What are the risk factors of losing vision?
If you have been diagnosed with AMD, you may ask, “Will I lose vision from AMD?” There are many risk factors that lead to the worsening of age-related macular degeneration (AMD). Some are genetic (inherited) and some are environmental. However, one the greatest risk factors is age. This is, the older you are with AMD, the greater the risk of loss of vision. Genetic testing can reveal high risk genes, such as CFH and ARMS2. Therefore, a family history of vision loss from AMD increases your risk. Other important factors that affect the risk of losing vision include tobacco use and diet.
What are the stages of AMD?
There are several stages of AMD that affect the risk of severe loss of vision: early, intermediate, and late AMD. Early AMD presents with medium sized deposits under the retina called drusen. These eyes usually have no symptoms and the vision is good. Intermediate AMD have large drusen and/or brown pigmentary changes under the retina. These changes frequently result in slow recovery from bright light (like coming in from outdoors) and the need for good lighting while reading. Late AMD causes distortion of straight lines and blind spots in the vision from geographic atrophy (loss of retinal tissue) and/or neovascularization (new blood vessels grow under the retina that bleed and cause blind spots from scar tissue). Geographic atrophy is also called advanced dry AMD, whereas neovascularization is called wet AMD.
How can I determine my risk of late AMD with vision loss?
A point system has been developed to determine your risk of loss of central vision from late AMD. Exam findings in each eye are given a point value. Then, all the points are added together from the two eyes to arrive at risk of progression to late AMD within 5 years.
| Exam Finding | Point Value |
| medium drusen | 0.5 |
| large drusen | 1 |
| pigmentary changes | 1 |
| geographic atrophy or neovascularization | 2 |
At total score of 1 yields a low risk of late AMD of under 5% in five years. With 2 points, the risk is 12 percent. Three points means a risk of 25% at five years. And 4 points means there is a 50% chance of late AMD in five years. Another way to calculate your risk of late AMD is to use an online calculator.
How bad can the vision fall from late AMD?
Late macular degeneration may cause a large blind spot in the center of the vision in both eyes. Although this renders an individual legally blind, it is important to remember that it is extremely rare to lose all vision from AMD. The peripheral vision usually remains strong and this allows a person to get around a room and care for himself independently.
Does everyone lose most of their central vision in late AMD?
No. Many people retain useful vision. Patients with advanced dry AMD may be treated with Syfovre or Izervay to slow the progression of geographic atrophy. There are a host of medications that slow the loss of vision from wet AMD, including Avastin, Lucentis, Eylea, Beovu, and Vabysmo. There is high expectation that further developments from ongoing research will offer even better odds of retaining useful vision in the future. Those patients who do lose vision from AMD can be helped with low vision aids.
For a telemedicine consultation with Dr Pautler, please send email request to spautler@rvaf.com. We accept Medicare and most insurances in Florida. Please include contact information (including phone number) in the email. We are unable to provide consultation for those living outside the state of Florida.
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