Retinal Diseases

AGE-RELATED MACULAR DEGENERATION (AMD)

WHAT IS AMD?

There are two types of AMD1, 2, 3: dry AMD and neovascular AMD (nAMD)2, 4, 5. Generally speaking, dry AMD progresses quite slowly and is usually less severe than the neovascular type6. However, both types damage your central vision, which helps you see fi ne detail directly in front of you.

WITH IMPAIRED CENTRAL VISION

You might not be able to do some of the things you normally take for granted, such as: Reading7, Driving7, Shopping8, Hobbies8

AMD remains a leading cause of severe vision loss and legal blindness in people aged over 50 years1, 7, 9, 10. Today, nAMD can be effectively controlled with treatments.

Early detection and intervention are vital to stop or delay vision loss1

AMD is a chronic, degenerative disease of the eye6. It affects a specialized area in the center of the retina called the macula2, 7. The macula helps you see fi ne details directly in front of you, such as words in a book or images on television6, 7. So, while the entire retina lets you see that there is a book in front of you, the macula lets you see what is written in the book.

In nAMD, new, abnormal blood vessels grow in the retina and macular region, affecting your vision3. This is known as neovascularization2, 3, 6, 7, 10. Your doctor might talk to you about this and treatments that can slow or stop neovascularization3, 9.

AMD is expected to affect 196 million people worldwide by 202011

WHAT ARE THE RISK FACTORS FOR nAMD?

AGE

Risk increases with advancing age2, 7, 10, 12

  • Less than 10% - 43 to 54 years9
  • Nearly 40% - Over 75 years9

FAMILY HISTORY

Up to 3 times greater risk within families (parents and siblings)

GENDER

Women are more susceptible 1, 10, 14, 15

RACE

Caucasians are at higher risk 4, 7, 10

Being proactive and making lifestyle changes can help reduce risk of nAMD worsening 2, 7, 9

DIABETIC MACULAR EDEMA (DME)

WHAT IS DME?

As its name suggests, diabetic macular edema (DME) is a disease linked to diabetes. Some people with diabetes will get a form of retinopathy – a disorder of the retina in the eye. Diabetic retinopathy can progress and result in DME (also known as retinal swelling) that may affect your vision, and is one of the most common causes of blindness1-3.

Although DME cannot be cured, there are treatments available that may help slow down the progression of vision loss and improve your vision2. There are also many ways for you to take part in your own healthcare, manage your diabetes and contribute to the health of your eyes.

Early detection and treatment can help slow down the progression of vision loss2

DME is caused by swelling in the back of your eye.

DME occurs when fl uid leaks into the center of the retina at the back of your eye (called the macula), causing it to swell1. This swelling blurs your vision and affects your ability to read and see detail clearly.2,5-7

DME occurs in both eyes in more than 50% of people with the condition, although vision may not always be affected in both8,9. If you already have DME in one eye, talk to your eye doctor about how you can reduce the risk of DME occurring in your other eye.

Talk to your eye doctor about how you can reduce your risk of DME

WHAT ARE THE RISK FACTORS FOR DME?

There are a number of factors both within and outside of your control that can put you at increased risk of developing DME, or making it worse if you already have it. All patients with type 1 or type 2 diabetes are at risk of developing DME7.

Risk factors for developing or worsening type 2 diabetes include:

  • High cholesterol1, 10
  • Being overweight or obese1, 7, 10
  • Not getting enough exercise10
  • Smoking10, 11

The following are additional risk factors associated with DME:

  • Diabetic retinopathy severity3
  • Poor glycemic control1
  • High blood pressure1, 7
  • Duration of diabetes1, 7
  • Age10

All people with diabetes – both type 1 and type 2 – are at risk of developing DME; your level of risk is related to how long you have had diabetes and how well your blood sugar is controlled

WHAT CAN I DO?

Fortunately there are some risk factors that you can change, by:

  • Quitting smoking 4, 6, 7, 9, 10, 13, 17.
  • Selecting foods high in anti-oxidants 7, 9, 10, 16. Eat a rainbow of brightly colored fruits and vegetables 6, 17.
  • Avoiding excessive sunlight exposure and wearing sunglasses with adequate protection when you go out in bright sunlight 4, 10.
  • Trying to reduce high blood pressure 6, 7, 10.
  • Avoiding excessive weight/obesity 6, 9, 11, 13, 17.

