Most people with age-related macular degeneration (AMD) rely on limited pension and superannuation incomes to cover living costs and medical bills; they shouldn’t have to choose between buying groceries and going blind.

Many individuals living with wet AMD require regular eye injections to stop further vision loss. Luckily, these treatments are readily available here in Australia.

Age-related macular degeneration (AMD)

Age related macular degeneration (AMD) is one of the primary causes of blindness in Australia. A progressive disease, AMD affects central vision and makes driving, reading and recognising faces difficult. While its initial stages may be painless, as time progresses it leads to significant loss of central vision affecting daily activities like food preparation and shopping as well as enjoying hobbies, sports and social interactions.

Research continues in hopes of discovering a cure for dry AMD; however, wet form AMD is treatable and currently being addressed using anti-vascular endothelial growth factor (anti VEGF) injections with sterile needles in clinic settings to slow its progress; such injections are very effective at stopping further wet macular degeneration progression – Lucentis and Eylea are two popular choices among these medications.

These injections are administered under local anaesthetic, making the experience very comfortable. However, it should be remembered that prevention remains key.

At least every year, visit an ophthalmologist for regular eye examinations if you smoke or have a family history of macular degeneration; additionally if diabetes increases your risk, regular examinations with an ophthalmologist become even more essential.

Diets rich in dark green leafy vegetables, yellow and orange fruits and supplements such as vitamins C, E, lutein zeaxanthin zinc copper are key in protecting against macular degeneration. Smoking should also be limited while exposure to sunlight should also be limited for optimal eye health and overexerting yourself with reading or computer use should also be limited to reduce strain on the eyes.

Photodynamic therapy has recently been shown to effectively slow the progression of wet macular degeneration. It involves administering verteporfin together with laser light therapy in order to destroy abnormal blood vessels that form beneath the retina and slow its progress.

The Amsler grid

An Amsler grid is an effective screening test to evaluate central vision for early signs of wet age-related macular degeneration, using small squares with dots in their centers arranged like graph paper. If any wavy lines on an Amsler grid become noticeable it is imperative that you visit an ophthalmologist immediately – earlier treatment increases visual outcomes significantly.

Wet AMD is more dangerous than dry AMD because leaking blood vessels can destroy central vision quickly and suddenly. Distortions caused by wet ARMD can occur either suddenly in one eye or both eyes; symptoms include straight lines appearing wavy, areas of central vision being missing, or dark patches on an Amsler grid appearing suddenly – these distortions can be detected easily using this grid and looking out for any missing or wavy lines on it.

Regular eye checks at your ophthalmologist’s office will help detect macular degeneration early, potentially avoiding its progression into wet ARMD. Additionally, The Macular Disease Foundation Australia recommends that those over 50 should use an Amsler grid at home to track any vision changes and inform their physician immediately of any discrepancies or changes that arise in vision.

To use an Amsler grid, place it at reading distance (typically 12-14 inches) and cover one eye at a time while looking through each. Next, move your head sideways to see if any distortion appears different between eyes. If wavy or missing lines appear as part of this test, this may indicate progressive macular degeneration which should be reported promptly to an ophthalmologist for diagnosis and treatment purposes.

Diabetic macular oedema (DMO)

Diabetes is a progressive illness that can lead to many eye-related issues, including diabetic macular oedema. This condition occurs when blood glucose levels rise rapidly and cause the fine meshwork of retinal blood vessels to close off, eventually leading to leakage of fluid into the macula, blurred vision and an impaired ability to see fine detail as well as hindering oxygen and nutrition delivery. Left untreated, this could result in progressive vision loss or blindness.

Diagnostic of this condition can be made through a comprehensive dilated eye exam and treatments may include anti-vascular endothelial growth factor (anti-VEGF) drugs, corticosteroid injections or even an implant that releases medication slowly over time. For optimal management of this condition it is vital that you follow your eye doctor’s advice, especially regarding controlling blood sugar levels and getting regular eye exams from them if applicable; at minimum they should take place once every year or more frequently if your doctor recommends. It is equally essential for expectant mothers who need regular eye exams throughout gestation to get proper eye exams from eye specialists for safe pregnancy.

DMO can be divided into two distinct forms, central (focal DME) and non-central or diffuse DME. Focal DME occurs due to fluid accumulation at the centre of the macula, while non-central DME results from widening or swelling of retinal blood vessels.

DMO and macular degeneration in general do not have a definitive cure, though treatment can help slow its progress and preserve your eyesight. Unfortunately, however, treatments may not completely restore it if there has been significant damage to the macula.

People living with wet age-related macular degeneration are now eligible for Susvimo, an intravitreal implant combining ranibizumab and Fluocinolone acetonide to treat neovascular AMD due to branch retinal vein occlusion or central retinal vein occlusion (BRVO/CRVO). Nurse practitioners will prescribe this drug and it can be made available for those unsuitable for, contraindicated for, or failed with Aflibercept.

Eye injections

If you suffer from wet macular degeneration (AMD), an intravitreal injection could provide invaluable assistance. It’s safe, quick and typically painless – your ophthalmologist injects the drug using a small needle directly into your eye. While lying comfortably, an injection will be administered and cleaned off to protect against infection. After treatment, your injection site may appear red for up to 24 hours due to subconjunctival haemorrhage – a superficial form of bleeding located just beneath the surface of your eye which usually resolves itself within this period. Your eye may feel gritty or watery for several days afterward and you might also see some smudges or floaters appear in your vision; to minimise irritation further and risk infection. Touching or rubbing should also be avoided in order to minimise infection risk.

There are various eye injection drugs available to treat macular degeneration and other retinal conditions, such as diabetic retinopathy, retinal vein occlusions, macular edema and cataracts. One such injection medicine is ranibizumab (LUCENTIS), which will be listed on the Pharmaceutical Benefits Scheme from 1 August 2007 for wet age related macular degeneration as it currently is one of Australia’s most effective anti-VEGF treatments.

Your ophthalmologist may recommend other treatments to slow the progression of eye disease, such as regular exercise, diet and changes to smoking habits. They might also recommend that you use magnifying lenses or have regular specialized eye tests in order to monitor it more closely.

At present, most patients with wet ARMD are being treated with ranibizumab; however, the Australian Government is considering cutting Medicare rebates by 69%! This would lead to annual out-of-pocket expenses more than doubling. The MDFA is dedicated to stopping this proposed cut and improving nationwide access to this sight-saving treatment; we believe no Australian should have to choose between eating well and going blind – this is especially important for elderly individuals relying on limited pension/superannuation incomes for daily living needs as well as healthcare expenses.