How to Pro­tect Your Vi­sion for the Long Term

How to re­duce your risk of age-re­lated reti­nal prob­lems

Reader's Digest Asia Pacific - - Front Page - BY LISA FIELDS

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

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