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Age Related Macular Degeneration
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Background

Age-related macular degeneration (ARMD) is the most common cause of vision loss in those over 50s and its prevalence increases with age.  It is caused by degeneration of the macula, the central, and most sensitive part of the retina at the back of the eye.
 
The macula is the part of the retina that allows the eye to see fine details at the center of the field of vision. Degeneration results from a partial breakdown of the retinal pigment epithelium (RPE).

The RPE is the insulating layer between the retina and the choroid (the layer of blood vessels behind the retina). The RPE acts as a selective filter to determine what nutrients reach the retina from the choroid. Many components of blood are harmful to the retina and are kept away from the retina by normal RPE.

Breakdown of the RPE interferes with the metabolism of the retina, causing thinning of the retina (the "dry" phase of macular degeneration). These harmful elements may also promote new blood vessel formation and fluid leakage (the "wet" phase of macular degeneration).

This disorder results in the loss of central vision only -- peripheral fields are always maintained. Although loss of ability to read and drive may be caused by macular degeneration, the disease does not lead to complete blindness.

The disease becomes increasingly common amongst people in each succeeding decade over 50. By age 75, almost 15% of people have this condition. Other risk factors are family history, cigarette smoking, and being Caucasian.

This is an example of what a patient with advanced macular degeneration might see.
  • Straight lines may become distorted
  • The central part of the visual field may be missing
  • Reading may become very difficult


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