Obviously you can’t change everything that puts you at risk but, wherever you can, consider making lifestyle changes to reduce your risk.

Your vision is precious, so do whatever is within your control to help you hold on to it. There are specific things you can do that may help to prevent or delay vision loss. Vision loss is not evitable.

PROACTIVELY MONITOR YOUR VISION

  • Visit your eye doctor regularly – do not miss any scheduled appointments 1,4,6,11.
  • If you notice a change in your vision, contact your eye doctor immediately2.
  • Be proactive about vision rehabilitation and the use of visual aids (eg. using a magnifying glass)12.

BE AWARE OF THE SIGNS2
You will probably be the first person to detect changes in your vision, such as:

You might first notice these changes when you do your Amsler grid test included in this kit 5, 7, 9, 12. Remember to check your vision regularly as directed by your doctor and tell your doctor or nurse if you notice any changes 7.

Making certain changes to your lifestyle can reduce your risk 9

LIVING WITH VISION LOSS DUE TO nAMD

Fortunately, total blindness or darkness almost never occurs 7; however, the disease can have a profound effect on your quality of life. A significant loss of central vision can severely impact your ability to function as before, making things you’ve always taken for granted, extremely difficult8. It can also impact your ability to work. However, the vast majority of patients retain their independence.

Visual aids and rehabilitation can help you to retain your independence

One of the most difficult things to overcome is the emotional toll that severe vision loss takes. On first diagnosis, people can experience a range of emotions including anger, denial, disbelief, loss, rage, resentment, sadness and shock8. If you feel depressed 7, 20, it is important to address these feelings.

Learning to carry on in new ways is the key. People who learn to adapt to altered vision can continue to do the things they love independently and with confidence.

TIPS FOR LIFE AT HOME

USE BRIGHTER LIGHTS IN YOUR HOME21
Brighter lights will help with reading and other daily activities.

SELECT SPECIAL APPLIANCES MADE FOR LOW VISION21
Some clocks, radios, telephones and other appliances have extralarge numbers. Other gadgets can talk to tell you the time or other important information. You may find it easier to watch a television with a large, high-defi nition screen, or you may want to sit nearer to the screen.

TIPS FOR THE KITCHEN

Many everyday activities can be successfully adapted so you can continue to live safely and independently.

A FEW EXAMPLES

  • Apply tactile markings to various appliances to help you accurately use the controls and dials22.
  • Convert measurements (such as milliliters or grams) to cups and spoons, choosing differently colored measuring equipment to increase contrast. Talking scales may help22.
  • Try using contrasting-colored chopping boards and focal lighting to help you see more detail and cut food safely and accurately22.
  • Try ready-made sauces to help simplify cooking22.

TIPS FOR EVERYDAY ACTIVITES

USE CAUTION WHEN DRIVING21

Check with your doctor to determine if driving is still safe based on your current vision. When you do drive, certain situations require extra caution, such as driving at night, in heavy traffi c or in bad weather.

CONSIDER OTHER TRAVEL OPTIONS21

Use public transportation or ask family members to help, especially with night driving. Make arrangements to use local van or shuttle services, volunteer driving networks or rideshares.

CHANGE YOUR COMPUTER DISPLAY AND ADD AUDIO SYSTEMS21

Adjust the font size in your computer’s settings. Adjust your monitor to show more contrast. You may also add speechoutput systems or other technologies to your computer.

TIPS FOR LEISURE ACTIVITIES

USE MAGNIFIERS21

A variety of magnifying devices can help you with reading and other close-up activities, such as sewing. Magnifying devices may include traditional hand-held magnifying lenses or special magnifying lenses you can wear just like glasses.

USE ALTERNATIVE OPTIONS FOR BOOKS21

Use large-print books, electronic readers, tablets or audio books. Some tablets and smartphones have applications that can be added to assist people with low vision, such as magnifying text.

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