The truth about AMD - the eye condition which will leave many of us in the dark

As the MI6 chief M in the Bond films, Dame Judi Dench was the epitome of sharp-eyed efficiency. In reality the actress is far from sharp-eyed, as her vision has been badly affected by the eye condition, age-related macular degeneration (AMD).

Eighty year old Dame Judi is one of more than half a million people in the UK living with late-stage AMD, and thee first ever Macular Week is aiming to draw attention to their condition and highlight what can be done to reduce the risk of developing it.

The prevalence of the condition roughly quadruples every decade from the age of 60, so one in 2,000 people are affected at 60, but by the age of 90, the figure goes up to one in five.

The condition, which spares the peripheral vision, but leaves dim images or black holes at the centre, means people with late-stage AMD may struggle or find it impossible to read, drive, identify faces, watch television, do fine detailed work and perform other everyday tasks. Dame Judi has admitted she now finds it difficult to read scripts and doesn’t like to travel alone.

“It’s becoming more common because it’s largely a condition associated with ageing. It’s an urgent, public health issue,” says Cathy Yelf, chief executive of the Macular Society. “With late-stage macular degeneration, you can’t see faces, you can’t read, you can’t see the food on your plate and you can’t drive. It can cause enormous depression and suicidal thinking.”

The vision loss of AMD is caused by deterioration in the macula, a tiny area of the retina about the size of a grain of rice. There are two forms, known as ‘wet’ AMD and ‘dry’ AMD, which can sometimes occur simultaneously.

“Dry AMD is the slow death of the photoreceptor cells,” explains Yelf. “It’s a bit like a carpet wearing out in patches, and it can take many months - or even years - for people’s vision to decline considerably.”

The first signs of dry AMD can be blurred vision, or seeing colours as more faded. There’s no treatment for this form of the condition, although there’s some evidence that nutritional supplementation can help slow down its progress. With wet AMD people can see a change in their vision overnight, noticing that images are distorted and straight lines appear wavy and while treatment is available there is no cure.

The most biggest risk factor when it comes to AMD is smoking. Smokers are three to four times more likely to get AMD, and even giving up in later life immediately reduces the risk. Smokers who get wet AMD will have more severe symptoms and treatment won’t work as well, says Yelf, who stresses that it’s never too late to stop.

Genes are also a risk factor - Dench’s mother had AMD, for example. If you smoke and have the genes that make you more susceptible, you’re 20 times more likely to develop the condition.

AMD risk factors are similar to those for heart disease, because of the vascular link, so eating a healthy diet including lots of green leafy vegetables like kale, and other vegetables containing lutein, including spinach, broccoli, peas, sweetcorn and lettuce, can help reduce risk, as can maintaining a healthy weight and reducing blood pressure. Protecting the eyes from UV and blue light can also help keep eyes healthy. The Macular Society also recommends that people have their eyes tested regularly, as opticians can detect early AMD.

“If you know you’ve got the early signs of AMD, you can at least modify your lifestyle to help slow its progress,” says Yelf. “As many of us will live into our 80s or 90s, we don’t want to live with sight loss in those last years. “People frequently say that of all the things going on with them in old age, this is the worst. It can be utterly devastating to lose your sight.”

For more information call the Macular Society’s on 0300 3030 111, or visit www.macularsociety.org