Age-related macular degeneration on the rise

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Clifford Smith knew something was wrong with his vision when the grid that his eye doctor had told him to look at weekly was suddenly wavy, unlike previous weeks when he had tested his vision.


Joan Palmer became alarmed when her vision was not only wavy, but also blurred. Because both patients promptly scheduled a visit to their eye doctor, they were able to prevent more serious, long-term damage to their eyes.


Both Smith and Palmer were experiencing symptoms of age-related macular degeneration, which is on the rise in the United States for those age 65 and older. Both patients were referred to Dr. Thierry C. Verstraeten of the Southwestern Pennsylvania Eye Center in Washington, who specializes in caring for patients with macular degeneration. Thanks to treatments and regularly scheduled checkups with Verstraeten, Smith and Palmer are able to continue working, driving and enjoying their hobbies without many side effects from their condition.


Since 2000, the number of cases of AMD in the United States has increased from 1.65 million to more than 2 million in 2010. Due to the alarming increase, the Pennsylvania Academy of Ophthalmology is encouraging Pennsylvanians to learn their risk factors and prevent vision loss from AMD, which damages the retina. Over time, retinal damage can lead to permanent loss of central vision. While there are no early warning signs for AMD, there are lifestyle and dietary changes that can prevent and slow the progression of the disease.


“I wish we had known more about this disease 30 years ago,” said Verstraeten. “We are still learning about the disease, but we are at a stage where we are able to at least slow down the progression. It is very important to maintain consistent eye care and to notify an eye care professional right away if we notice changes in our vision. We believe that protecting the eyes from the sun, not smoking, maintaining a healthy weight and eating a well-balanced diet can help prevent and control the disease. Blue-eyed, blond-haired people are at greater risk as well, so it is essential that they protect their eyes from the sun even as youngsters.”


There are two types of macular degeneration: wet and dry. Wet macular degeneration is characterized by blood vessels that grow under the retina in the back of the eye, leaking blood and fluid. A common way to treat wet macular degeneration is through injections in the eye that block a chemical called vascular endothelial growth factor. By blocking VEGF with drugs, the growth of abnormal blood vessels is reduced, leakage and vision loss is slowed, and in some cases, vision is improved.


Dry macular degeneration (the most common form seen in about 85 percent of cases) causes vision loss in the center of the field of vision and is caused by the deterioration of the macula. Currently, there is no single proven treatment for the dry form of macular degeneration. However, a large scientific study has shown that antioxidant vitamins and zinc may reduce the impact of AMD in some people by slowing its progression toward more advanced stages.


Smith, 72, of Robinson Township, said he is thankful that he didn’t wait to call his eye doctor when he recognized a problem.


“A few years prior, Dr. (Ronald) Salvitti gave me the Amsler Grid at the end of one of my visits and he told me to look at it every once in a while, just to check my eyes. He said if the lines became wavy I should call the office. I don’t know what made me look at the grid one morning, but when I saw the wavy lines, I called and thought I’d schedule an appointment the following week because I was getting ready that day to leave on a trip. They told me I needed to come in right away. At the time, I didn’t understand the urgency, but I do now, and I’m so thankful that I didn’t waste any time.”


Smith was diagnosed with wet macular degeneration in his left eye. So far, the right eye is not affected. By getting to the office quickly, Smith was able to receive eye injections to shrink the blood vessels and control the bleeding and leaking of fluid.


“The idea of injections into the eye sounds terrible, but it is not nearly as bad as it sounds,” said Smith. “They numb the eye so I feel virtually nothing. I am just so thankful that I am still able to see well enough to continue living my life.”


Smith continues to work part time and enjoys playing golf and riding his motorcycle. While he finds it difficult to read fine print and sees some things with distortion, he maintains his activity level.


Palmer, 59, of South Fayette Township, was devastated when she was diagnosed with macular degeneration in both eyes: dry macular degeneration in the right eye and wet macular degeneration in the left. She makes regular visits for check-ups and receives injections in the left eye when bleeding or leaking is present. In the left eye she has some peripheral vision damage and is unable to read with that eye, but fortunately, Palmer’s eyesight in the right eye is still good. She is able to maintain her computer-related job and continue with her love of sewing in the evenings.


“I have to use a special, bright light to see when I sew, but all in all, I feel thankful that I can still see well enough out of my right eye to work continue my daily activities. I have so much respect for Dr. Verstraeten. I owe so much to him for all that he has done for me.”


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