Macular Degeneration

Age related macular degeneration (AMD) is the most frequent cause of severe visual loss in the over 55 year age group and sometimes requires urgent medical treatment. 

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What is Macular Degeneration?

Age related macular degeneration (AMD) is the most frequent cause of severe visual loss in the over 55 year age group and a condition that often co-exists with many other eye conditions e.g. cataract or glaucoma. AMD is generally divided into two types, ‘dry AMD’ which is the more widespread and a milder form of AMD and ‘wet AMD’ which is more rapidly progressive and can cause sudden and profound visual loss. Wet AMD requires urgent medical treatment.

David Anderson is not a retinal or macula disease specialist but works closely with experts in the treatment of AMD and retinal conditions so you will receive prompt expert advice and care should you require treatment or further investigation.

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Normal Vision
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Age-Related Macular Degeneration (AMD) Progression
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Age-Related Macular Degeneration (AMD) Further Progression

Types of Macular Degeneration

Dry AMD

Dry AMD represents the majority of cases of AMD and is typically milder than wet AMD. Patients may experience no symptoms with findings of AMD observed during a routine sight test at an Optician or by an OCT (optical coherence tomography) scan. The presence of drusen, small yellow deposits at the macula are an early sign of AMD. 

Dry AMD explained animation

Wet AMD

Wet AMD is a more advanced form of AMD accounting for around 10% of all cases of AMD. It is caused by new blood vessels growing into the retina under the macula and bleeding, leaking fluid or causing scarring. Wet AMD is often treated by injections into the eye with a class of drug called an anti-VEGF agent. VEGF stands for vascular endothelial growth factor and is a substance produced normally by the body to encourage new blood vessels to grow in a healing response. In wet AMD however, this response causes harm rather than help as the new blood vessels can leak or bleed under the surface of the macula causing visual loss or distortion of vision. 

Wet AMD explained animation

Wet AMD can cause a variety of symptoms but metamorphopsia or distortion of the central vision is an important sign that urgent treatment may be required, other symptoms include sudden blurring of vision or seeing objects as being larger or smaller than they should be. These symptoms can be charted using a grid of squares called an Amsler grid – see below.

If you have signs of wet AMD you require urgent medical assessment in a specialist AMD clinic.

Macular Degeneration Treatment

Dry AMD

Current treatment for dry AMD focusses on reducing risk factors e.g. smoking cessation, losing weight and improving diet. Diets which contain high levels of antioxidants called carotenoids such as leafy greens, carrots, broccoli, raw spinach etc. are thought to lower the risk of developing AMD. For patients with moderate AMD certain high dose vitamins have been shown to reduce the risk of progression, these are called AREDS II vitamins such as VitEyes 2.

Although there are no widely available treatments for dry AMD a treatment called Photobiomodulation (PBM) or Red Light Therapy using the Valeda Light Delivery System by LumiThera® has been shown in some studies to both improve visual acuity and contrast sensitivity and reduce the thickness of retinal drusen. The light is a mixture of red, yellow and infrared light and treatment consists of treatment cycles on an outpatient basis. Treatment is painless. Large scale studies are in progress across Europe and the USA to evaluate the effectiveness of this treatment to evaluate whether PBM can slow down the progress of dry AMD.

Further information regarding can be downloaded here

Wet AMD

Wet AMD is often treated by injection or series of injections into the eye using a class of drug called an anti-VEGF agent.

RETINA: Intravitreal injections animation

A variety of anti-VEGF agents may be employed to treat wet AMD including Lucentis® (Ranibizumab), Avastin® (Bevacizumab) and EYELEA® (Aflibercept). The advantages and disadvantages of treatment with each agent should be discussed with your medical retina specialist. Further information about anti-VEGF treatment can be found on the RNIB website here or the Macular Society website here.

Macular Degeneration FAQs

These are some of the questions we are often asked about AMD:

AMD affects around 2% of the population older than 65 years in Europe and around 25,000,000 people worldwide. ‘Wet’ AMD represents about 10% of all cases of AMD.

The most important risk factor for AMD is age. A family history of AMD or having one eye show signs of AMD are also important risk factors. It is important to recognize those risk factors which can be modified e.g. smoking so that preventative measures can be taken e.g. entering a smoking cessation programme.

Dry AMD represents the majority of cases of AMD and is typically milder than wet AMD. Patents may experience no symptoms with findings of AMD observed during a routine sight test or by an OCT (optical coherence tomography) scan. The presence of drusen, small yellow deposits at the macula are an early sign of AMD. 

At the present time there is no known cure for dry AMD but a number of studies suggest that diet can play an important role in reducing the risk of developing dry AMD or reduce the risk of it progressing.

AMD is monitored through a combination of clinical examination including a visual acuity test, use of an Amsler Grid, a dilated eye examination and typically non-invasive OCT scanning. OCT’s have become highly sophisticated and can provide highly detailed, often 3D images of the retina and macular. OCT scanning is now performed by many Opticians as part of a more detailed eye examination in addition to measuring the spectacle prescription.

