If you’re over 60, you may have noticed changes in your vision as you age. However, you may be wondering which vision problems are normal and which mean you are developing a serious medical condition.
Having trouble seeing in low light, reading close text, and distinguishing colors are all normal age-related eye changes. Seeing blurry areas or spots in your vision – or experiencing sudden vision loss – is not normal and should be evaluated by a qualified eye doctor as soon as possible. These symptoms could be signs of an advanced macular disease called geographic atrophy.
What is age-related macular degeneration and how is it related to geographic atrophy?
You may have just been diagnosed with age-related macular degeneration (AMD) and are troubled by your ophthalmologist’s concerns about geographic atrophy. Are these two different names for the same condition? Not enough.
Read on to learn more about retinal atrophy in men and understand how geographic atrophy is linked to age-related macular degeneration.
Macular degeneration. AMD affects the part of the eye called the macula, which is an area of the retina (the back of the eye) that helps you focus on small visual details like printed text, small movements and strokes of the face. The most common form of AMD – with up to 90% of patients diagnosed with this subtype – is called “dry” AMD. The other subtype is “wet” AMD.
- Dry AMD: Retinal waste products known as drusen appear in the macula. They look like little yellow spots and can make a big difference in the quality of your vision. A patient with dry AMD may go from just one or a few of these tiny drusen to many. However, dry AMD tends to grow slowly, making it easier to monitor over time. A patient may first notice blurry vision and problems with small details (rather than sudden vision loss).
- Wet AMD: This vision loss is not caused by drusen. Instead, small blood vessels grow in the retinal space and break. This causes bleeding, which is why it is called “wet” AMD. An accumulation of blood and fluids at the back of the eye. Unlike dry AMD, wet AMD can cause sudden vision loss that cannot be avoided.
Geographical atrophy. The final stage of dry AMD is called geographic atrophy. At this point, the drusen damage is so extensive that it causes blind spots in the patient’s central vision. Up to 20% of people with AMD develop geographic atrophy.
Geographic atrophy is more commonly associated with the dry subtype. However, it is possible for a patient to have both wet AMD and dry AMD and develop geographic atrophy independent of wet AMD. In other words, having wet AMD does not mean that a patient is immune to geographic atrophy.
What are the common symptoms of geographic atrophy?
Young people may be able to skip one or two annual eye exams if they have no vision problems and are otherwise healthy. If you’re over 50, however, you should schedule an eye exam every year to make sure you can see clearly and to make sure you don’t develop an eye disease like AMD.
People who notice the following symptoms, whether they are over 50 or under, should make an appointment with a qualified ophthalmologist:
- Loss of central vision: Loss of vision in the middle of your field of vision. You use this part of your view for almost every task.
- Difficulty in low light conditions: If you cannot read, cook, sew, or see another person clearly when the lights are not bright, you need to be assessed. You might notice you turn on extra lights to see better, or someone in your family might comment on how many lights you need to complete a daily task.
- Difficulty seeing colors clearly: This symptom may be harder to notice if you are not a color conscious person. If your vision looks dull, faded, or obscured in any way, you could be developing geographic atrophy due to AMD.
What are the risk factors for geographic atrophy?
Being over 60 puts you at risk for age-related macular degeneration and geographic retinal atrophy. Other risk factors include the following:
- Being a smoker
- Having one or more close relatives with AMD
- Have high blood pressure, high cholesterol, or both
- Being overweight or obese
- Adopting a poor quality diet
- Stopping hormone replacement therapy (HRT) or not using HRT at all during menopause
- Experiencing lots of direct sun exposure throughout your life
- Have chronic medical conditions like heart disease or diabetes
What is the best treatment for geographic atrophy?
Many patients don’t know they have AMD, and others don’t attribute geographic atrophy to symptoms such as faded colors or a need for more light to read. Symptoms of dry AMD are difficult to recognize unless the patient loses all of their central vision all at once. Likewise, a patient who develops symptoms of geographic atrophy in one eye may not make an appointment immediately. Unfortunately, delaying treatment could mean permanent loss of vision.
Dry AMD – the type that most often leads to geographic retinal atrophy – is usually treated with high quality dietary supplements. Currently, there are no FDA-approved drugs or treatments for this condition, but clinical trials are available for some eligible patients. Your doctor may want you to take zeaxanthin, lutein, and zinc to slow the progression of geographic atrophy. You can also take vitamins that contribute to eye health, such as vitamin C and vitamin E.
It is important to follow your treatment and make an appointment with your ophthalmologist to monitor your condition. If your dry AMD progresses, you may still be able to slow the disease and preserve your vision before you reach the stage of geographic atrophy.
Remember that patients with wet AMD can also develop dry AMD at any time. Don’t assume you can’t have one if you have the other.
What can a patient do if they have already lost their sight due to AMD?
If you have ever lost part of your vision due to this condition, you may be eligible for special aids and devices that can help you. There are many lifestyle changes you can make to help you at home and at work. Consider writing with bolder pens and markers, setting your devices to display large print, and using motion-sensor lights around your house so you don’t fall over trying to find the light switch.
It is possible to have a good quality of life even when living with low vision or vision loss due to AMD and geographic atrophy. If you’ve just been diagnosed with this condition or your treatment isn’t working as well as you’d hoped, contact your eye doctor to help you navigate your options.