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Dry Eye and Macular Degeneration: The Connection

AMD (age-related macular degeneration) is a condition of the eye that is painless, but means you lose central vision. In most cases, AMD happens in both eyes. As a result of this loss of central vision, you may notice that reading becomes quite hard, the colors around you appear less vibrant and you find it more difficult to recognize people’s faces. Although some people suffer from rapid AMD, the changes are usually very gradual. It also doesn’t affect your side or peripheral vision, so you will not turn completely blind.

Two Types of AMD

The table below highlights the two types of AMD and what they mean.

Type of AMD Details
Dry AMD
  • Most common form, covers 90% of all AMD cases
  • Caused by Drusen deposits (yellow in color) on the macula’s cells
  • Gradual vision loss
  • Can develop into wet AMD, which happens in 10% of cases
  • Most noticeable at first during reading
  • Can lead to tissue death or atrophy
  • People experience blind spots
  • Central vision may be completely lost over time
Wet AMD
  • Known as neovascular AMD
  • Caused by the development of abnormal blood vessels, damaging other cells
  • More serious and can lead to significant deterioration in just days if left untreated
  • Straight lines appear wavy
  • Loss of central vision can occur
  • People experience blind spots
  • Central vision may be permanently and completely lost over time

Dry Eye and Macular Degeneration

Dry eye is a condition whereby the eye no longer produces sufficient tears or has a disruption in the components (water and oil) of the tear, leading to the tears evaporating too quickly. It is also commonly associated with dry macular degeneration. This disorder is most often seen as a result of aging, with people over 65 being most likely to be affected. The macula, which is the part of the eye’s retina responsible for giving you clear central vision, starts to thin with this condition.

Many people find that dry AMD starts in one eye, but that the second eye quickly follows suit. It is, as the name suggests, a degenerative condition, meaning that it gets worse over time. Driving, reading and recognizing faces become increasingly difficult. Blindness, however, is rare, particularly if you are able to detect it early and know how to care for your eyes.

Causes of Dry AMD

As people age, some of the cells in their eyes become damaged and don’t function as well anymore. This means that they do not absorb the nutrients that they are supposed to, nor are they able to clear waste material as well. Additionally, the quality of tears diminishes. Put together, vision can be significantly impaired.

There is no one single cause for AMD, although there are a number of factors more commonly seen in people who develop it. These include:

  • People with high blood pressure, although the evidence for this is still inconclusive
  • People who smoke
  • People who have a family history of AMD, although it is not as simple as it being hereditary
  • People who spend too much time looking at the sun, although the evidence for this is still inconclusive. Scientists suggest that retina damage caused by UVA and UVB rays may contribute to AMD.
  • Age
  • Caucasian ethnicity

Symptoms of Dry AMD

There are a number of symptoms to look out for. Some people experience just one of these symptoms, while others experience them all. This is why it is so important to have your eyes checked regularly. The symptoms to look out for include:

  • Central vision blurring, which means you find it harder to read and recognize faces, and colors seem to be less vivid.
  • Visual distortion, which happens with almost anyone who is developing AMD. This means that straight lines suddenly look as if they are crooked or wavy.
  • Blind spots in the center of your field of vision, which usually come after visual distortion. The longer AMD is left untreated, the larger the blind spot
  • Hallucinations, which indicate the ‘Charles Bonnet syndrome’, although this generally only happens with people who have severe AMD. With treatment, it usually goes away after around 18 months.

AMD is a painless condition and it usually takes between five and 10 years for the symptoms to reach their peak.

Treatment for AMD

Unfortunately, AMD is a permanent, degenerative disorder. This means that it cannot be cured. However, progression is usually very slow, and you can slow it down even more with proper care and attention. It is not, in other words, life limiting.

Once it becomes advanced, however, there is nothing that can be done to stop more vision loss from happening. This is why it is so important to spot AMD when it is mild to intermediate, as it can mean delaying the onset of severe AMD. The AREDS study has shown that taking zinc and a special formulation of high dose antioxidants helps to prevent intermediate AMD from escalating into advanced stage. The same study also demonstrated, however, that taking this formulation (vitamins A, C, and E and zinc) did not benefit people who had early-stage dry macular degeneration. The study did also warn that people who are at an increased chance of developing lung cancer should not take vitamin A for AMD. Further studies are currently being conducted to determine whether there is any benefit to taking bilberry and lutein.

Lifestyle changes are also an important factor to slow down the progression of dry eye AMD. People who suffer from it should eat more fruits and vegetables and remove unhealthy saturated fats from their diets, replacing them with unsaturated fats instead. Additionally, they should consume higher levels of omega-3, found in fatty fish, and whole grains wherever possible.

There are also numerous over the counter vitamin products available that claim to be specifically designed for people with AMD. While these products usually contain vitamins and are therefore not harmful (so long as you do not exceed your daily recommended amount), there is no evidence that any of these products work. Instead, doctors recommend that people focus on their overall bodily health through diet and exercise. A healthy body means healthy eyes, after all.

How to Cope with Dry Eye AMD

It can be very upsetting to be diagnosed with AMD. A lot of people think they ‘simply’ have dry eye syndrome, which can easily be treated with some eye drops. AMD, however, is a chronic, permanent, degenerative condition and it is normal to feel very upset about that diagnosis. People most often worry about going blind, and about how they will manage with reduced vision.

There are a number of support groups available for people who do suffer from AMD. Talking with people who understand what you are going through can be very beneficial. It will make you feel less like you’re alone.

What matters most, however, is that you learn how to do things to make the most out of the vision you still have. You may, for instance, be a good candidate for certain types of vision aids from low vision specialists, including a magnifier. There is also training available for people with AMD, which teaches you how to read with your peripheral vision. As your sight deteriorates, you may have to register as being ‘partially sighted’ or even ‘blind’. This will also entitle you to further support services, particularly through your local health organizations and social services.

Latest Research

A lot of research is being done into AMD, with scientists hoping to gain a better understanding of what the condition means, how it works and whether or not it can be stopped. It is, by now, clear that there are some hereditary and genetic factors at play, so this is one area that scientists are particularly interested in.

Various clinical trials are also currently taking place to find out whether there are different ways to slow down, stop or even reverse macular degeneration at any stage of the condition. Specifically, scientists are determining whether certain drugs, including anti-inflammatory drugs and drugs that stop the body from creating new blood vessels, may be of benefit. Finally, some studies are currently being conducted to see whether cell transplantation, whereby healthy cells are injected into the damaged cells (for instance through stem cell treatment), may be of benefit to people with AMD..

Resources and References:

Facts About Age-Related Macular Degeneration – Information on age-related macular degeneration. (National Eye Institute)
The Difference Between Wet and Dry Age-Related Macular Degeneration – Comparison between dry and wet age-related macular degeneration. (Vision Aware)
Antioxidant Vitamins and Zinc Reduce Vision Loss from Age-Related Macular Degeneration – How zinc and vitamins can decrease vision loss from age-related macular degeneration. (National Eye Institute)