AGE-RELATED MACULAR DEGENERATION (AMD) strikes at the macula, the heart of the eye’s vision center. This small part of the retina, which measures only about 3 by 5 millimeters (less than one-quarter-inch square), is responsible for sharp, central vision. People with AMD often develop blurred or distorted vision and cannot clearly see objects directly in front of them.
Eventually they may develop a blind spot in the middle of their field of vision that increases in size as the disease progresses.
Although the disorder eventually can become debilitating, in the earliest stages of AMD there often are no warning symptoms. If the condition progresses to intermediate AMD, some people begin to notice blurring in the center of their vision.
At the advanced stage, the blurred area increases, making it hard to read or even recognize people. About eight million Americans have early or intermediate AMD, and more than two million people ages 50 and older have an advanced form that is characterized by severe vision problems.
How To Test Yourself With the Amsler Grid
An Amsler grid test (above..click to enlarge) can help to identify the distorted vision typical of AMD. This test is by no means a replacement for having your eyes examined by and Ophthalmologist or Optometrist.
If you need reading glasses, please wear them while you use the Amsler grid. The grid should be at about the same distance from your eyes that any other reading material would be.
Cover one eye, then focus on the dot in the center.
- Do any of the lines look wavy, blurred or distorted? (All lines should be straight, all intersections should form right angles and all squares should be the same size.)
- Are there any missing areas or dark areas in the grid?
- Can you see all corners and sides of the grid?
- Don't forget to test both eyes.
Report any irregularity to your eye doctor immediately.
Currently, the only treatment for dry AMD is vitamin supplementation combined with a well-balanced diet that includes leafy green vegetables and several servings of fish per week. However, success in the treatment of wet AMD has led to increased efforts in the prevention and treatment of dry AMD. Several innovative approaches are being evaluated, and while the results won’t be available for several years, there is hope for the future. You can search online for a listing of clinical trials evaluating such treatments at www. clinicaltrials.gov, or ask your doctor.
The federally funded Age-Related Eye Disease Study (AREDS) found that high doses of particular supplements can slow (and sometimes even prevent) progression from intermediate to advanced AMD, thereby preserving vision in many people. A follow-up study, AREDS2, will determine whether adding additional supplements—lutein and zeaxanthin (found naturally in plants) and the omega-3 fatty acids DHA and EPA (found in fatty fish)—will further slow the progression to advanced AMD.
Editor's note: Information in this article was based on "The Aging Eye: Preventing and treating eye disease," a Harvard Medical School Special Health Report.