Sam Bauman: Macular degeneration: A problem for seniors and others

Most seniors have heard of age related macular degeneration (AMD) but may not know what it is. It’s the leading cause of blindness in people over the age of 65.

I first heard of it while in the Air Force taking a physical for flight training. A major was in line ahead of me, and I heard the doctor tell him his macular degeneration was worse and he would have to be grounded, and the doctor looked at me and passed me on to the next doctor. After a quick session with a book of colored dots, he said I was red and green weak and washed me out of flight school. (I later found I could have appealed and taken a test with colored lights at the end of a runway and passed, but it probably saved my life and an aircraft of the Air Force).

So what is age related macular degeneration (AMD)? It’s a degenerative eye disease that causes damage to the macular area at the center of the retina that’s responsible for central vision.

When the macula is damaged, blurriness or distortion of images can occur and the potential loss of central vision. Typically, changes in the macula from AMD are gradual, but in some cases the vision loss is faster and more noticeable.

I use an Amsler chart stuck on my fridge door regularly to check on macula. It consists of a square with parallel lines intersecting at right angles. I’m OK if I cover one eye and look at the dot in the center and the lines stay straight; I don’t know what it looks like when the macula is bad.

There are two forms of AMD, dry and wet. Most cases are dry. This happens when the tissues of the eye begin to age and dry out. Dry is also tied to yellow dry deposits called “duress” that form beneath the retina. Dry AMD sufferers usually experience a lesser degree of vision loss. It develops slowly. Early AMD always starts out as dry, but in 10 percent of cases it becomes wet.

Wet AMD takes place when abnormal blood vessels form under the retina. These leak blood and fluid under the retina causing it to distort or scar. That’s why the loss of sharp vision in wet AMD progresses more rapidly than dry with more severe effect, potentially complete loss of central vision.

AMD results in loss of high definition, straight-ahead vision we need to perform activities that require sharp, straight-ahead vision. Brighter lights may be needed when reading.

As the disease progresses, dark or blank spots in vision and faces may become blurry. Other changes may be visual distortions or objects becoming larger of smaller than they really are.

There are several risk factors that can help and some that cannot. The greatest risk factor for AMD is age.

Risk of AMD is only 2 percent at 50, but it’s 37 percent by 75. Family members with AMD increase the risk three times higher. Those with light colored skin and eyes are more likely to develop AMD.

Risk factors one can control include no smoking. Smokers are three to four times more likely to develop AMD than non-smokers. And diet — vitamins C and E, lutein and zinc are helpful. Obesity, high blood pressure and high cholesterol are risk factors. Too much sun means protect your eyes from UV and wearing sun glasses and wide-brimmed hats.

Studies by the National Eye Institute offer a positive view. Check for the AREDS formulas on the Internet. I get my supplement PresserVision from the VA of eye vitamins that I take twice a day. And last time the eye doctor checked me out, he referred to files which showed my AMD was unchanged, so the pills must be working.

Head of Hair

Seniors face hair loss, and most of the time there’s little to do about it. Heredity plus aging is largely to blame, and hair loss is acutely felt. But all may not be lost. There are treatments that can help regain some hair loss.

If you experience unexpected patchiness that causes concern, see your doctor to check for a medical condition such as thyroid disease or lupus. Sometimes hair loss is caused by drugs such as those to treat cancer, gout, arthritis, depression or heart problems or high blood pressure.

In men hair loss is usually a receding hairline and balding on the top of the head. Women tend to lose hair volume, around the top of the head, temples or around the middle part line.

Like skin cells, hair grows regularly and goes through a cycle of growth (anagen), regression (catagen) and rest (telogen). The growth phase usually lasts two to three years. During this time your hair grows about a half-inch a month. During the regressive phase of two weeks, the hair follicles shrink, leading to the resting phase, which lasts three to four months. At the end of the resting phase a hair strand falls out and a new one replaces it, starting the whole cycle over again.

In most people, about 90 percent of the hair is in the growth phase with the remaining 10 percent in the resting phase or headed that way. People generally lose about 100 hairs a day.

Gradual thinning is normal, but in some cases the growth cycle shortens and hair doesn’t grow back as thick.

I’ll go back to this subject with the help of the Mayo Health letter next week, including treatment of hair loss.

Sam Bauman writes about senior affairs, among other things, for the Nevada Appeal.