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Age-Related Macular Degeneration (AMD) in Singapore: Causes, Symptoms, and Treatments
Age-related macular degeneration (ARMD) is a condition that tends to affect the elderly (over 50 years) where the central part of the retina called the macula is damaged. It leads to the loss of central vision leaving behind only peripheral vision and does not typically cause complete blindness.
However, if advanced, daily activities such as cooking and watching TV become impaired. Risk factors include age, race, smoking and genetics (positive family history). In general, there are 2 types of ARMD. During diagnosis your ophthalmologist may use an Amsler grid or examine your eyes with a special lens to monitor changes in the retina and macular.
1. ‘Dry’ ARMD (accounts for 80% of cases and is slowly progressive)
2. ‘Wet’ ARMD (20% of cases where progression may be more rapid).
The risk of age-related macular degeneration may be reduced by not smoking, exercising regularly, maintaining normal blood pressure and cholesterol levels and eating a healthy diet rich in green, leafy vegetables and fish. In the intermediate stage, your ophthalmologist may prescribe a combination of high dose vitamins and minerals which may slow disease progression (AREDS and AREDS 2 trials). Advanced ‘wet’ ARMD may be treated with anti-VEGF (vascular endothelial growth factor) injections, PDT (photodynamic therapy) or laser therapy.
Overview - What is Age-related Macular Degeneration (AMD)
Age-related macular degeneration is an eye condition that can blur your central vision. In this condition, ageing damages the macula, which is the part of the eye that controls sharp, forward-looking vision. For older adults, age-related macular degeneration is a leading cause of vision loss. Though it may not lead to complete blindness, the vision impairment it causes makes it challenging to do simple everyday tasks including reading and driving. Some people experience age-related macular degeneration very slowly, while others experience it much faster. It may take a long time for you to notice vision loss if you have early age-related macular degeneration. That is why regular eye check-ups at an eye clinic in Singapore is so important. For more detailed information on age-related macular degeneration, you can visit the SingHealth Age-Related Macular Degeneration page, a trusted source for insights into managing age-related macular degeneration in Singapore.
Causes of Age-related Macular Degeneration
While more extensive and comprehensive research is required to uncover the actual cause of age-related macular degeneration, it is revealed that a combination of heredity and environmental factors play a part. Smoking, obesity and diet can affect the progression of age-related macular degeneration. As the tissue in your macula thins over time, you may lose cells responsible for your vision.
Symptoms of Age-related Macular Degeneration
Age-related macular degeneration may develop gradually and without pain. One of the symptoms include visual distortion such as straight lines seeming bent. There are two types of age-related macular degeneration. The development of new blood vessels under the retina can cause “wet” macular degeneration in some people with dry macular degeneration. These vessels may bulge or pucker the retina during the early stages of wet macular degeneration, which results in vision distortion.
Another symptom of age-related macular degeneration involves poor dark adaptation. The ability of your eyes to adjust from seeing in light to seeing in the dark is known as dark adaptation. Dark adaptation declines at the earliest stages of age-related macular degeneration. Night vision difficulties worsen with the progression of the disease. Other symptoms may also include increased blurriness, difficulty recognising faces and decreased brightness of colours.
Diagnosis of Age Related Macular Degeneration in Singapore
Accurate diagnosis plays an important role in identifying the stage and type of age related macular degeneration patients in Singapore may experience. At Nova Eye Centre, several diagnostic tests are used to evaluate the retina and determine the most suitable management plan.
Comprehensive Eye Examination
A detailed eye assessment allows the ophthalmologist to check for changes in the macula and other parts of the retina. This may include visual acuity tests, pupil dilation, and the use of specialised lenses to examine the eye’s internal structures.
Optical Coherence Tomography (OCT)
OCT is a non-invasive imaging test that provides high-resolution cross-sectional images of the retina. It helps detect fluid accumulation, tissue damage, or early signs of macular thinning which are important indicators in assessing disease progression.
Fluorescein Angiography
This diagnostic test involves the injection of a fluorescent dye into a vein in the arm. As the dye travels through the retinal blood vessels, photographs are taken to highlight any leakage or abnormal vessel growth. This information assists in determining the form and severity of macular degeneration.
