age-related macular degeneration (AMD), a leading cause of blindness in individuals over the age of 50 due to damage to the macula, the part of the retina responsible for sharp, central vision. ▪ OBSERVATIONS: The early and intermediate stages of AMD usually start without symptoms. A comprehensive dilated eye exam can detect AMD; the exam usually includes an Amsler grid test. A blurred area near the center of vision is a common symptom as the disease progresses. A slow, progressive loss in central vision may become a significant disability. ▪ INTERVENTIONS: Lifestyle changes such as improvements to diet, control of blood pressure, and cessation of smoking may slow the progression of the disease. Currently, no curative treatment exists for AMD, and it is important to determine, with yearly dilated eye examinations, whether the condition is advancing. Researchers at the National Eye Institute have identified certain high-dose vitamins and minerals that can slow progression of the disease in people who have intermediate AMD. Advanced (or neovascular) AMD typically results in severe vision loss. However, therapies exist to stop further vision loss. They include the injection of medications to block the growth of new vessels in the eye, photodynamic therapy, and laser therapy. ▪ PATIENT CARE CONSIDERATIONS: Low-vision services and visual rehabilitation services will assist individuals in coping with the loss of vision and in maintaining independence.
