In most people, ARMD advances so slowly that vision loss does not occur for a long time. In others, the disease progresses faster and may lead to a loss of central vision in one or both eyes. As ARMD progresses, a blurred or distorted area near the center of vision is a common symptom. Over time, the blurred area may grow larger or you may develop blank spots in your central vision. Objects also may not appear to be as bright as they used to be.
ARMD by itself does not lead to complete blindness, with no ability to see. ARMD generally only affects the central vision and spares side (peripheral) vision. For example, you may be able to see the outline of a clock but not be able to tell the time. The loss of central vision in ARMD can interfere with simple everyday activities, such as the ability to see faces, drive, read, write, or do close work, such as cooking or fixing things around the house.
The macula of the retina is made up of millions of light-sensing cells that provide sharp, central vision. It is the most sensitive part of the retina, which is located at the back of the eye. The retina turns light into electrical signals and then sends these electrical signals through the optic nerve to the brain, where they are translated into the images we see. When the macula is damaged, the center of your field of view may appear blurry, distorted, or dark.
Can I decrease my risk of developing ARMD?
You might be able to reduce your risk of ARMD or slow its progression by making these healthy choices:
During the exam, your eye care professional will look for drusen, which are yellow deposits beneath the retina. Most people develop some very small drusen as a normal part of aging. The presence of medium-to-large drusen may indicate that you have ARMD.
Another sign of ARMD is the appearance of pigmentary changes under the retina. In addition to the pigmented cells in the iris (the colored part of the eye), there are pigmented cells beneath the retina. As these cells break down and release their pigment, your eye care professional may see dark clumps of released pigment and later, areas that are less pigmented. These changes will not affect your eye color.
Not everyone with early ARMD will develop late ARMD. For people who have early ARMD in one eye and no signs of ARMD in the other eye, about five percent will develop advanced ARMD after 10 years. For people who have early ARMD in both eyes, about 14 percent will develop late ARMD in at least one eye after 10 years. With prompt detection of RAMD, there are steps you can take to further reduce your risk of vision loss from late ARMD.
If you have late ARMD in one eye only, you may not notice any changes in your overall vision. With the other eye seeing clearly, you may still be able to drive, read, and see fine details. However, having late ARMD in one eye means you are at increased risk for late ARMD in your other eye. If you notice distortion or blurred vision, even if it doesn’t have much effect on your daily life, consult an eye care professional.
Currently, no treatment exists for early ARMD, which in many people shows no symptoms or loss of vision. Your eye care professional may recommend that you get a comprehensive dilated eye exam at least once a year. The exam will help determine if your condition is advancing.
As for prevention, ARMD occurs less often in people who exercise, avoid smoking, and eat nutritious foods including green leafy vegetables and fish. If you already have ARMD, adopting some of these habits may help you keep your vision longer.
Researchers at the National Eye Institute tested whether taking nutritional supplements could protect against ARMD in the Age-Related Eye Disease Studies (AREDS and AREDS2). They found that daily intake of certain high-dose vitamins and minerals can slow progression of the disease in people who have intermediate ARMD, and those who have late ARMD in one eye.
The first AREDS trial showed that a combination of vitamin C, vitamin E, beta-carotene, zinc, and copper can reduce the risk of late ARMD by 25 percent. The AREDS2 trial tested whether this formulation could be improved by adding lutein, zeaxanthin or omega-3 fatty acids. Omega-3 fatty acids are nutrients enriched in fish oils. Lutein, zeaxanthin and beta-carotene all belong to the same family of vitamins, and are abundant in green leafy vegetables.
The AREDS2 trial found that adding lutein and zeaxanthin or omega-three fatty acids to the original AREDS formulation (with beta-carotene) had no overall effect on the risk of late ARMD. However, the trial also found that replacing beta-carotene with a 5-to-1 mixture of lutein and zeaxanthin may help further reduce the risk of late AMD. Moreover, while beta-carotene has been linked to an increased risk of lung cancer in current and former smokers, lutein and zeaxanthin appear to be safe regardless of smoking status.
Here are the clinically effective doses tested in AREDS and AREDS2:
A number of manufacturers offer nutritional supplements that were formulated based on these studies. The label may refer to “AREDS” or “AREDS2.”
If you have intermediate or late ARMD, you might benefit from taking such supplements. But first, be sure to review and compare the labels. Many of the supplements have different ingredients, or different doses, from those tested in the AREDS trials. Also, consult your doctor or eye care professional about which supplement, if any, is right for you. For example, if you smoke regularly, or used to, your doctor may recommend that you avoid supplements containing beta-carotene.
Even if you take a daily multivitamin, you should consider taking an AREDS supplement if you are at risk for late ARMD. The formulations tested in the AREDS trials contain much higher doses of vitamins and minerals than what is found in multivitamins. Tell your doctor or eye care professional about any multivitamins you are taking when you are discussing possible AREDS formulations.
Finally, remember that the AREDS formulation is not a cure. It does not help people with early ARMD, and will not restore vision already lost from ARMD. But it may delay the onset of late ARMD. It also may help slow vision loss in people who already have late ARMD.