This article is written by David Allamby, FRCS (Ed), FRCOphth of Focus Clinics.
Age-related macular degeneration is the biggest cause of sight loss in the UK, affecting over 600,000 people. If you’re living with age-related macular degeneration, you’re not alone. One of the symptoms of AMD is the loss of contrast sensitivity. For example, it can become difficult to determine black from navy blue or identify black objects on dark countertops.
What is Age-Related Macular Degeneration?
Age-related Macular Degeneration (AMD) is a disease of the central retina, which is the light-sensitive layer that lines in the inside of the back 80% of the eye. The central part of the retina at the rear is called the macula.
The macula is only around 5mm in diameter and provides us with all of our detailed central vision, for example, when reading, driving or looking at screens. AMD damages this vital central vision making the above activities difficult or impossible. Macular disease also makes it very hard to identify faces.
AMD is mostly incurable and is not correctable with glasses or contact lenses, and laser eye surgery will also not be of value. There are two types of AMD:
1. Wet AMD
In wet macular degeneration, new blood vessels start growing underneath the retina. The new blood vessels often leak and allow blood and fluid to seep into the retina, which damages cells. Wet AMD causes quicker vision loss, but treatment can help to slow down the progression of the disease.
2. Dry AMD
Dry AMD is the more common presentation and found in 90% of all cases. It progresses more gradually than wet AMD and is less likely to cause vision loss. Dry AMD causes a slow breakdown of light-sensitive cells in the retina. However, most people with very advanced AMD have the wet version of the condition. Dry AMD can turn into wet AMD which will quickly worsen if left untreated.
How to Live with Age-Related Macular Degeneration
Macular disease has an exhaustive effect on those affected as well as their loved ones. Fortunately, the right support and information can help to retain independence.
AMD at Home
If you have poor vision, good lighting is important. Many people mistakenly think that they need low vision aids when actually they need better lighting. In the home, we mostly use task lighting and general lighting. General lighting should be bright without causing glare. Adjusting your task lighting for activities such as reading can make a surprisingly big difference.
Think about the way your house is decorated. Pale walls and ceilings reflect light back into a room. Also, windows and door frames that are painted a different colour from the walls are easier to see.
Are you struggling to find your way around the kitchen? Good colour and contrast make objects stand out. For example, try using a brightly coloured chopping board for different food types. Also, choose contrasting cutlery and tablecloths to make them easier to see. Try wrapping coloured tape around the handles of utensils to make them easier to find.
Some people choose to peg their shoes together in pairs and hang colour-coordinated outfits together.
Big button phones and large print address books are beneficial to those with AMD. It’s also a great idea to keep task lighting by the phone, as well as programming the phone’s speed dial function to store numbers.
Going Outdoors with AMD
There are several ways to tell when it’s safe to cross a road at a pedestrian crossing. Some crossings will make a noise while others will have a bump or vibrating plate under the control box which moves when it’s safe to cross.
Alternatively, a short, foldable symbol cane indicates that you have sight loss and warn you of hazards such as kerbs, steps and obstacles.
Technology is becoming an essential part of life for people with vision loss. Even if you struggle with technology, learning a few skills on a tablet, computer or smartphone can make a huge difference and help AMD sufferers to stay in touch with their loved ones and continue their hobbies.
Smartphones have many advances accessibility features such as enlarged text, built-in voice assistants, zoom-in camera functions and downloadable apps for people with sight loss.
Tablet computers are smaller alternatives to laptops and larger alternatives to smartphones. Their low weight and versatility mean that people who are visually impaired can easily access the internet, read an e-book and increase the text size and screen contrast. Some tablets may include screen reading and magnification.
Most newspapers are available in electronic format, and tablets let you read these by changing the settings to make the text or images larger. There are also options to alter the background colours to improve contrast and readability.
Smart assistants allow people who’re suffering from sight loss to control their computer, mobile phones, lighting and even heating using their voice. Some smart assistants can be linked with compatible telecare and home automation applications to alert chosen people if assistance is needed.
Reading and Writing
Arranging a low vision assessment will help AMD sufferers to select the most suitable magnifiers and train them on how they’re used.
The most common type is a handheld magnifier. The lens is held away from the object using the handle. Some handheld magnifiers have built-in lighting, and others are pocket-sized, which is perfect for shopping and other outdoor tasks.
Stand magnifiers are designed to be placed on a page to maintain the perfect distance between the lens and the text. Stand magnifiers are ideal for those with shaky hands. They can be plugged into a power source or fitted with batteries.
Round-the-neck magnifiers are useful for hobbies such as knitting. However, they’re only available in lower levels of magnification so it may not be suitable for sufferers with more advanced macular disease.
When writing, using a black ink pen can make it easier to see. White sticky labels with black capital letters stuck to household items such as medication can be helpful.
Alternatively, some people find talking labels helpful as they allow the user to record a message describing an item that can be played back to identify a variety of household items.
Remember, those who suffer from AMD can make easy adjustments to help them maintain their independence. Small lifestyle changes can have a huge effect on your eye health and make a difference on your vision.
Author bio: My name is David Allamby and I’m the founder and medical director of Focus Clinics. Focus’ commitment is to be the #1 clinic for vision outcome results with 100% of patients achieving 20/20 vision or even better.
I graduated from Sheffield University Medical School in 1987 and specialised in ophthalmic surgery since 1989. I’m a fellow to both the Royal College of Surgeons of Edinburgh and the Royal College of Ophthalmologists. I was the first UK surgeon to perform Conductive Keratoplasty for long-sightedness. Additionally, I’m one of the only laser eye surgeons in the UK to focus on refractive laser treatment full-time and I sit proudly in the list of the top 10 laser eye surgeons in the UK.
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