Does vision deteriorate as we age? Let's talk about Macular Degeneration (AMD)!

Have you ever had a strange experience when reading a newspaper or looking at someone's face, where you can only see the edges, not the exact center? Maybe the straight lines you see, like window frames, look stretched and wrinkled? These are not just random things. These can be symptoms of an eye condition that many people develop after the age of 50-60. That's what we're talking about today.

Simply put, what is Macular Degeneration?

Macular degeneration is a disease that affects the central vision of the eye, that is, what we see when we look straight ahead. It usually occurs more often as we age. Therefore, it is also called age-related macular degeneration or ``Age-Related Macular Degeneration'' or ``(AMD)''.

Think of our eye as a camera. Inside the eye, at the back, there is a part called the `retina`. That is what works like the `sensor` of the camera. Right in the middle of this `retina`, the very important small spot that captures the finest details and clearest image of what we see is called the `macula`. We read a book, recognize someone, drive a car, and this part called the `macula` helps us with all of these.

In macular degeneration, the part called the `macula` is damaged. Then, our central vision becomes weak. But in this case, we do not go completely blind. Peripheral vision is still good. That means that even though what we look at directly appears blurry, the things around us can be seen normally.

This condition can affect only one eye, or it can affect both eyes. Sometimes the severity of the disease in the two eyes can also vary.

Who is more likely to develop this condition? (Risk factors)

As the name suggests, aging is the main risk factor. This risk increases after the age of 50-60. But there are several other factors besides that.

• Family history: If your mother, father, or sibling has had the disease, you are more likely to develop it too.
• Smoking: People who smoke are at a much higher risk of developing this disease.
• Overweight: It is also important to maintain a healthy body weight.
• High blood pressure (Hypertension): If you have high blood pressure, controlling it well is very important for your eyes.
• Unhealthy foods: It is also not good to regularly eat foods high in saturated fats, such as oils, fried foods, and fast foods.
• White people: Research has found that white people are at slightly higher risk of developing this disease than others.

There are two main types of macular degeneration:

This condition can be divided into two main types: dry and wet.

Let's also learn about the stages of the disease.

There are three main stages of dry eye. Symptoms often appear in the later stages, but an eye doctor can detect these changes early during an examination.

1. Early stage: Changes in the macula have begun, but vision is not affected.

2. Intermediate stage: Vision becomes a little blurry, wrinkles begin to appear.

3. Late/Advanced: Central vision is almost completely lost.

What are the symptoms of this disease?

Many people don't experience any symptoms in the early stages. These symptoms only start to appear when the disease is more severe. See if you're experiencing any of these symptoms.

• Reduced vision in low light: Visibility decreases at night when there is little light at home.
• Blurred vision: You may feel blurry in the middle, especially when reading or looking at faces.
• Changes in color perception: Colors may appear darker and more distorted.
• Straight lines: This is a very important characteristic . If straight things like window frames, door frames, and tile lines appear to be wrinkled and stretched, don't ignore it.
• Seeing black or empty spots in the middle of vision: Seeing a black spot or empty space in the middle of something you are looking at.

If you have any of these symptoms, it is very important to see an eye specialist immediately .

How does a doctor detect this?

Since macular degeneration often has no symptoms in its early stages, it's important to have your eyes checked annually , especially if you're over 50. This allows your doctor to detect the disease early and start treatment quickly.

When you go to the doctor, he will check your retina and macula for changes. He may do one or more of the following tests.

• Amsler grid test: This is a grid with a grid on it. There is a big dot in the middle. The doctor will ask you to look at the grid and see if there are any lines that are stretched, broken, or blurry. This can give you an idea of ​​whether you have the disease or if it is severe. You can also use this to monitor your vision at home.
• Dilated eye exam: The doctor will use eye drops to dilate your pupil and a special lens to look inside your eye.
• Fluorescein angiography: A yellow dye is injected into a vein in the arm, and a special camera takes pictures of the dye as it travels through the blood vessels inside the eye. This can help determine if there is any blood or fluid leaking under the macula.
• Optical coherence tomography (OCT): This is like taking a scan of the inside of your eye. It's painless. As you look into the lens of the machine, it takes very clear three-dimensional (3D) images of a cross-section of the retina and macula inside your eye.

What are the treatments?

Treatment depends on what type you have.

Treatment for dry type

There is no specific treatment for the dry type. However, large studies called ``AREDS`` and ``AREDS2`` have found that taking a specific combination of vitamins and minerals can slow down the progression of the disease. These nutritional supplements usually contain:

• Vitamin C
• Vitamin E
• Lutein
• Zeaxanthin
• Zinc
• Copper

You should talk to your ophthalmologist about whether you should take these and in what dosage. Don't just take vitamins on your own.

Treatment for the Wet Type

Because the wet type is severe, it requires prompt treatment.

• Anti-VEGF injections: This is the main and most effective treatment available. This is a drug that blocks a protein called VEGF, which causes the growth of weak new blood vessels inside the eye. The doctor numbs the eye and injects the injection painlessly . These injections can sometimes restore some of the vision that has been lost.
• Photodynamic therapy (PDT): This involves injecting a light-sensitive drug into a vein and then directing a special laser beam into the eye to destroy the newly formed unwanted blood vessels.
• Laser photocoagulation: A high-energy laser beam is used to seal/destroy bleeding blood vessels. However, the use of these methods has decreased significantly since the advent of new `Anti-VEGF` vaccines.

How can we protect ourselves from this situation?

Although it cannot be completely prevented, there are many things we can do to reduce the risk.

• If you smoke, stop immediately. This is the best thing you can do.
• Maintain a healthy weight.
• Exercise regularly.
• Keep your blood pressure and cholesterol levels well controlled.
• Adopt a healthy diet. Eat more green vegetables, fruits, and fish (especially oily fish like salmon and mackerel).
• Wear sunglasses with good UV protection when going outside.

Loss of central vision can have a major impact on daily activities. It can be difficult to read a book, recognize faces, and drive a car. This can lead to depression and anxiety. In times like these, it is important to seek support from family and, if necessary, seek medical advice.

Macular Degeneration, AMD, eyesight, vision, aging, eye diseases, retina, macula, dry AMD, wet AMD