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Dear Readers,
In this issue of Sitenews the theme that we are focussing on is Macular Degeneration (MD). With increasing life expectancy eye diseases like MD are on the increase. For aged people this means not only diminished quality of life but specific adjustments in their daily life activities besides the need to pay regular visits to their Ophthalmologists.
This issue focuses on one hand to understanding the problem, its magnitude, symptoms and its solution. However this is not a curative problem rather it is a chronic eye condition and the patients quite often need a lot of support as they try to cope with the disease and its ramifications.
Health education materials need to be actively used to increase the awareness of the patients and their family not just to identify the disease but to learn how to live an active and productive life with it. Other resources in the form of web links to organisations and networks connected to Macular Degeneration are also provided.
The featured organization is AMD ALLIANCE INTERNATIONAL which is working with a focus in Macular Degeneration.
We wish you an experience of learning that is very practical. Your feedback will let us know how we can improve. Please send in your feedback at eyesite@aravind.org. We look forward to your feedback.
Wish you a productive reading!

Happy reading!
Regards,
Vision 2020 e-resource team
The Issue Features...
Amblyopia
Vol. 5 No. 9 September 2008
•   Understanding the Problem
•   Magnitude
•   Symptoms
•   Solution
•   Coping
•   Health Education Materials
•   Resources
•   Featured Organization

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      Age-related macular degeneration (ARMD) is a degenerative condition of the macula (the central retina). AMD is caused by hardening of the arteries that nourish the retina. This deprives the sensitive retinal tissue of oxygen and nutrients that it needs to function and thrive. As a result, the central vision deteriorates.
      Macular degeneration varies widely in severity. In the worst cases, it causes a complete loss of central vision, making reading or driving impossible. For others, it may only cause slight distortion. Fortunately, macular degeneration does not cause total blindness since it does not affect the peripheral vision.    

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      An epidemic of "ageing" is impeding in the western world. According to the latest predictions released by the United Nations, the number of people aged over 60 will triple from 606 million worldwide in 2000 to nearly 2 billion by 2050. The increase in population aged over 80 is expected to be more than five fold, from 69 million in 2000 to 379 million by 2050.
  • The UN estimates the number of people with age related macular degeneration at 20-25 million worldwide
  • WHO's estimate is 8 million people with severe visual impairment.
  • AMD was found to be second only to cataract as the cause of severe visual loss.
  • Prevalence of AMD varies from 1.2% to 29.3%
  • 3 population based studies; the Beaver Dam Eye Study, Blue Mountain Eye Study and the Rotterdam study report the prevalence rates to be 1.7%in US, 1.4% in Australia and 1.2% in Netherlands respectively.
  • In South India, the prevalence is 1.1% whereas, another study from North India reports the prevalence rate to be 4.7%.

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      One or more of these symptoms could mean you have AMD, but these vision problems can also be caused by other conditions.
  • Objects cannot be seen clearly
  • Straight lines may appear to be wavy
  • Distorted vision
  • Lack of clear and correct colour vision
  • Print looks washed out while reading
  • Darkness in the center of your vision
  • Gray or white spot in the center of your vision
  • AGE-RELATED MACULAR DEGENERATION SYMPTOMS

  • Abstract:
    This section talks about the signs and symptoms of AMD.

  • MACULAR DEGENERATION - SYMPTOMS AND DIAGNOSIS

  • Abstract:
    This article describes the causes and symptoms of AMD, the methods used for diagnosis and the treatments available.

  • AGE-RELATED MACULAR DEGENERATION AN OVERVIEW

  • Abstract:
    Age-related macular degeneration (AMD) is a slow, progressive and painless eye condition. It is the leading cause of blindness in Western societies, with up to a third of the population over the age of 70 affected to some degree. It accounts for almost 50% of those registered as blind or partially sighted in the UK1. This article provides an overview of the clinical features, pathophysiology and management including an update on recent treatment developments of AMD.

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      The treatment for macular degeneration is prescribed based on the disease stage (wet or dry) as well as the location of the damage. The goal of treatment is to stop further vision loss. In most cases, the damage that has already occurred cannot be reversed, making early detection very important for vision preservation.

Dry Macular Degeneration
    There is no treatment currently available to reverse dry macular degeneration. This condition normally progresses slowly, and many people are able to live relatively normal lives, especially if vision is affected only minimally.
     The good news is that the progression can be slowed by taking high doses of vitamins A, C, E and the mineral Zinc.

Wet Macular Degeneration
    In wet macular degeneration, new abnormal blood vessels behind the retina begin forming at a rapid rate. These vessels begin to leak blood and fluid, causing damage to the macula, the region of the retina responsible for central vision. The doctor will prescribe treatment based on the location and extent of the abnormal blood vessels. Some treatments for wet macular degeneration are
  • Anti-angiogenic medicine
  • Photocoagulation
  • Photodynamic Therapy
  • Macular Translocation Surgery

  • SEEING RESULTS: TREATMENT CAN SLOW PROGRESS OF EARLY MACULAR DEGENERATION

  • Abstract:
    This article discusses about a new treatment for dry age-related macular degeneration. Patients have two- to three hour sessions where blood is filtered to remove excess amounts of large proteins and fatty molecules from the blood, which have been associated with the disease.