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Multi-modality retinal imaging with OCT-Angiography (OCTA). Image courtesy of Carl Zeiss Meditec, Inc.

Other ways of investigating AMD include the use of fluorescein angiography where a yellow dye called fluorescein is injected into a vein and a series of photographs are taken as the dye moves through the retinal circulation.

An Amsler grid is a test chart that doctors use to check central vision if AMD is suspected or to monitor vision when AMD has been diagnosed. Using the chart should not replace a medical consultation or examination but early diagnosis of change can help speed up treatment. You can download a copy of an Amsler grid and instructions on how to use it here.

AMD can affect your ability to drive safely and you must fulfill the minimum standards of vision for driving which can be found here.

You are required by law to tell the DVLA about your condition if AMD affects both of your eyes or if it affects one eye but your remaining vision falls below the minimum standard required. You can do this by following this link.

The Macular Society is an excellent source of information and advice and can be reached by this link here.

 

The RNIB also offer excellent support including RNIB Connect Radio and many solutions for everyday living, they can be accessed via this link here.

David Anderson supports the Gift of Sight Appeal based at University of Southampton and Southampton Eye Unit, its mission is to fund and produce world-class research into the prevention and treatment of blindness and can be reached through this link: https://www.giftofsight.org.uk/

This page is intended to provide general information about AMD and not medical advice. If you suspect that you have AMD or in particular have developed wet AMD you will require assessment by a specialist in AMD within two weeks.

Excellent 5-Star Reviews

Peter
Excellent result extremely satisfied
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I was extremely short sighted in my left eye minus 10.5 which with appropriate contact lens did still not give me good vision. I had several consultations with David Anderson as I was rather nervous of surgery due to a previous unfortunate experience with my right eye. David had not been involved with my right eye surgery. David was very reassuring and gave me confidence so I went ahead and had the surgery. Excellent result extremely satisfied. I would definitely recommend a consultation.
Juliet
Life Changing Surgery
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Yes cataract surgery is scary but David and his team were wonderful. David listened very carefully to what I wanted to achieve and patiently answered my detailed questions. He worked closely with my optician so that I could try contact lenses of different prescriptions to see which suited me best. In the end I had one eye adjusted for distance/normal vision and one eye for reading. My surgery was 2 months ago and everyone was kind and patient. It took time to get use to my new eyes but I now don't need glassed for the first time since I was 12 years old! I am completely use to my eyes now and don't notice that I have had anything done other than I don't wear glasses which is life changing! I would definitely recommend David and would like to say a BIG Thank You!
Dean
My optician referred me
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I am absolutely delighted with the total lens replacement surgery I had at Anderson Eye Care. From my first consultation with Mr. Anderson, through to surgery and aftercare, my experience was of the highest professional quality. The procedure itself was painless quick and very relaxed. I unreservedly would recommend Mr. David Anderson and his team at Anderson Eye care. I now have 20/20 vision, which speaks for itself!
Peter
Extremely impressive
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Extremely impressive professional experience from the initial consultation, to the surgery and post operative follow up. An absolute model in every respect for every health care professional to digest. The team atmosphere at Eastleigh Nuffield was brilliant from start to finish. Their team camaraderie is obvious and can’t be faked. My personal outcome is perfect. Many thanks to David and the Nuffield team.
Sharon
Very pleased with cataract procedures
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Mr Anderson has carried out cataract surgery on both of my eyes. I had my right eye done first. A year later, when it was time to have my left eye done, I only wanted Mr Anderson to carry out the procedure. On both occasions I discussed what I wanted the outcome to be, and Mr Anderson delivered exactly. The procedure was painless and quick. I am very pleased with the outcome. I found Mr Anderson and his staff very comfortable and reassuring to be around. I have no reservations in recommending Anderson Eye Care.
Merilyn
My optician referred me
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My optician referred me urgently to the Eye Hospital but it was going to be a wait of several months to be seen so I came to David Anderson privately. The initial consultation was reassuring and without pressure and I decided to go ahead with cataract surgery. It worked well having the eyes done a week apart and was an easy experience. I had a worry after the second one and was seen quickly and reassured about it. All is well now.
Gareth
I am now completely glasses free
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I was referred to Mr Anderson by my optician. I found him to be extremely personable and professional and was immediately reassured by his calm manner. He recommended refractive lens exchange, in both eyes. I was a little apprehensive pre op, but all the staff were reassuring, and the op itself was painless, and over very quickly. (probably around 15 minutes) I could see the results almost immediately. 4 weeks on and after 55 years of spectacle wearing the results are amazing. From a prescription of +9.5 I am now completely glasses free even for reading. Thank you
Customer
Happy 20/20 Vision!!!!
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I am absolutely delighted with the total lens replacement surgery I had at Anderson Eye Care. From my first consultation with Mr. Anderson, through to surgery and aftercare, my experience was of the highest professional quality. The procedure itself was painless quick and very relaxed. I unreservedly would recommend Mr. David Anderson and his team at Anderson Eye care. I now have 20/20 vision, which speaks for itself!
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