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Dr. Randolph Kinkade, a low
vision optometrist with a Master of Public Health degree reports age-related
macular degeneration (AMD) is the most common form of permanent vision loss in older
adults. Dr. Kinkade and the National Eye
Institute, a division of the National Institutes of Health, know the prevalence
of AMD will increase with our aging population.
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| Dry AMD |
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| Wet AMD |
With the baby boomers moving
into the macular degeneration age group it is estimated that there will be 3
million people with AMD by the year 2020 in the United States.
“Macular degeneration is a
progressive condition that destroys the macula in back of the eye,” said Dr.
Kinkade. “It usually progress slowly in
most individuals with minimal vision loss for years while in others it can
appear to dramatically destroy eyesight overnight.”
The vision loss can make it
difficult to read, write or drive a car.
Daily activities (i.e., cooking, sewing, bill paying) and recreational
activities (i.e., card playing, knitting, painting) become challenging for some
and difficult or impossible for others.
From a Public Health stand point,
macular degeneration is most likely caused by a complex set of aging, genetic
and environmental factors,” said Dr. Kinkade.
Vitamin and antioxidant therapy appears to slow down the progress in
some individuals. Telescopic, high-power
prismatic lenses and E-scoop lenses are usually beneficial.
AMD alters your central vision
and leaves your side or peripheral vision unaltered. So despite the vision loss, AMD does not
cause complete blindness allowing individuals to walk and see where you are
going.
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| Simulated Central Scotoma |
“The macula is part of the
central retina in the back of the eye and is made up of millions of
light-sensitive cells that give sharp, detailed central vision,” said Dr.
Kinkade. “The retina is responsible for
converting light energy into electrical energy and sending the information via
the optic nerve to the brain. The eye
can be considered to be an extension of the brain.”
When the macula is damaged
fine detailed vision is lost and images in the brain are no longer clear. Individuals can see, but the fine points in
your vision are missing.
In the early stages of AMD
vision becomes slightly unclear and reading can become challenging. With moderate advancement, distortion and
blank spots appear in your central vision and reading becomes significantly more
difficult without the use of magnification.
Faces and television are no longer clear. With the advanced stage of the disease
individuals require low vision rehabilitation to resume many visually-guided
daily activities.
There is no cure for AMD, but
its progression can be slow with vitamins and nutritional supplements. Medical treatment is available to curb the
progression in the “wet” form of AMD with eye injections. There is no medical treatment for the “dry”
form.
Dr. Kinkade describes the term
“Low Vision” as the level of permanent vision loss that significantly impairs
the ability of individuals to see when there is no treatment by medicine,
surgery or regular eyeglasses.
Low Vision Rehabilitation
offers good news to those with low vision caused by AMD. With the use of proper magnification,
enhanced illumination and high-contrast materials vision can be improved.
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| Dr. Randolph Kinkade Fitting Bioptic Telescopic Glasses |
“If you remember that if the eye is part of the
brain you can relearn to see,” said Dr. Kinkade.
Dr. Kinkade has been treating
the low vision rehabilitation needs of patients with AMD for over 30
years. He continues to study the causes
and treatment of macular degeneration from a medical, rehabilitative and public health point of
view.
