Age related macular degeneration

Danny Scott / 24 January 2018

Strange little changes in Christine Finlay’s vision signalled a huge change in her life.

Being driven home from the airport one rainy night about ten years ago, it struck me that the tail lights of the cars ahead looked funny – wobbly and out of focus.

I went to my optician in Poole for a check-up. ‘Oh yes. There is something a little strange at the back of the eye,’ the optician announced and referred me to Royal Bournemouth Hospital.

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An eye specialist carried out all kinds of weird tests on me and took photos of the back of my eyes. They revealed that I had age-related macular degeneration (AMD) in both eyes. The condition damages the macula in your retina, a part of the eye responsible for central vision, affecting your ability to look straight ahead. But even though I was only 60, and just retired from my job as a computer analyst, I not only had dry AMD, where a build-up of harmful deposits damages the macula – but the wet type, too. Abnormal blood vessels were growing in my eye, causing harmful bleeding.

The bad news was there was nothing the doctors could do. There are no treatments for dry AMD and, at that time, the now common anti-VEGF (anti-vascular endothelial growth factor) injections into the eye, which help to prevent the growth of blood vessels, were still at the experimental stage. All the medics could suggest was to try to keep my blood pressure down to minimise the bleeding. But, over the next few years, my central vision kept deteriorating.

It started to impact my life seriously. Reading and driving became impossible. Doors began to look fuzzy and I wondered whether I could walk through them. There were no longer straight lines to anything – windows, floors, shelves, stairs – making stuff tricky to negotiate.

I was also diagnosed with pigment epithelial detachment, which is connected to AMD and leads to fluid beneath the layer of cells under the retina.

After about five years, doctors began to give me anti-VEGF injections. They numb your eye with drops, so you feel no pain. But they were still pretty terrifying. Talk about something being ‘better than a poke in the eye with a sharp stick’! Though they may have stopped some new bleeding, they didn’t improve my eyesight.

I was 65, single with grown-up children, and I wanted to stay as independent as possible. So I moved into a bungalow to make it easier to navigate. I put bright lights up everywhere so I was never in my own shadow. It was fantastic – like the Blackpool illuminations! I had all the walls painted white and mirrors put up to reflect the light. I replaced dark kitchen worktops with pale ones so that objects stood out, and put bright orange tactile stickers on my cooker’s knobs so I’d know if they were on or off.

Meanwhile, I had a major bleed in my left eye that led to scarring and more loss of vision. That eye was too far gone to keep injecting. Then, two years ago, the right eye bled so badly that it pushed the retina off the back of my eye. I needed operations to re-attach it, after which I regained my peripheral vision, but my central vision is just a messy smudge, like dirty fingerprints in the middle of your spectacle lens.

I no longer have injections in either eye, but though my central vision will probably never return, I try to keep my eyesight as best I can, by taking lutein supplements and eating a lot of dark green, leafy veg. And my peripheral vision allows me to be aware of certain things around me, even if it can’t stop me bumping into lampposts.

I have bad days. I miss playing mahjong and eating runny honey (it goes everywhere now). But it’s not all bad. At least I can’t see my face too well when I look in a mirror – the wrinkles have disappeared! I joined a club at my library where we listen to books, then meet to discuss them, which I really enjoy. Having worked in computers, I’ve also adopted various helpful technologies, such as software that reads my emails to me and voice recognition on my mobile that allows me to dictate text messages.

Recently, the Macular Society hosted a ‘supercar’ day at an Oxfordshire racetrack. I never thought I’d drive again… but I zoomed along at 90mph (next to a brave man equipped with his own brake), seeing nothing but trackside cones and a blur of grass. It was wonderful!

Treatments for age-related macular degeneration

Age-related macular degeneration (AMD) is the most common cause of sight loss in the UK and generally affects those over the age of 50. More than 600,000 people currently suffer from the condition. Though it can’t be cured, if caught early, wet AMD can be treated in various ways that will slow down its progress and limit its effects.

Anti-VEGF injections

These block the production of the chemical VEGF (vascular endothelial growth factor), too much of which causes the growth of unwanted, unhealthy blood vessels that bleed and cause wet AMD. Administered under local anaesthetic over several treatments.

Photodynamic therapy

A light-sensitive medicine, verteporfin, is injected into your arm and attaches itself to the abnormal macular blood vessels. A laser is then shone into your eye to activate the verteporfin, which destroys the vessels. Repeat treatment is needed every couple of months.

Laser photo-coagulation

A powerful laser is used to burn sections of the retina. These sections then harden, preventing the blood vessels moving up into the macula. The results tend to be less effective than the other treatments, so it is mostly used for people who cannot be treated with anti-VEGF medication or photodynamic therapy.

Reducing the risk of AMD and detection

AMD is connected to ageing and believed to be partly hereditary, but it’s unclear what triggers the process that causes the condition. Experts believe healthy lifestyle choices, such as not smoking, reducing alcohol intake, eating plenty of fruit and veg (particularly leafy green vegetables) and wearing UV-absorbing sunglasses, may help to guard against it.

Early diagnosis and treatment of wet AMD is essential. Visit your GP or optometrist if your vision is gradually deteriorating. If it gets worse suddenly, book an emergency appointment with an optometrist.


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