Prevention of Age-related Macular Degeneration
There are a few ways in which you can lower your risk of age-related macular degeneration. Firstly, is to stop smoking. Smoking is a risk factor for age-related macular degeneration and quitting can help save your vision. Secondly, use sunglasses especially when the sun is glaring outdoors. The long-term exposure to bright light may increase the risk of age-related macular degeneration and also cause permanent damage to the retina. Thirdly, always go for regular eye examinations. Regular eye examinations at an eye clinic are very important, especially when you age with risk factors associated with age-related macular degeneration.
Treatment for age-related Macular Degeneration
Treatment options depend on the type of age-related macular degeneration you have. Unfortunately, there is no treatment for dry age-related macular degeneration, but vision aids can help minimise its effects. With regards to wet age-related macular degeneration, eye injections and photodynamic laser therapy are viable treatment options.
For eye injections, your eye doctor may inject anti-angiogenic drugs into your eye. These medications prevent new blood vessels from forming and block leaks from abnormal vessels that cause wet macular degeneration. In photodynamic laser therapy, medication is injected into your bloodstream and absorbed by the blood vessels in your eye. A laser that activates the drug is then shone into the eye, damaging abnormal blood vessels. Ultimately treatments vary based on conditions. Talk to your eye doctor in Singapore to better understand the most suitable treatment for you.
Risk Factors of Age-related Macular Degeneration
There are several risk factors affecting age-related macular degeneration with the most prevalent one being age. This is the top risk factor that puts patients at risk and it is one of the leading causes of vision impairment in the elderly. Race and ethnicity are also risk factors. Whites are most likely to develop age-related macular disorder, followed by the Chinese and Hispanics/Latinos, while African-Americans have the lowest risk.
Apart from genetics, health and lifestyle choices may impact age-related macular degeneration as well. Those that have suffered from strokes, anginas or heart attacks may find themselves at a 1.5 times higher risk for age-related macular degeneration as compared to someone that has not. High cholesterol, long exposure to the sun and smoking may also increase that risk.
Meet Our Experienced Specialist in Age-Related Macular Degeneration
Dr Eugene Tay: Ophthalmologist
With over 25 years of clinical experience, Dr Eugene Tay provides evidence-based care for patients managing age-related macular degeneration (ARMD) in Singapore. His approach focuses on precision, early detection, and patient education, helping individuals understand their condition and explore suitable treatment options.
Learn more about Dr Eugene Tay on Our Doctor.
Frequently Asked Questions
Can age-related macular degeneration be reversed?
While there is no cure for age-related macular degeneration, treatment may slow the disease and keep you from having severe vision loss. Contact us and talk to our eye doctor for a suitable treatment option.
At what age does age-related macular degeneration usually begin?
Age-related macular degeneration usually begins at age 55 or older. If diagnosed, it is important for the patient to keep track of its progression. However, the impact and rate of change can vary for each individual, depending on factors such as the stage at which the condition is detected and the patient’s responsiveness to treatment.
At Nova Eye Centre, we offer screenings and follow-up care to support patients in managing the condition.
Is macular degeneration a normal part of ageing?
Macular degeneration is not a normal part of ageing. While it is more common in older adults, it can occur at any age and is often linked to a combination of factors such as genetics, hereditary health conditions, and long-standing or poorly controlled issues like diabetes or high cholesterol. An annual general eye screening can help detect the condition early and allow for timely management.
How long does it take to go blind from macular degeneration?
According to the American Optometric Association, most people reach legal blindness within 10 years of diagnosis. However, this is just an estimate. The exact time frame is unknown. Following your eye doctor’s advice, taking vitamins, and taking care of your health may all be vital to slowing down this process.
For more on how we can help you manage this condition, visit our About Us page.
What are early warning signs of macular degeneration?
Some early warning signs of age-related macular degeneration include gradual increase in haziness of your central or overall vision, difficulty adapting to low light levels and a blurred or blind spot in the centre of your field of vision.
For more information on other age-related conditions and the treatments we provide, visit our Treatments & Conditions page.