Dimming of Vision: Age-Related Sight Loss in Adults 50 and Older

By Geracimos, Ann | The World and I, August 2004 | Go to article overview

Dimming of Vision: Age-Related Sight Loss in Adults 50 and Older


Geracimos, Ann, The World and I


Ann Geracimos is a staff writer for The Washington Times.

Walter Ross, a 90-year-old New York City resident and former Reader's Digest roving editor, is legally blind from age-related macular degeneration (AMD) he has had for 37 years. He can't see enough to read or drive, and facial features appear fuzzy because of the disease, which affects his central vision.

"Don't be sorry for me," the upbeat nonagenarian says. "I'm able to do whatever I feel like doing, except drive in the Indianapolis 500."

For the past 15 years, Ross has written a newsletter called Eyes Only for a nonprofit volunteer membership group helping others with the disease. He does so with the help of a computer program that reads aloud what he types.

"People were very unaware of [AMD] when I got it, and the first eye came before I understood what was happening," he says.

Norman Burton, 70, of Kensington, another AMD victim, has been luckier. He has some peripheral vision in his left eye and is hoping to stem the loss in his right eye by taking part in a clinical trial being conducted by Dr. Karl Csaky at the National Eye Institute (NEI), part of the Bethesda-based National Institutes of Health.

The purpose of the treatment, which involves computer software as well as laser surgery, is to stop fluid leaking into feeder vessels in the retina in the back of the eye and, ultimately, if possible, to prevent the growth of new vessels. Left unattended, such vessels can grow and lead to complete vision loss.

Unlike Burton, Ross has been unable to get help for a disease that is the leading cause of vision loss in adults 50 and older and which the Association for Macular Diseases Inc.--the New York-based nonprofit to which Ross belongs--says afflicts to some degree one-quarter of men and one-third of women by age 75.

Ross says the lesions in his eye were too close to the macula--the center portion of the retina that makes central vision and sharpness of perception possible--to try any form of treatment.

Burton sought help immediately when he noticed his right eye weakening. Even after only one month of weekly sessions as one of Csaky's 20 research subjects, he has noticed some improvement. "It's slight, but I can tell it hasn't gotten worse," he says.

The procedure, which can take several hours, begins with an injection of dye into the arm that will fill in the vessels in the area under study. A special imaging machine then scans and photographs the area in two dimensions. The resulting image is aligned by computer with an invisible infrared image to enable Csaky to pinpoint the exact portion of the vessel he wants to close off with the laser, preventing damage to the surrounding tissue. The experimental treatment works only on so-called wet AMD.

In wet AMD, abnormal blood vessels form beneath the macula and leak blood and fluid that damage the macula's photoreceptor cells. Wet AMD progresses rapidly, often dramatically. In dry AMD, which accounts for as many as 90 percent of all cases, yellow-white deposits called drusen form in the retinal tissue beneath the macula. Dry AMD results in slightly blurred vision and can lead to wet AMD, which causes vision loss.

Dry AMD has three stages: early, intermediate, and advanced. Any wet AMD is considered advanced.

At present, no treatment is available for dry AMD, and medical researchers are only cautiously optimistic about helping or delaying onset of the wet version. While fighting off the progress of wet AMD in his right eye, Burton is able to use magnifying devices to shop and read, but he no longer drives.

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