Affinity Health Plan

  • Understanding the leading cause of vision loss in older adults

    February 12, 2015

    The main reason for vision loss among people who are 50 years old and older is age-related macular degeneration (AMD), reports the National Eye Institute (NEI).  Slowly, almost imperceptibly, AMD harms the eyes' ability to use central vision and to see clearly. In other words, objects that are looked at directly become blurry. Those diagnosed with AMD will not go completely blind, but their vision becomes so poor that reading, watching TV, seeing a face and walking outside without help will be close to impossible.

    Many things increase a person's chance of getting this common eye condition. Of those risks, aging is the biggest one. "The older you get the more common it is," said Dr. Howard Levin, an optometrist in Linthicum, Maryland.

    These are other AMD risk factors:

    • Smoking
    • High blood pressure
    • Race (It's seen more often in Caucasians than in African-Americans or Hispanics/Latinos.)
    • Heredity

    Why do two controllable risk factors - smoking and high blood pressure - cause AMD? It is because the flow of blood from the vessels to the eye becomes blocked, according to Dr. Levin.  "Anytime blood vessels are restricted you don't get a good exchange of nutrients to the eye," he said.  Without a healthy flow of blood to the eye, it becomes damaged. "That is why smoking is a risk; it constricts your blood vessels. High blood pressure also constricts blood vessels."

    Interestingly enough, Dr. Levin pointed out that AMD was once very rare. "People just didn't live that long," he said adding, "as the population ages, you see these things that affect people at an older age."

    amdAMD harms the macula, a small spot near the center of the retina. The macula is the part of the eye needed for sharp, central vision. It lets people see objects that are straight in front of them. When an optometrist or ophthalmologist looks at the back of the eye that person is looking for a yellow or white substance called drusen.  Small drusen appear as a part of aging.  But many large drusen show that there is a chance of getting AMD, reports the National Eye Institute, which is a part of the National Institutes of Health. 

    About 1.8 million Americans who are age 40 or older have AMD, the Centers for Disease Control and Prevention in Atlanta stated.  An additional 7.3 million people have large drusen and are at risk of getting AMD. By the year 2020, 2.95 million people will have AMD, reports the CDC.

    AMD takes two forms - dry and wet. Dry AMD is when drusen appear. It is the most common form and appears in the early stage of the disease. Vision loss "is very slow," Dr. Levin said. "You don't know it."  The treatment, he said is to "watch it over the years."

    The disease can go on to become wet AMD, which is the more serious form.  With wet AMD, the NEI explains that abnormal blood vessels grow underneath the retina, which can leak fluids and blood causing vision loss. "It can be very devastating," said Dr. Levin. "You can really lose your sight fast."

    No cure exists for AMD.  Research is being done to stop it from getting worse.  "The major goal is to keep the disease at bay," he said.

    There are several ways to slow AMD:

    Get your eyes checked: "It is widely encouraged for seniors," said Dr. Levin. He strongly recommends a dilated eye exam, where eye drops are used to see the inside and back of the eye. "With a dilated exam, you can see if a person is getting the precursor to AMD, which is drusen." Either an optometrist or ophthalmologist can perform the exam. An ophthalmologist is an eye doctor with a medical degree, who can provide all forms of vision care services including surgery. An optometrist does not hold a medical degree, but a doctor of optometry (OD) degree. An optometrist can do testing, diagnosis, treatment, and vision care management.

    The NEI recommends an eye exam:

    • from age 40 to age 54, every one to three years
    • from age 55 to 64, every one to two years
    • after age 65, every six to 12 months

    Take vitamins and eat your vegetables: For intermediate or advanced AMD, studies have showed that vitamins and food that have certain vitamins can slow the disease. "It's eating all the good things your mother told you to eat when you were little, and you didn't," Dr. Levin said.

    The NEI suggests taking the following vitamins:

    • 500 milligrams (mg) of vitamin C
    • 400 international units of vitamin E
    • 80 mg zinc as zinc oxide (25 mg in AREDS2)
    • 2 mg copper as cupric oxide
    • 15 mg beta-carotene, or 10 mg lutein and 2 mg zeaxanthin

    A trial showed that a combination of vitamin C, vitamin E, beta-carotene, zinc, and copper can reduce the risk of late AMD by 25 percent," reports the NEI. The Institute also warns against smoking while taking the vitamins. Beta-carotene has been linked to an added risk of lung cancer in smokers.

    For advanced AMD: Doctors can try eye injections to slow the growth of abnormal blood vessels. They also can try laser treatments to close off abnormal blood vessels and laser surgery to destroy eye vessels.

    Low vision services are available for those with AMD.  Don't delay in asking for help.  Make an appointment with your eye doctor today. Below is a list of resources for the blind and people with low vision:


    Dr. Levin is the Clinical Director of Superior Vision Benefit Management, Inc. in Linthicum, Maryland.  He has been in private practice since 1972 in Baltimore, Maryland.  Dr. Levin has received several awards for his work within the community, including the Maryland Optometrist of the Year award in 2003.  He has served as the president of the Maryland Optometric Association. Currently, Dr. Levin is on the quality improvement board of CareFirst Blue Cross Blue Shield of Maryland.

    Comments (0)

    Leave a comment
    Name *
    Email *