Please note the following instructions:

  • If you wear a visual aid, leave it on for the test.
  • Look at the image with each eye separately at a distance of 35 to 40 centimeters. Cover one of the eyes with your hand while doing so, but do not pinch it shut.
  • Fix the point in the center. With a healthy eye, the grid lines appear straight, the squares are all the same size, all corners are visible.
  • If you have noticed one or more of the following changes in the grid, you should see an eye doctor. It may be the first sign of macular degeneration.

Changes in the grid

  • Missing corners of the image
  • Different size squares
  • A gray shadow that settles on the image
  • Blank spaces in the grid
  • Blurred or distorted lines

Appointments at the Augencenter Wollishofen

If you cannot find an online appointment in a useful time, please contact us by phone.

Agreed dates (GTC's):

If you are unable to keep your appointment, please inform us as soon as possible. Appointments booked online can be canceled electronically up to 24 hours in advance. Appointments that are not cancelled 24 hours in advance will unfortunately be charged. The emergency surcharge can be charged according to the valid tariff for same-day appointments. Thank you for your understanding.