Published: 03 February 2022

Age-related macular degeneration, often called ARMD or AMD, is the leading cause of vision loss among Americans 65 and older.

AMD causes damage to the macula, which is the central portion of the retina responsible for sharp central vision. AMD doesn't lead to complete blindness because peripheral vision is still intact, but the loss of central vision can interfere with simple everyday activities such as reading and driving, and it can be very debilitating.

Types of Macular Degeneration

There are two types of macular degeneration: Dry AMD and Wet AMD.

Dry (non-exudative) macular degeneration constitutes approximately 85-90% of all cases of AMD. Dry AMD results from thinning of the macula or the deposition of yellow pigment known as drusen in the macula. There may be gradual loss of central vision with dry AMD, but it is usually not as severe as wet AMD vision loss. However, dry AMD can slowly progress to late-stage geographic atrophy, which can cause severe vision loss.

Wet (exudative) macular degeneration makes up the remaining 10-15% of cases. Exudative or neovascular refers to the growth of new blood vessels in the macula, where they are not normally present. The wet form usually leads to more serious vision loss than the dry form.

AMD Risk factors

• Age is the biggest risk factor. Risk increases with age.
• Smoking. Research shows that smoking increases your risk.
• Family history. People with a family history of AMD are at higher risk.
• Race. AMD is more common in Caucasians than other races, but it exists in every ethnicity.
• Gender. AMD is more common in women than men.

Detection of AMD

There are several tests that are used to detect AMD.

A dilated eye exam can detect AMD. Once the eyes are dilated, the macula can be viewed by the ophthalmologist or optometrist. The presence of drusen and pigmentary changes can then be detected.

An Amsler Grid test uses pattern of straight lines that resemble a checkerboard. It can be used to monitor changes in vision. The onset of AMD can cause the lines on the grid to disappear or appear wavy and distorted.

Fluorescein Angiogram is a test performed in the office. A fluorescent dye is injected into the arm and then a series of pictures are taken as the dye passes through the circulatory system in the back of the eye.

Optical coherence tomography (OCT) is a test based on ultrasound. It is a painless study where high-resolution pictures are taken of the retina.

Article contributed by Jane Pan M.D.

Published: 26 January 2022

At some point, you might be the victim of one of these scenarios: You rub your eye really hard, you walk into something, or you just wake up with a red, painful, swollen eye. However it happened, your eye is red, you’re possibly in pain, and you’re worried.

What do you do next?

Going to the Emergency Room is probably not your best bet.

Your first reaction should be to go see the eye doctor.

There are many causes for a red eye, especially a non-painful red eye. Most are relatively benign and may resolve on their own, even without treatment.

Case in point: Everyone fears the dreaded “pink eye,” which is really just a colloquial term for conjunctivitis, an inflammation or infection of the clear translucent layer (conjunctiva) overlying the white part (sclera) of our eye. Most cases are viral, which is kind of like having a cold in your eye (and we all know there is no cure for the common cold).

Going to the ER likely means you’re going to be prescribed antibiotic drops, which DO NOT treat viral eye infections. Your eye doctor may be able to differentiate if the conjunctivitis is viral or bacterial and you can be treated accordingly.

Another problem with going to the ER for your eye problem is that some Emergency Rooms are not equipped with the same instruments that your eye doctor’s office has, or the ER docs may not be well versed in utilizing the equipment they do have.

The primary instrument that your eye doctor uses to examine your eye is called a slit lamp and the best way to diagnose your red eye is a thorough examination with a slit lamp.

Some eye conditions that cause red eyes require steroid drops for treatment. NO ONE should be prescribing steroids without looking at the eye under a slit lamp. If given a steroid for certain eye conditions that may cause a red eye (such as a Herpes infection), the problem can be made much worse.

Bottom line: If you have an eye problem, see an eye doctor.

Going to the ER with an eye problem can result in long periods of waiting time. Remember, you are there along with people having heart attacks, strokes, bad motor vehicle accidents and the like-- “my eye is red” is not likely to get high priority.

Whenever you have a sudden problem with your eye your first move should be to pick up the phone and call an eye doctor. Most eye doctor offices have an emergency phone number in case these problems arise, and again, if there is no pain or vision loss associated with the red eye, it is likely not an emergency.

Article contributed by Dr. Jonathan Gerard