How to Protect Your Vision for the Long Term

How to reduce your risk of age-related retinal problems

GRETEL SCHMITZ- MOORMAN

wore glasses for decades, but when she was 53, they stopped helping. No matter how her eye doctor adjusted her prescription, she simply couldn’t read anymore. The problem? Age-related macular degeneration (AMD), which cloaks the central field of vision, making it difficult to see whatever you look at directly, although peripheral vision remains intact. There is no treatment for her condition.

“If you think of a dark spot wherever you look, that’s almost exactly what my vision is like,” says Schmitz-Moormann, now 79. “It took months, if not years, for me to allow the idea that this eye disorder was part of my life.”

AMD is one of three common conditions affecting the retina, the area at the back of the eye that the lens projects images onto. To see those images, your retina must send details to the optic nerve so that your brain can process the scene. If the retina becomes damaged, part or all of your vision can be wiped away, sometimes permanently.

Millions of older adults have retinal conditions. While they’re often caused by ageing or associated diseases, many of us also neglect our eye health.

“As people get older, they have an expectation that there will be a decline in their vision,” says Dr David Garway-Heath, an ophthalmology professor at University College London, “so they don’t necessarily seek out routine care to detect eye disease.”

Skipping check- ups can have dire consequences – retinal problems progress silently, surrept itiously robbing you of sight when interventions might have helped. “People with these conditions may have no complaints,” says ophthalmology professor Dr Sehnaz Karadeniz. “Therefore, regular eye examinations are mandatory to save the sight.”

AGE-RELATED MACULAR DEGENERATION

AMD is one of leading causes of blindness in adults over the age of 50 in South East Asia, as it is for the world as a whole. Changes within the eye damage the centre of the retina, impacting vision. Early on, straight lines look distorted. Later, dark spots block what you’re viewing.

“The centre of the retina gives you the most quality of life,” says Dr Hansjürgen Agostini, retinal specialist at the Eye Center of the University of Freiburg in Germany. “That’s where you read, where you recognise faces.”

There are two forms of AMD: wet and dry. About 80 per cent of affected people have dry AMD, caused by retinal thinning due to ageing. There’s currently no treatment, although there is ongoing research. “An early study showed that in a specific genetically defined group, which is about half the population, you can slow the progression of the disease by a monthly injection, but these findings will have to be confirmed by late-stage trials,” he says.

Only 20 per cent of people have wet AMD, but it causes significant vision loss – abnormal blood vessels grow behind the retina, leaking blood, scarring and damageing the retina. Intra-ocular injections can stop the

bleeding, but they must be given frequently, often over years.

Although the injections aren’t pleasant, because they go into the eye, patients are prepared with a topical anaesthetic so they don’t feel any pain. Several studies have proven the value of the injections in preserving vision.”

People with AMD don’t go completely blind and can navigate with peripheral vision. Schmitz- Moormann maintains her independence with absorptive- filter glasses that improve contrast, a mobility cane for walking and a magnifying glass for reading large-print books.

DIABETIC RETINOPATHY

One- third of adults with diabetes have diabetic retinopathy, the leading cause of preventable blindness among diabetic adults. Uncontrolled blood-glucose levels damage blood vessels throughout the body, including vessels that nourish the retina. They can become swollen and leak blood. Or new, leaky vessels may grow on the retina. Leaked blood or insufficient blood flow can distort or block vision. People often don’t notice a problem until their vision is damaged. People with diabetes have gradual visual loss due to retinopathy and often are not aware of it unless their daily life is affected,” says Dr Karadeniz. “We can prevent severe visual