InSight #2: Macular Degeneration

Macular degeneration, often called AMD or ARMD (age-related macular degeneration) affects an estimated one million Canadians and is most common in people over 50.   Vision loss from macular degeneration is a growing problem because of an aging population.  AMD can be devastating, but with proper support sufferers can livesatisfying and independent lives.

AMD occurs with degeneration of the macula, which is the part of the retina responsible for the sharp, central vision needed to read or drive.  Because the macula primarily is affected in AMD, central vision loss may occur.

Dry Macular Degeneration

  • Dry AMD is more common and occurs because the tissue beneath the retina thins as we age.  It progresses over a matter of years.
  • Dry AMD is diagnosed when yellowish spots (know as drusen) begin to accumulate typically around the macula from deposits or debris from deteriorating tissue.  Gradual central visual loss may occur, but it is not as severe as wet AMD.

Wet Macular Degeneration

Dry AMD progresses to this more advanced and damaging form of the eye disease in about 10 percent of cases.  With wet AMD, new blood vessels grow beneath the retina and leak blood and fluid.  This leakage causes permanent damage to light-sensitive retinal cells which die off and create blind spots in central vision.

Wet AMD falls into two categories:

  • Classic:  When blood vessel growth and scarring have very clear, delineated outlines observable beneath the retina, this type of wet AMD is known as classic choroidal neovascularization (CNV), and usually produces more severe vision loss. 
  • Occult:  New blood vessel growth beneath the retina is not as pronounced, and leakage is less evident in the occult CNV form of wet macular degeneration, which typically produces less severe vision loss.


Normal VIsion

Vision With Macular Degeneration

Controllable Risk Factors
Smoking: This is a major risk factor.  A British study found about 25% of AMD cases causing severe vision loss to be directly associated  with smoking.  Another study showed that people living with a smoker doubled their chances of developing AMD.

Over exposure to the sun : Wear a hat when outside and sunglasses with at least 98% UV protection.

High Blood Pressure

Obesity and Inactivity:  Overweight patients with AMD had more than double the risk of developing advanced forms of the disease compared with people of normal body weight.  In the same study, those who performed vigorous activity at least three times weekly reduced their risk of developing advanced AMD, compared with inactive patients.  Make sure you maintain a low-fat diet and a healthy weight. 

Drug Side Effects  Some cases of AMD can be induced from the side effects of toxic drugs.  Make sure to tell your eye doctor if you are taking any medications or drugs for other conditions you may have.


  • Blurred or fuzzy vision
  • Straight lines that appear wavy or crooked
  • Decreased contrast or colour sensitivity
  • Difficulty seeing at a distance
  • A small but growing blind spot in the center of vision

More Information

 If you would like more information on diabetic retinopathy, talk to your eyecare professional or check out the following online resources available to you. 

  • CNIB
  • Canadian Opthalmological Society
  • Canadian Association of Optometrists

InSight #1: Diabetic Retinopathy

What is it?

Diabetic Retinopathy is an eye condition where elevated blood sugar levels cause blood vessels in the eye to swell and leak into the retina. 

Without treatment, it can result in uncorrectable vision loss or even blindness.  However, with regular, comprehensive eye exams by your eye doctor, it can be detected early and treated.


In the early stages of Diabetic Retinopathy, there are often no symptoms and your vision still may not be affected.

People with proliferative retinopathy or macular edema may experience vision loss when blood from leaking blood vessels blocks the field of vision.  However, at this stage, if is still possible to have no noticeable symptoms, or for symptoms to occur suddenly with no apparent warning.

That is why it is so crucial for people living with diabetes to see their eye doctor regularly for comprehensive eye exams.  The earlier diabetic retinopathy is detected, the better the chance that it can be effectively treated and further vision loss prevented.

Visit your eye doctor without delay if you notice:

· Dark spots in your visual field.

· Blurred, distorted, or double vision.

· Large “floaters” - specks in the form of dots, circles, lines, or cobwebs that move across your field of vision.

Prevention & Risk Factors

Everyone with diabetes is at a risk of developing diabetic retinopathy, but there are certain factors the increase this risk.  Some of these factors of can be controlled of course, but others cannot.

Uncontrollable Risk Factors:

· Type of diabetes:  People with Type 1 diabetes are more likely to experience vision loss sooner.

· Ethnicity:  Aboriginal Canadians are three to five times more likely than the general population to develop Type 2 diabetes, placing them at a much higher risk of developing vision problems related to diabetes.

Controllable Risk Factors:

· High blood sugar:  Target ranges for blood sugar levels are dependant upon age, medical condition, and other risk factors.  Ask you doctor what your levels should be.

· Smoking:  Smoking increases your risk of vision loss when you have diabetes.  It also increases blood pressure and blood sugar levels, making it harder to control your diabetes.

· High blood pressure and cholesterol:  If you have diabetes and high blood pressure and/or high lipid (fat) levels, you are more likely to develop diabetic retinopathy.

More Information

 If you would like more information on diabetic retinopathy, talk to your eyecare professional or check out the following online resources available to you. 

  • CNIB
  • Canadian Opthalmological Society
  • Canadian Association of Optometrists