Frequently Asked Questions

The National Eye Institute's Age-Related Eye Disease Study (AREDS) found that taking a specific high dose formula of antioxidants and zinc (500 milligrams of vitamin C, 400 International Units of vitamin E, 15 milligrams of beta-carotene, 80 milligrams of zinc as zinc oxide and two milligrams of copper as cupric oxide) may delay or prevent intermediate AMD from progressing to the advanced stage. There is no evidence, however, that the AREDS formula benefits people with early stage AMD. Patients with intermediate AMD in one or both eyes or advanced AMD (dry or wet) in one eye but not the other eye should consider taking the formula. Consult a physician before taking any supplements because they may be contraindicated for certain medical conditions or may react negatively with some medications.

It is possible to develop AMD in only one eye. However, as the disease progresses both eyes may become affected. If an individual has macular degeneration in one eye, he or she is more likely to develop it in the other eye than someone who does not.

Yes, there are several forms of juvenile macular degeneration (JMD), and all are inherited. The most common form of JMD is Stargardt's disease, also called fundus flavimaculatus or macular dystrophy, which normally develops in the childhood or teen years. Best disease or vitelliform macular degeneration is the second most common form of JMD; symptoms usually occur between birth and age 7. People in their thirties or forties can develop genetic forms of macular disease such as Sorsby's fundus dystrophy, Behr's dystrophy and Doyne's honeycomb retinal dystrophy. Finally, myopic macular degeneration can occur in people who are severely near-sighted due to extreme elongation of the eyeball. This condition can result in macula tears and bleeding beneath the retina.

Yes, some people with macular degeneration also develop Charles Bonnet Syndrome (CBS) and hallucinate. Some eye diseases prevent normal nerve impulses from reaching the brain, and it is believed that spontaneous, brain-generated nerve activity may cause visual hallucinations. CBS appears to be more common in women than men and is more likely to occur if both eyes are affected by disease. The hallucinations are normally complex and can include detailed patterns or fully formed images such as animals, people, faces or scenery. Patients know that the hallucinations are not real. These images are not associated with any other sensory (e.g., sound or odor) hallucinations, nor are they delusions. The hallucinations may last for seconds or for most of the day. They tend to disappear when people close their eyes. CBS may last for days or even years, but can be managed by educating the patient and reassuring him or her that the images are a result of eye disease, not a mental disorder.

• View a video of neurologist and author, Dr. Oliver Sacks, discussing Charles Bonnet Syndrome.

All wet AMD is considered advanced; however, the dry form of AMD has three stages:

• Early AMD - patients have several small drusen or a few medium-sized drusen. There is no vision loss or symptoms at this stage.
• Intermediate AMD - patients have many medium-sized drusen or one or more large drusen. Some people may need more light for tasks such as reading. A blurry spot may appear in the center of the visual field.
• Advanced AMD - patients exhibit a large number of drusen deposits and a breakdown of RPE and photoreceptor (light sensitive) cells and supporting tissue in the retina. A large blurry spot occurs in the center of the visual field and can become larger and darker, eventually causing a complete loss of central vision.

• More light is needed for tasks such as reading
• A blurry spot appears in the center of the visual field
• A blurry spot becomes larger and darker
• Straight lines may appear wavy
• Straight-ahead vision becomes distorted or lost entirely in a short period of time

To discover any changes to your vision as early as possible, your eye care professional will probably have you test your own vision on a regular schedule using a small, hand-held Amsler grid.  He or she may also do this at the office. At home, you will hold the chart at reading distance in good light, cover one eye, and focus on a black dot in the middle of the grid, then repeat with the other eye. If the lines of the grid appear dim, irregular, wavy, or fuzzy, you should schedule an eye exam immediately.

You can download an Amsler grid at www.brightfocus.org/amsler.

There are a great many resources available to people with low vision and their caregivers. For instance, every state has an agency on aging. You may find it in the phone book, online, or with the help of a librarian or friend. Professional low-vision therapists at eye clinics or other organizations can assist you. Let your eye doctor know what kind of limitations you are experiencing due to vision loss. He or she can then refer you to a vision rehabilitation center, where a low-vision therapist can work with you to help you adapt and resolve specific problems.

You can also modify your environment, use low-vision aids, develop your senses of hearing and touch, and practice using peripheral vision. Your doctor can prescribe optical devices such as magnifiers. Many non-prescription magnifying glasses and devices are also available to assist with reading and other close work, such as sewing or model-building. These devices range from the simple and inexpensive to more expensive high-tech products that can aid in using computers and watching television.

Many styles of magnifiers, including discreet ones, can be found at drug and medical supply stores, or may be ordered online or by phone through low-vision product catalogs. A hand-held magnifying glass can help with reading medicine bottle labels, mail, price tags in stores, and restaurant menus. Other magnifiers come in the form of eyeglasses or clip onto glasses to free your hands for other activities.

Commonly used household items with large numbers and letters, and others that “talk,” are also available. There are many sources for large-print books and audio materials, as well as services that read newspapers and magazines by phone or over the radio.

Electronic reading aids are proliferating, such as: computer programs that magnify the computer screen and/or read screen text out loud; special scanners to carry while shopping that read out prices, sizes, and colors; web browser plug-ins; and smartphone applications. One specialized device can take pictures of signs or menus and read the words in the pictures aloud.