Caring for an Older Loved One with Macular Degeneration

When a loved one develops macular degeneration, we may face a variety of emotional, mental and physical challenges as they learn to adjust and develop new ways of living. As caregivers, we can encourage loved ones to remain as self-reliant as possible and provide the support they need to maintain their physical, mental and emotional well-being through understanding the condition and adopting care planning strategies.

What is macular degeneration?

Macular degeneration is a serious eye disorder and the most common cause of vision loss in adults over the age of 60. Age-related macular degeneration (AMD) affects the macula, which is the part of the retina that sends light from the eye to the brain. It causes blurred central vision, which can lead to difficulty completing tasks which require clear vision, such as reading, sewing and driving. According to the BrightFocus Foundation, an estimated 11 million people in the United States have some form of AMD, and it is recognized as one of the leading causes of vision impairment around the world.

Types of macular degeneration

There are two types of macular degeneration: wet and dry. Both forms of the disease develop gradually. Although they are serious disorders, neither causes pain nor discomfort. Most people are unaware they have AMD until it is discovered during a routine eye exam.

• Wet Macular Degeneration. "Wet" AMD causes deterioration in the area of the macula that makes it possible to see fine details. The condition occurs when abnormal blood vessels begin to develop in the macula. Over time, these new vessels separate the macula from its normal position in the back of the eye, resulting in vision loss. Although wet macular degeneration is less common than the dry form of the disease, according to the BrightFocus Foundation, it is responsible for 90 percent of legal blindness in people of all ages.
• Dry Macular Degeneration. Dry macular degeneration is more common than wet AMD. It develops when light sensitive cells in the macula gradually disintegrate, resulting in blurred vision and loss of central vision. People with dry macular degeneration have difficulty recognizing faces, need more light for reading and have slightly blurred vision.

Macular degeneration risk factors

What causes the development of either form of macular degeneration is not completely understood. However, the incidence of macular degeneration does increase with age, according to Mayo Clinic. Other physical and lifestyle factors associated with macular degeneration include:

• Extreme farsightedness, or the inability to see nearby objects clearly compared to faraway objects
• High cholesterol diet, or obesity
• Smoking
• Sun exposure
• Family history of macular degeneration
• Race (according to the National Eye Institute, Caucasians have the greatest likelihood of developing AMD) 

Diagnosing and treating macular degeneration

Because there is no cure for either wet or dry macular degeneration, the goal of treatment is to control disease symptoms and slow down vision loss with laser surgery and medications. All older adults should consider scheduling annual eye examinations with an ophthalmologist or optometrist at least once a year to detect macular degeneration, cataracts, glaucoma and other eye problems, whether they have an existing vision disorder or not.

As caregivers, we may also want to encourage our loved one to check their vision every day for macular degeneration symptoms with an Amsler Grid. This tool looks like a piece of graph paper with a dot in the center. While a loved one focuses on the dot, we can then ask them if any of the lines appear blurred, wavy or seem to be missing. If so, the loved one we care for should schedule an appointment with their ophthalmologist as soon as possible.

A copy of the Amsler Grid can be downloaded from the Internet, or can be provided by an eye doctor upon request.

Low vision aids

A variety of low vision products are available to help make it possible for loved ones with vision problems to live as independently as possible. Some useful low vision aids include:

• Magnifiers that allow a loved one with limited vision to use a computer, sew, knit or read.
• Large print or voice-technology supported dictionaries, cookbooks, globes, maps and calculators
• Talking clocks, radios, kitchen timers and scales
• Canes, walkers or other mobility aids to prevent falls
• Magnifying screens for TVs and computers, or screen reader software
• Low vision playing cards, Bingo boards and board games
• Audible pill and medication reminders
• Needle guides to help loved ones with diabetes locate and stick the needle through the rubber stopper on an insulin bottle.

These and other useful low vision tools are available at pharmacies, medical supply stores, or on the Internet.

Most public libraries have a wide variety of materials available for the use of those with low vision. In addition to large print books and recorded books on CD or in Braille, libraries may also provide Braille sports schedules, tax forms and raised-line maps, as well as recorded foreign language books.

If your loved one has been diagnosed with AMD, the GuideMe program developed by Prevent Blindness can create a customized guide with helpful information, tips, resources and steps to help you and your loved one with future care.

A version of this article appeared in the Private Health News.