AMD (Age-Related Macular Degeneration) is a disease involving a retinal area called macula lutea. This eye region is responsible for e.g. central vision, which is required to perform precise activities, such as reading, writing, face recognition, driving a car.
AMD is a chronic disease which may lead to loss of vision. AMD is one of the most frequent causes of adult blindness in the world. Sometimes the disease progresses slowly and causes vision damage only to a low degree. In other cases, AMD may show a rapid progression, leading to sudden vision deterioration. The disease is usually manifested after the age of 50, and affects about 30% of subjects over 70. Pathological lesions usually occur in both eyes, although they may not appear at the same time and may show various level of advancement.
Age-related macular degeneration may occur in two forms: dry (atrophic) and exudative (wet, neovascular).
Involves almost 90% cases. It is a milder form of degeneration. Vision impairment progresses slowly, within months or even years. The changes occurring in this form are mostly atrophic in nature. So called drusen, e.g. small deposits are formed at the eye fundus, retinal cells die, and retinochoroidal atrophies are formed.
involves approx. 10% cases. It has usually a severe course, and loss of vision may occur even within a few days. Pathological lesions develop as a result of the formation of abnormal vessels under the retina, in the macular region. At the fundus there appears swelling, exudates, subretinal fluid, or even bleeding. An advanced disease is characterised by a scar and permanent, irreversible retinal damage.
In the initial phase of the disease, the patient notices vision deterioration, especially during reading and writing. Letters become blurred, colours seem to be paler, and images distorted. Straight lines start to curve and bend, and in the centre of the visual field, a dark spot appears. An early diagnosis of AMD and its treatment are very important, since they may prevent loss of vision. Patients over 50 should undergo an ophthalmological check-up at least once a year. Patients may also conduct vision control on their own, using a so-called Amsler test. It is a checked square with 10 cm sides. With the use of this test, one may detect the disease in the home setting, and monitor its progression. The examination is conducted in reading glasses, separately for each eye. If the patient notices distortion of the straight lines, or a dark spot in the centre, he/she should immediately consult an ophthalmologist, since these might be signs of AMD.
If the exudative form of AMD is diagnosed early and promptly, the introduction of adequate treatment (intravitreal injections of anti-VEGF preparations) may stop the loss of vision, and in some patients even improve vision.
of anti-VEGF preparations involve the administration of injections containing a drug inhibiting the development of abnormal subretin,al vessels. This is the latest and the most effective method of treating the exudative form of AMD. During the treatment with anti-VEGF preparations, the intravitreal injections are usually administered every 4 weeks for the first 3 months, and then the frequency of injections depends on the therapy efficacy and the type of drug (usually every 8 weeks or less frequently).
Dietary supplements in AMD
In healthy eyes, the use of supplements does not prevent the development of AMD. However, vitamin-based prophylaxis delays the development of the disease, if used regularly. Therefore, AMD patients are recommended to use a proper diet and supplementary preparations formulated for ophthalmological purposes. The diet should include fruit, vegetables, and other lutein-rich foods, zeaxanthin, antioxidants (e.g. vitamin A, C, E, minerals, i.e. zinc, selenium, copper, manganese), omega-3 acids, resveratrol. It is also important to change one’s lifestyle, maintain physical activity and regular exercise, and definitely resign from smoking cigarettes and tobacco.
Optical aids for partially-sighted persons
Loss of vision due to AMD causes problems with basic daily activities, moving around in unknown environment, and loss of independence. For those partially-sighted due to AMD, there are various methods of rehabilitation available, which will not restore vision, but may improve functioning of patients with poor visual acuity. These include e.g. optical aids (for near and far distances), non-optical aids (TV enlargers, computer systems, books on tapes), movement and orientation aids, occupational therapies. At Eye Surgery Centres of Professor Zagórski, we conduct full ophthalmological diagnosis, which enables early detection of AMD and modern treatment of this disease. We perform all necessary examinations, e.g. OCT (optical coherence tomography), fluorescein angiography, indocyanine angiography, angio-OCT. For the treatment with intravitreal injections, we use leading products. At the Centre in Rzeszów, patients have a possibility to qualify for the treatment of exudative AMD as part of the Drug Programme reimbursed by the National Health Fund.
During a basic ophthalmological visit, the patient’s ophthalmological history is taken, and the following examinations are conducted: autorefraction, keratometry, intraocular pressure measurement, visual acuity examination, slit lamp examination and fundoscopic examination.
In most cases, yes. If the doctor decides that some additional examinations are necessary, they may be performed during the visit, or if the doctor does not perform that kind of examinations, the patient is referred to another specialist.
An ophthalmological visit with performance of basic examinations lasts about 20 minutes. In some Centres, the examinations being part of the visit are performed by auxiliary personnel in the examination room. These activities are also included in the time of the basic visit.
Yes, it is recommended that contact lenses be removed before the visit. The patient should bring the lenses to the visit, since the doctor may ask the patient to insert them.
The cost of a visit is as per the price list on our website.
The waiting time for a private visit is up to a week. This time may be longer if the patient wants to see a particular specialist. The waiting time for a National Health Fund visit is according to the waiting list. Please call or e-mail us to appoint a specific date.
Yes, but you should inform the doctor that you would like to select glasses or lenses at the beginning of the visit.
Yes, you should normally apply your eye drops.
An ophthalmological visit does not require special preparation. If this is your first visit at the centre, you should have the identity card, which is necessary to create a patient record. Also remember that in most cases it is not allowed to drive a car after an ophthalmological visit.
During the first visit, the doctor takes the patient’s ophthalmological history. If the patient has any ophthalmological documentation from other institutions, it is worth taking it to the visit.
You can return to work/school after the ophthalmological visit, but please remember that if you received eye drops at the visit, your vision may be disturbed and blurred for about 2-3 hours.
Ophthalmological check-ups is an individual matter. The doctor usually informs the patient during the visit when he/she should return. Patients over 50 should have a check-up at least once a year.
If you received pupil-dilating drops at the visit, you must NOT drive a car directly after the visit. You should wait for about 2-3 hours.