Did your parents or grandparents ever have difficulty driving, reading or recognizing faces?

They could be suffering from age-related macular degeneration, a progressive disease that affects around 11 million people, mostly aged over 60. This figure is likely to double by 2050, as our population ages.

What is macular degeneration? There is a structure called the retina at the back of our eyes that acts like film, capturing images that go to our brain for interpretation. The retina is vulnerable to changes with age and can slowly degenerate due to environmental and physiological factors.

Cells at the back of the retina – which are supposed to prevent stress from light and oxidation, as well as provide the neural cell layer with food and oxygen – can die. A byproduct called drusen results. This byproduct can block the supply of food to photoreceptor cells in the retina or stimulate the growth of new blood vessels around the macula. Uncontrolled diabetes can also lead to inflammation of the retina and the formation of new blood vessels.

When these blood vessels leak, the macula can become damaged. Damage to the macula, the pigment-rich area in the central part of the retina, leads to age-related macular degeneration.

The macula has a high density of cones which give us clear vision. It also helps with fine details and contrast. Our color vision, especially that in the center with good resolution, comes from the macula. The yellow color of the macula absorbs yellow and ultraviolet light, acting as a sort of sunscreen.

What happens if you have macular degeneration? This can cause blurred vision, loss of central vision, and make it difficult to read, drive, or recognize familiar faces.

AMD can be of two types: dry and wet.

The dry type, which causes thinning of the macula, is more common. Patients suffer from a buildup of drusen – leftover lipids and proteins that build up in the macula over time. About 10% of people with the dry form can develop wet AMD, which is more serious. People can experience dry and wet macular degeneration, at the same time, and in either eye. About a third of people with dry AMD may develop a more severe, irreversible form called geographic atrophy or thinning. In this case, large areas of retinal cells die. Lesions appear on imaging like a map.

The wet type is caused by abnormal growth blood vessels that supply the retina; These blood vessels leak fluid behind the retina.

Who is most likely to suffer from AMD? Factors that predispose to MAD include high blood pressure, heart disease, being overweight, smoking, eating unhealthy foods, and a sedentary lifestyle.

There could be a genetic basis to the disease, given that about a fifth of patients have a sibling or parent who has it. However, approximately 19 genes have been associated with AMD. People of European ancestry tend to be at greater risk.

What can we do about AMD?

Obviously, prevention and exercise with a healthy diet are recommended. Although I would prefer that you speak to an ophthalmologist or optometrist, using a Amsler chart might be a way to see for yourself. It’s a square with grids and a point in the middle. If you tape this grid to the wall and look at the dot from 12 to 15 inches away, with one eye closed, the lines should not appear wavy. This can tell you if there are problems with your central field of vision.

Carotenoids such as lutein and zeaxanthin are sold as supplements to prevent the progression of dry AMD. The yellow color of the macula is due to the yellow pigments: lutein and zeaxanthin. Yellow fruits and vegetables also contain carotenoids. Antioxidants such as vitamins C and E have also been suggested by the ARED and AREDS2 study.

As for wet AMD, medications called anti-VEGF antibodies can prevent the abnormal growth of blood vessels in the retina. They are injected into the vitreous body or into the gelatinous fluid that fills the eye. These injections are given monthly at first, but the dose is reduced thereafter.

Studies tout the use of a blood sugar-lowering drug, metformin, to slow the progression of AMD. Recently, a Cleveland Clinic study found that taking melatonin was associated with a lower risk of developing AMD.

Please stay vigilant and take care of your eyes. Knowing the threat of age-related macular degeneration can help you see clearly far into the future.

Syed Jamal teaches chemistry, biology, and anatomy/physiology at the college level and researches phytoremediation and cancer biology. Through its opinion section, Kansas Reflector strives to amplify the voices of people affected by public policy or excluded from public debate. Find information, including how to submit your own comments, here.