SEEING PROGRESS
AGE-RELATED MACULAR DEGENERATION: DISPELLING
THE MYTHS AND MISCONCEPTIONS
AUTHOR Thomas Harper, MD
“M
y mom can watch TV,
but she can’t see the food
on her plate.” “Doctor,
I think I need stronger
reading glasses.” “I have
no trouble driving, but I
sometimes have difficulty
reading road signs.” I hear these complaints
frequently in my retina practice. Many times, a
change in glasses prescription is all that is required, but if the patient
is 65 years of age or older, there may be other factors contributing
to these symptoms.
Age-related macular degeneration (ARMD) is a significant
cause of vision impairment in this demographic. However, there are
many misconceptions concerning the disease. The most common
misconception is that macular degeneration causes complete
blindness. Macular degeneration affects central vision but spares
peripheral vision. Therefore, even in the most severe cases, patients
most often retain sufficient vision to avoid “bumping into things”
and continue many activities of daily living. Figure 1, on page 22,
approximates the visual field of a patient with advanced macular
degeneration. Central vision impairment does, however, make it
difficult to read and drive, and can have a significant impact on
one’s quality of life. Another misconception is that there is no
treatment for the disease. Although there is no current cure, there
are treatments available to slow down the process, and in many cases
improve vision, depending on the severity and type of the disease.
According to the National Institute of Health, as of 2010,
approximately 2 million Americans were living with macular
degeneration, and this number is expected to more than double
by 2050. Women are more likely to develop ARMD compared
to men, accounting for 65% of ARMD. A majority of cases, 89%,
occur in white Americans. The disease affects more than 14% of
white Americans 80 years or older. As our population lead longer,
healthier lives, the disease is becoming more prevalent. Advanced
age and family history are known risk factors for the development
of ARMD. Smoking is a controllable risk factor. All patients with
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