gerontological nursing Mansoura university

department Faculty of nursing

first semester 2022- 2023

Age-Related Macular
Degeneration (AMD)

Under supervision :
Asmaa ali
Outlines:
Overview.

Introduction.

Definition.

Classification.

1-dry

2-wet

Risk factors.

Causes.

Signs and symptoms.

Diagnosis.

Management.

Living with it.

overview

- Age-related macular degenerate is the third cause of blindness worldwide , and the first in •
developing countries.
It's a common cause of vision loss in people aged 50 or older.
- AMD accounts for 8.7% of blindness worldwide.
- prevalence is expected to increase exponentially due to population aging.
- projected number of people affected with the disease is expected to reach 288 million in 2020.

introduction
Age-Related Macular Degeneration (AMD) is one of the most common causes of vision loss in
people aged 60 and older. AMD affects the macula, a small, yet extremely important area in the
retina responsible for:
seeing fine details clearly.

When the macula is damaged, the center of our field of vision may appear blurred, distorted, or
dark, which may interfere with everyday tasks such as reading, writing, driving or recognising
faces.
definition
Age-related macular degeneration (AMD) is an eye disease that can blur your central vision. It
happens when aging causes damage to the macula — the part of the eye that controls sharp,
straight-ahead vision. The macula is part of the retina (the light-sensitive tissue at the back of the
(eye).

Classification:
1- Dry AMD " early stage"
2- Wet AMD " advanced stage "
Dry AMD "early stage"
This type is the most common. About 80% of those with AMD have the dry form.
Its exact cause is unknown, although both genetic and environmental factors are thought to play
a role.
This happens as the light-sensitive cells in the macula slowly break down, generally one eye at a
time. The loss of vision in this condition is usually slow and gradual.
It is believed that the age-related damage of an important support membrane under the retina
contributes to dry age-related macular degeneration.

Wet advanced stage

Though this type is less common, it usually leads to more severe vision loss in patients than dry
AMD.
It is the most common cause of severe loss of vision.
- Wet AMD happens when abnormal blood vessels start to grow beneath the retina. They leak
fluid and blood hence the name wet AMD and can create a large blind spot in the center of the
visual field.
Risk factor
1- uncontrollable risk factors
- sex
- family history
- Age
- Race
2- controllable risk factors
- smoking
- diet
- sun exposure
- obesity
- high blood pressure
- Cardiovascular diseases
causes
No one knows exactly what causes dry macular degeneration. But research indicates it may be
affected by a combination of heredity and environmental factors, including smoking, obesity and
diet.

Symptoms
-Visual distortions, such as straight lines seeming bent.
-Reduced central vision in one or both eyes.
-The need for brighter light when reading or doing close-up work.
-Increased difficulty adapting to low light levels, such as when entering a dimly lit restaurant.
-Increased blurriness of printed words.
-Decreased intensity or brightness of colors.
-Difficulty recognizing faces.
-A well-defined blurry spot or blind spot in your field of vision.
Diagnosis
1- amsler grid
2- dilated eye exam
3- ophthalmoscopy
4- fluoresce in anaiography
5- OCT
6- tonometry
Treatment
Treatment depends on the type of AMD you have.
*Dry AMD – there's no treatment, but vision aids can help reduce the effect on your life. Read
about living with AMD.
*Wet AMD – you may need regular eye injections and, very occasionally, a light treatment called
photodynamic therapy, to stop your vision getting worse.
Adaptation
Help with low vision
Speak to your eye specialist about a referral to a low-vision clinic if you're having difficulty with
daily activities.
Staff at the clinic can give useful advice and practical suppor.
For example, they can talk to you about:
- useful devices – such as magnifying lenses-
changes you can make to your home – such as brighter lighting
software and mobile apps that can make computers and phones easier to use
If you have poor vision in both eyes, your specialist may refer you for a type of training called
eccentric viewing training.
- This involves learning techniques that help make the most of your remaining vision.

Staying healthy
AMD is often linked to an unhealthy lifestyle.
If you have it , try to:
eat a balanced diet
exercise regularly
lose weight if you're overweight
stop smoking if you smoke

Driving
AMD can make it unsafe for you to drive. Ask your specialist if they think you should stop driving.
You're required by law to tell DVLA about your condition if:
it affects both eyes
it only affects 1 eye but your remaining vision is below the minimum standards of vision for
driving
Monitoring and check-ups
You'll have regular check-ups with a specialist to monitor your condition.
Contact your specialist as soon as possible if your vision gets worse or you notice any new
symptoms.

Information:
Keep having routine eye tests (usually every 2 years). They can pick up other eye problems that
your check-ups do not look for.