Preserving Vision, Preventing Loss

As most eye care professionals (ECPs) know, the stages of AMD progress through early to intermediate to advanced disease states (1). Since I started my practice, several AMD classification systems and severity scales, including the AREDS simplified severity scale and – more recently – the Beckman classification system, have emerged as guides to help diagnose and manage the condition (2).

In early-stage AMD, patients may not show any symptoms or changes in visual acuity. However, as the disease progresses into the intermediate stage, patients may have difficulty seeing in dim light or may notice slight blurriness in central vision. Over time – or if left unaddressed – AMD can progress to an advanced stage or geographic atrophy (GA), where patients experience more extreme vision changes like wavy or blurred vision, increased difficulty seeing in low light, and central vision loss (3). It’s also important to note that just because a patient may not necessarily complain of acute vision loss or blurriness, that doesn’t mean they are not affected by AMD.

Currently, there’s no way to repair vision loss due to AMD, so it’s important to help patients prevent the condition from getting worse as early as we can. Here are some best practices I encourage my fellow ECPs to consider adopting as age-related eye disorders become increasingly prevalent due to our ageing population.

Firstly, I monitor my patients early and often, especially if they complain of difficulty seeing in dim light, as impaired dark adaptation may be an indication of early-AMD (4). Additional risk factors for AMD can include smoking, age, family history of AMD, light skin and eye color, high cholesterol, high sunlight exposure, and heart disease (5). So if any of my patients have one or more of these risk factors, I try to maintain a routine schedule of annual eye exams even if there are no noticeable vision problems.

Secondly, I try to educate at-risk patients by sharing resources on topics, such as what to expect as they age and strategies to help protect their vision. Patients are often scared or nervous after being diagnosed with AMD, so one resource that I provide to my patients is SightMatters.com, which includes information on the latest scientific findings on AMD, a support network to help people understand and manage the condition, as well as other tools and expert advice. I also recommend that all my patients eat a healthy, well-balanced diet and exercise to help reduce the risk of developing AMD.

Aside from lifestyle, I recommend taking an AREDS 2 formula eye vitamin supplement. Research from the Age-Related Eye Disease Study (AREDS) and AREDS2 clinical trials shows that a specific formulation of nutritional supplements can help in AMD management (6). Conducted by the National Eye Institute (NEI), these studies spanned over two decades and included thousands of participants between the two trials. Both trials successfully demonstrated that a specific combination of antioxidants and zinc could help reduce the risk of vision loss progression in those with moderate to advanced AMD.

Persistent benefits of the AREDS 2 nutrient formula were confirmed with the publication of the 10-Year AREDS2 Follow-on Study (6). Another recent data analysis published by the NEI indicates that AREDS and AREDS2 formulas – specifically, lutein/zeaxanthin and their antioxidants, including vitamin C, vitamin E, and β-carotene – can also reduce GA lesion progression toward the macula (7).

As ECPs, we can empower our patients to take an active role in managing their eye health as they age. By monitoring our patients throughout the stages of AMD and encouraging them to make healthy lifestyle choices – including a healthy diet, vitamin supplementation, and ongoing education about their condition – we can support them in protecting their vision and continuing to engage in the activities they love.