Symptoms of AMD Not Always Obvious to Patients

Age-related macular degeneration (AMD) can have multiple causes, including decreased blood flow, but is hard to identify by a patient due to the gradual onset of symptoms, according to Hasenin Al-khersan, MD, a retinal surgeon at Retina Consultants of Texas.

This transcript was lightly edited for clarity.

Transcript

What is the cause of AMD in patients?

So I think to understand [AMD], it's important to understand a little bit of the anatomy of the eye. So the retina is the tissue that collects the light that enters the eye, transmits it to the brain, and allows us to see. And the macula is a very important part of the retina. It's the central part where we get most of our central vision for doing things like reading, driving, and watching TV. And [AMD] is a process whereby that macula starts to degenerate, as the name suggests. And the reason that it happens is a whole host of different factors that we're starting to understand more and more now, but likely a combination of the immune system starting to attack that part of the eye, as well as decreased blood flow, and all these different factors that lead to debris building up underneath the retina. And that's the start of [AMD]. Of course, as the name suggests, the older you are, the more likely you are to have it, and over time it can progress to the point where it really damages the vision, and people can lose that central vision.

What should patients look out for to assess if they have AMD?

So initially, patients may not even be aware that they have macular degeneration, which is why routine evaluations with an ophthalmologist or optometrist are important, because we actually may be the ones to tell you for the first time that you have macular degeneration. And in that case, the earlier we pick up progression, usually the easier it is to treat patients. In some of the later stages, patients may notice missing areas in their central vision, particularly when they're doing up-close tasks like reading. They might notice some letters are missing. And these changes may be gradual, so in the very advanced forms of what we call dry macular degeneration, certain patches of retina start to die, and those areas no longer can see well. But these changes can also happen very abruptly in something called wet macular degeneration; that's where you can get a buildup of fluid or blood vessel growth that accumulates underneath the retina, and in that case, patients may notice a sudden loss of their central vision or parts of their central vision. So in either case, whether it's gradually progressive or very sudden onset, it usually affects that central part of the vision. I always tell folks it's important to check 1 eye at a time if they are sensing they might have a change in vision. Because sometimes, if you have good vision in 1 eye, it may actually mask a decrease in loss of vision in the other eye.