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Living with Macular Degeneration

 

Did you know that vision loss is not a part of normal aging? Normal aging might include changes in your vision, but the loss of vision altogether is not a normal part of aging. Normal aging includes changes to the body that all people will experience, provided they live long enough. Changes to hair—such as hair loss, or hair turning white/gray—is a normal part of aging. Everyone’s hair will eventually turn colour and become thinner if they live long enough. Macular degeneration, by contrast, is not a normal part of aging because it is not inevitable that someone will eventually experience macular degeneration.

 

Age-related Macular Degeneration (AMD) is the leading cause of vision loss for people over age 50. It affects 15% of people over age 50; it affects 30% of those over age 75. AMD is a serious condition because it can severely impair someone’s sight as it progresses.

 

The macula is an area of the eye that is responsible for detail vision. It is the bull’s-eye of the retina, and it is what allows people to read. The macula is essential for the detail vision necessary for reading; the rest of the retina cannot read; only the macula can read. If the macula is severely impaired, the ability to read will disappear; larger or stronger glasses won’t solve the problem as only the macula can provide the detail necessary for reading.

 

There are two types of macular degeneration—dry and wet.

 

Dry AMD is much more common, accounting for 85% of all AMD cases. Its impact is less severe because those with dry AMD typically only lose 10-20% of their vision.  Wet AMD is less common, but its impacts are more severe. Only 15% of those with AMD experience the wet version, but they will typically lose 80-90% of their vision and become legally blind.

 

Dry AMD always precedes wet AMD. Sometimes people ignore symptoms and by the time they see an ophthalmologist, the dry AMD has become wet and is much more severe. With dry AMD, the peripheral vision is maintained and will not be lost. The visual detail provided by the macula is what may be affected. Reading will become difficult, but most people will not become blind as a result of dry AMD alone. In fact, only 5% of people with dry AMD will progress to vision that measures as legally blind, and that typically requires 10 years of progression. Dry AMD typically progresses quite slowly.

 

What are the risk factors for AMD?

 

Heredity — almost half of all AMD cases are genetic. It isn’t as simple as having a specific gene; it is a series of genes that are responsible for AMD.


Smoking — increases risk by 3-4 times the rate of a non-smoker. Smoking also increases the risk of wet AMD. Combine the hereditary risk with smoking, and the risk rises to 34%!


Age — while you cannot control the risk factor of age, you can control sun exposure. AMD is the wearing out of the macula. Overexposure to the sun can expedite this process.

 

Nutrition maintaining excellent nutrition is important for eye health. Once diagnosed with AMD, patients are advised to eat a nutrient-rich diet that is high in vitamins, minerals and antioxidants (or supplement as needed). When patients follow this regimen, there is a 25% reduction in vision loss.

 

Wet AMD — if someone has wet AMD in one eye, they have a 50% risk of also developing AMD in the other eye.

 

Those with AMD are well aware of vision changes and how that impacts detail activities such as reading or needlework. What people underestimate is how AMD can impact practical elements of day-to-day living and increase risk in other areas of life.

 

 

Older adults with vision loss have:

  • Twice as much difficulty with day-to-day living compared to their peers
  • Twice the risk of falling
  • Three times the risk of depression (often linked to the loss of reading ability, a key enjoyment activity for many people)
  • Four times the risk of a hip fracture

Vision loss affects more than just vision! With increased risk of falls, fractures, depression, and difficulty with daily living, someone’s life could be severely impacted.

 
How do you prevent AMD?
 

Regular eye exams are crucial to ensure that AMD or any other vision concerns are detected early and treated in the most effective ways possible. Of Canadians who do not wear glasses, 50% have not had their eyes checked in the past 5 years, if ever! Even if someone does not wear glasses, they should still visit an optometrist occasionally to check eye health.

 

If you know a senior with vision loss who is at risk of falls, fractures, depression or having trouble with daily tasks, we can help! 

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