How does AMD damage the eye

This year, some 840,000 people across the world will go blind from preventable causes such as cataracts and macular degeneration. In the UK, an estimated 8.5m people are eligible to receive sight-saving surgery. If you're one of them, here are the facts you need to know about age-related macular degeneration, the most common cause of blindness, how to lower your risk, and who could be at risk.

Age-related macular degeneration (AMD) is a progressive condition that gradually causes sight loss in the center of the field of vision in both eyes. It usually affects older people, but it can affect people of any age, including children. AMD results when abnormal, abnormal-shaped cells, known as photoreceptors, begin to die in the macula, the part of the retina responsible for central vision. It is thought to be caused by the gradual breakdown of blood vessels in the retina, which affects light absorption and leads to reduced vision.

What is AMD?

An estimated 8.5 million people in the UK could be eligible for sight-saving eye surgery. In the UK, it is the most common cause of blindness.

Doctors think that macular degeneration is linked to a build-up of a particular protein called 'beta-amyloid, which accumulates in the central part of the retina and causes it to swell. Over time, these fibers of protein gradually form in the macula, leaving it deformed.

Other factors that increase your risk of developing AMD include diabetes, high blood pressure, smoking, and age.

What are the symptoms of AMD?

Because AMD is so slow-moving, you might not notice its symptoms until your vision has deteriorated significantly. In most cases, the first sign is that you're not able to see as well in bright light. Over time, you'll also have fewer nerve fibers, making it more difficult to make out details and colors. The early stages of the disease are often invisible, with few symptoms other than blurred vision. As your vision deteriorates, blurred vision will lead to severe eye fatigue, making it harder to see things clearly, read or work.

How does AMD damage the eye?

Your retina is vital to your sight. It is a small, thin film of light-sensitive cells that converts light into an electrical signal, which your brain translates into a picture of the world around you. Your retina is covered by a delicate network of blood vessels. When AMD causes the macula to swell and cause its blood vessels to dilate, the cells that normally make up the blood vessels in the retina die and dry out.

With fewer blood vessels, the retina can't absorb as much light as it used to, and in some cases, this can cause damage to the retina. This is particularly bad in the macula, where about 90% of your central vision is made up of blue light, such as that from the glowing screens of our smart devices. This damage is more likely when you're using your computer for long periods or reading for a prolonged period.

What are the causes of AMD?

There are many theories about the causes of AMD, but evidence has strongly linked a build-up of 'beta-amyloid protein to the condition. This protein is created by the body when certain proteins called 'amyloid precursor proteins' fuse together to form toxic molecules. It is thought that AMD may be due to the accumulation of these toxic molecules, which in some people can become trapped in the blood vessels of the macula and cause it to swell, damaging the cells that give us our central vision.

A second theory is that a problem with blood vessels in the macula causes AMD. This may be due to damage caused by inflammation, particularly as a result of high blood pressure or diabetes.

In some patients with AMD, the protein does not accumulate in the macula, and instead affects a different part of the eye, leading to less severe disease. This is known as AMD with dilator thickness or vascular and accounts for up to 10% of cases. It is known as degenerative and is usually slow-moving and fairly gradual, but sometimes it progresses very quickly.

A third possible cause is that the protein deposits are not toxic and you have normal vision, but your retina will become inflamed and weakened. This inflammation can lead to macular edema, which is known as Macular Edema Retinitis. This condition is more common and has several causes including a viral infection or a strain of the common cold.

What is macular edema?

Macular edema is swelling of the macula caused by fluid leaking into the eye. It is often a symptom of AMD and can progress quickly if untreated, leading to vision loss.

How is AMD diagnosed?

The main way of finding out whether you have AMD is by having an eye examination. This is an easy test to do, as it only requires you to stare at a small image on a screen for a short period. This image will typically be a cross or other lettering, so you should be able to see the cross at the bottom of the screen.

If you can see the cross, your doctor will use a pair of special glasses to slightly block out some of the light coming through your eyes. This will help you see the image properly.

Is there a cure for AMD?

There is currently no cure for AMD. Most sufferers will have to rely on glasses or contact lenses for the rest of their lives to see clearly, which can get very frustrating.

For some AMD patients, it may be possible to slow the progression of the condition by controlling high blood pressure or diabetes. For others, drugs called cholinesterase inhibitors may help.

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