  • TEN STEPS TO HELP PREVENT MACULAR DEGENERATION

  • Abstract:
    This article gives you guidelines to help prevent or slow the progression of AMD

  • VISUDYNE PHOTODYNAMIC THERAPY

  • Abstract : This section describes about various treatments for AMD like Visudyne Photodynamic Therapy, Pharmacologic (Drug) Therapy, Laser Treatment and Experimental Treatments like Retaane, offlabel drugs, rheopheresis, low dose radiation therapy, submacular surgery, RPE transplantation, macular translocation surgery, laser treatment of drusen and artificial vision.

  • EXAMINATION & DIAGNOSIS

  • Abstract:
    This article discusses about the various examination process for AMD and its diagnosis.

  • AGE-RELATED MACULAR DEGENERATION CLINICAL GUIDELINES

  • Abstract:
    International Clinical Guidelines on AMD are prepared and distributed by the International Council of Ophthalmology on behalf of the International Federation of Ophthalmological Societies. These Guidelines are to serve a supportive and educational role for ophthalmologists worldwide. These guidelines are intended to improve the quality of eye care for patients.

  • AGE-RELATED MACULAR DEGENERATION: ECONOMIC BURDEN AND VALUE-BASED MEDICINE ANALYSIS


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          For patients diagnosed with AMD, making a few simple lifestyle changes could have a positive impact on the health of their retina.
    • Encourage patients to monitor their vision daily with an Amsler grid.
    • Take a multi-vitamin with zinc.
    • Incorporate dark leafy green vegetables into their diet.
    • Always protect their eyes with sunglasses that have UV protection.
    • Quit smoking.
    • Exercise regularly
    • Use a halogen light.
    • Shine the light directly on your reading material.
    • Use a hand-held magnifier.
    • Try large-print or audio books.
    • Consult a low vision specialist.
    • Use a bright reading light
    • Wear reading glasses if appropriate
    • Hold the chart approximately 14-16 inches from the eye
    • Cover one eye
    • Look at center dot
    • Note irregularities (wavy, size, gray, fuzzy)
    • Repeat the test with other eye
    • Contact ophthalmologist if patient observes any irregularities or notice any changes
    • LIVING WITH AMD


    • GETTING ORGANIZED: SETTING UP YOUR IDEAL OFFICE

    • Abstract
      An overview of patients experiences of living with age related macular degeneration (AMD) was reported in a survey of members of the Macular Disease Society. Whilst it was primarily aimed at identifying their experiences with health care, it also served to highlight those related to changes in vision and the impact of the diagnosis on their well-being.

    • MACULAR DEGENERATION: COPING WITH REDUCED VISION

    • Abstract
      Reduced central vision from age-related macular degeneration (AMD) makes it difficult to work and manage many of the activities of daily life. Learning to adapt to low vision can make your life easier and safer. Here are some tips for the same.

    • RESOURCES FOR COPING WITH MACULAR DEGENERATION

    • Abstract :
      This link connects you to various AMD resources which help AMD patients to enhance their quality of life.

    • DEPRESSION AND AGE-RELATED MACULAR DEGENERATION

    • Abstract
      This article discusses about recognizing the signs of depression, coping with vision loss and also some hint on where to turn for help.

    • FINDING SUPPORT

    • Abstract
      If you've recently been diagnosed with AMD, you may need help building a community of people with whom you can share your concerns, questions, and feelings. In addition to seeking treatment and rehabilitation, emotional support is crucial.

    • AMD ALLIANCE INTERNATIONAL - PATIENT STORIES

    • Abstract
      This link contains AMD patient stories that AMD Alliance International has collected. If you would like to submit your own story to be added to this page you can do it by submitting a form.

    • LIFE IS TOO PRECIOUS TO WASTE

    • Abstract
      All of us with macular degeneration have a story. And here is the story of Mary Betty suffering from macular degeneration.

    • WHAT MEASURES CAN I TAKE AT HOME TO HELP ME ADAPT TO LIVING WITH REDUCED VISION?

    • Abstract
      There are many changes that you can make in your home to make living with low vision easier and safer. Vision rehabilitation and training specialists can help you identify and learn to make low-vision adjustments that will work for you. These are some suggestions.

    • COPING WITH MACULAR DEGENERATION

    • Abstract
      Adjusting to life with low-vision is a challenge. Patience, flexibility and imagination can help you find new ways of doing what you've loved to do and may even bring positive changes to your life. This article discusses about the way Your Living Environment should be for your betterment.

    • HEALTH & NUTRITION

    • Abstract
      A number of factors are known to increase the risk of developing macular degeneration. These risk factors are: age, family history, smoking, high blood pressure, elevated serum lipids, complement factor H, and excessive exposure to bright sunlight. Some of these factors are within an individuals control and can be modified through changes in behavior.

    • THE PSYCHOSOCIAL IMPACT OF MACULAR DEGENERATION

    • Abstract :
      Age-related macular degeneration (AMD), the leading cause of irreversible blindness and low vision among the elderly, has not been well studied with regard to its impact on daily life. This study was designed to demonstrate the impact of AMD on quality of life, emotional distress, and functional level.


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    AMD ALLIANCE INTERNATIONAL
          The AMD Alliance International strives to bring knowledge, help and hope to individuals and families around the world affected by AMD. Their mission is accomplished through:
    • Generating awareness and understanding of age-related macular degeneration;
    • Promoting the importance of education, early detection, knowledge of treatment and rehabilitation options; and
    • Preserving vision and improving the quality of life of individuals affected by age-related macular degeneration.
         Information on early detection, timely treatment, comprehensive rehabilitation and support services, as well as new prevention suggestions have been provided on this website.

    Visit our website : http://amdalliance.org

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