Medically reviewed by Dr. Danielle Campbell

Understanding Age-Related Macular Degeneration in Canada

Age-related macular degeneration (AMD) is a major cause of vision loss in Canadians over 55, affecting about 2.5 million individuals. This condition damages the macula, the part of the eye essential for clear central vision, necessary for activities like reading and driving. There are two types of AMD: the more common 'dry' form and the more severe 'wet' form. Regular eye exams with an eye doctor are crucial for early detection and management of AMD. Risk factors include aging, smoking, poor diet, and genetics. While there's no cure for AMD, lifestyle changes and nutritional supplements, and in some cases injections can slow its progression. For both forms, maintaining a healthy lifestyle and regular eye check-ups can help manage the condition.

What is Age-Related Macular Degeneration (ARMD)?

AMD is a progressive eye disease that affects the retina, specifically the macula—the central part responsible for sharp, detailed vision. The macula allows us to perform tasks that require clear central vision, such as:

Reading
Driving
Recognizing faces

When AMD damages the macula, it can lead to a gradual or sudden loss of central vision. Peripheral (side) vision usually remains unaffected. There are two main types of AMD:

Dry AMD: This more common form progresses slowly as the macula thins and protein clumps called drusen develop. Geographic atrophy is an advanced, severe form of dry macular degeneration.
Wet (neovascular) AMD: Less common but more severe, this type involves the development of abnormal blood vessels under the retina, which can leak fluid and cause rapid vision loss.

Regular eye exams are essential for early detection, as macular degeneration may not have symptoms in its early stages.

How Many People are Affected by AMD in Canada?

AMD is a significant concern for the aging population in Canada, with approximately 2.5 million Canadians affected by this condition. As the population continues to age, the number of individuals impacted by AMD is expected to rise. Consider these statistics:

1 in 4 Canadians over the age of 45 may develop AMD
The risk of developing AMD increases significantly after age 60

Given the prevalence and projected growth of AMD cases in Canada, it is crucial for individuals to understand the risk factors, symptoms, and available treatments. Regular eye exams are essential for early detection and management of AMD, especially for those in high-risk groups. By staying informed and proactive about eye health, Canadians can take steps to preserve their vision and maintain their quality of life as they age.

What Causes AMD and Who is at Risk?

Several factors can contribute to the development of AMD, with age being the most significant. However, other risk factors can also play a role, including:

Smoking: Cigarette smoking doubles the risk of AMD and can cause the condition to progress more rapidly.
Diet: A diet high in saturated fat and low in fruits and vegetables may increase the risk of AMD.
Genetics: Having a family history of AMD increases an individual's likelihood of developing the condition.

Lifestyle choices can also influence the risk and progression of AMD. Maintaining a healthy diet rich in fruits, vegetables, and omega-3 fatty acids, exercising regularly, and protecting the eyes from UV light can help reduce the risk of developing AMD. On the other hand, smoking, obesity, and excessive exposure to sunlight without proper eye protection can increase the likelihood of developing the condition.

How to Identify and Diagnose AMD

Regular comprehensive eye exams are important for identifying AMD in its early stages as symptoms may not be apparent. During these exams, your optometrist will dilate your pupils to examine the back of your eye, looking for signs of AMD such as drusen (yellow deposits of proteins and lipids under the retina) or pigment changes.

As AMD progresses to the intermediate stage, you might experience:

Blurring of central vision
Difficulty seeing fine details
Need for brighter lighting when reading or doing close-up work

In later stages, AMD can lead to significant central vision loss, making it difficult to recognize faces, read, or drive. If you notice any changes in your vision, it's essential to schedule an eye exam promptly.

Your optometrist may use various tests to diagnose AMD, including:

Visual acuity
Amsler grid
Dilated eye exam
Optical coherence tomography (OCT)

By detecting AMD early, you and your eye care professional can develop a plan to manage the condition and slow its progression. Regular eye exams are key to maintaining eye health, especially as you age.

What Treatments are Available for AMD in Canada?

Treatment options for AMD vary depending on the type and severity of the condition. For dry AMD, there is currently no specific treatment available. However, making lifestyle changes such as quitting smoking, maintaining a healthy diet rich in antioxidants, and taking nutritional supplements like the AREDS2 formula may help slow the progression of the disease.

In the case of wet AMD, treatments focus on slowing vision loss and, in some cases, improving vision. The primary treatment for wet AMD is anti-VEGF (vascular endothelial growth factor) injections. These medications, administered directly into the eye, work by inhibiting the growth of abnormal blood vessels that cause damage to the retina.

Did You Know? In Canada, there are several anti-VEGF medications approved for the treatment of wet AMD, including Lucentis, Eylea, and Beovu. These treatments have shown significant success in preserving and even improving vision for many patients with wet AMD.

It's essential to work closely with your eye care professional to determine the best course of treatment for your specific case of AMD. They can help you understand the potential benefits and risks associated with each treatment option and develop a personalized plan to manage your condition effectively.

How to Manage Living with AMD

Living with AMD can be challenging, but there are various tools and strategies to help manage the impact of the condition on daily life. A crucial aspect of managing AMD is regular check-ups with an eye care professional, to monitor for the progression of the condition and make any necessary adjustments to treatment plans. Between appointments, an Amsler Grid can be used to monitor their vision at home. The Amsler grid is a square grid with a dot in the center, and any changes in the appearance of the grid, such as wavy lines or missing areas, can indicate changes in vision that should be reported to an eye care professional.

If vision loss progresses, vision aids, such as glasses, magnifiers, lights, and large-print books. These aids can help individuals with AMD to read, write, and perform other daily tasks more easily.

In addition to these tools, making lifestyle changes such as quitting smoking, maintaining a healthy diet, and protecting the eyes from UV light can also help to manage AMD and slow progression. Talk to your FYidoctors optometrist about the best strategies for managing AMD and maintaining the best possible quality of life.

FAQ

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