Aged related Macular Degeneration (ARMD)

The macular is the most sensitive part of the retina (the screen) at the back of the eye where there is the highest density of light sensitive nerve cells. It is the one spot where our quality precision vision is supplied to the brain. Losing some or all of these delicate cells will cause increasingly dramatic changes in our ability to see.

It is usually noticed later in life and its causes are dependent on the type (wet or dry) and sometimes are not found. Wet ARMD (around 10%) is a fast progressive disorder created by excess fluid under the retina. Urgent referral, diagnosis and action by laser treatment are essential and can be partially successful in early stages. Dry ARMD is a slow developer caused by aging and failing nerve cells often in both eyes but not necessarily at the same time or speed. It is a painless and innocuous disorder often disguised by one good eye compensating for the bad one. Regular eyecare is essential in later life to spot this condition early.

Some experts consider that dry ARMD could be caused by a build up of oxidants over our lifetime which could be reduced by eating food high in anti oxidants (see our Nutrition and ARMD page for more details). A definite link to smoking and ARMD has been proven.

Almost all ARMD sufferers retain some sight to help them get along in life so don’t panic – there are many professionals in place to help with differing levels of visual disability and to help you explain to your relatives and friends how best to deal with the lack of vision.

Wet AMD sufferers get the green light from NICE to help stave off blindness

NICE agrees after 2 years of consultation to allow Lucentis, the injected treatment to counter the onslaught of wet age-related macular degeneration. This has come after NICE originally rejected the drug on a cost benefit basis. An agreement has now been made with the drugs manufacturers Novartis that allows the NHS to provide the first 14 injections per patient and thereafter for Novartis to bear the cost burden.

A second drug, Macugen from Pfizer, was rejected as not cost-effective.

“Lucentis is an expensive drug, costing more than 10,000 pounds for each eye treated. But that cost needs to be balanced against the likely cost savings,” NICE Chief Executive Andrew Dillon said in a statement. On an interview with Radio 4’s Today program he expressed sadness that it had taken so long for this capping deal to have been made, during which time undoubtedly some suffers have lost their sight. He stated that these were complex negotiations and that given the openness of the NICE organisation time must be given to all parties to raise objections.

NICE estimates that up to 14 shots should result in stable vision for most patients and improved vision for around a quarter of them.

This is great news for patients, those involved with treatment and those fighting for its full application after NICE, had decided that only a fifth of patients with AMD should get the drug. Patients who have been refused this drug in the past are recommended to seek further urgent advice.

Cataract

As we are all enjoying a more active and longer life, the occurrence of cataracts is far more prevalent. This is a misting of vision caused by normal ageing problems of the lens inside your eye which loses its transparency giving you a view of the world as if looking through a steamy or frosted window.

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Glaucoma

Glaucoma is caused by raised pressure in the chamber of the eye immediately in front of the lens and behind the cornea. There is a continuous flux of fresh fluid being produced in the eye and old fluid being drained out which normally remains in balance

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Retinal Detachments

This is a condition caused by a wide variety of conditions both from eye disease and structural failure. The retina contains all the visual receptors necessary for vision and is supplied constantly by blood vessels. If the retina is separated from its support structure, the nerve cells will soon die.

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Retinitis Pigmentosa (RP)

An inherited disease caused by gene defects instructing the cells in the retina to miss fire. There are a number of hereditary routes to RP, either male only with females as carriers (X linked) familial inheritance where both male and female siblings have a 50% chance of suffering RP from one of their parents and recessive inheritance where two carriers create a 25% chance of a sibling with RP whilst there appears to be no familial link.

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Sight threatening vision disorders

The eye is generally a robust and healthy sense organ, but from time to time serious defects occur either through a natural ageing process of the eye, genetic malfunctioning or a deterioration brought on by other general health issues.

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The effects on vision by diabetes

There is a predicted dramatic increase in Type 2 Diabetes in the population in addition to those earlier in life with insulin dependent type 1 diabetes. Having diabetes does not necessarily mean that your sight will be affected but if it is early diagnosis and treatment is essential to stop reduction or loss of vision.

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