Judi Dench's macular degeneration highlights plight of growing numbers of patients with the condition

20 February 2012

More patients than ever being diagnosed with Age Related Macular Degeneration

Dame Judi Dench's revelation that she suffers from Age related Macular Disease (AMD) and consequently can't see the faces of people she is talking to; join in with visual jokes such as cast members trying to suppress unintentional laughter (known as “corpsing”) or read scripts; highlights the isolation many people feel when they are diagnosed with this serious, sight reducing condition.

She describes the effects of AMD as “distressing”. AMD affects the vision people use when they are looking directly at something - when they're looking at someone they are talking to, watching TV or reading - but not their peripheral vision: things you can see from the corner of your eye.

Dame Judi is one of 40,000 people a year who develop wet age-related macular degeneration (wet AMD) in the UK, according to a study published earlier this year in the British Journal of Ophthalmology. Numbers of people living with the condition are rising as the population ages.

Mr Larry Benjamin, Vice President of The Royal College of Ophthalmologists, says: “AMD is caused by deterioration of the macula, part of the retina which is responsible for fine detail at the centre of the field of vision. It is usually age related.

“It is important that patients who are diagnosed with AMD understand that there is hope. Dame Judi has two types of AMD: the wet type in one eye and dry AMD in the other eye. Wet AMD is more aggressive but can be treated and in some cases, the progression of the disease halted, with injections that are available on the NHS. Dry AMD develops more slowly but can turn into the wet type. Patients with AMD need regular hospital check-ups.

“Ophthalmologists are specially trained to be sensitive and positive when they break bad news to their patients such as a diagnosis of AMD. The College also has guidelines on how ophthalmologists and their support staff in hospital eye departments can guide patients to the right sources of help and information.

“Aside from the help patients receive from ophthalmologists in hospital, the good news is that patients can do a huge amount for themselves to help make the best use of their remaining vision. Low vision services can help with advice about visual aids such as anti-glare spectacles, computers and software, lighting and other adaptations they can make in the home and assistive technologies such as e-readers, large text mobile phones and electronic magnifiers that will help them to continue living an independent life. Social Services should be able to offer information on staying safe in your home and getting out and about safely. They should also be able to offer some practical mobility training. These sources of information and help vary from region to region so it's vital that patients ask for contact details of these local organizations from their hospital.

“The emotional impact of a diagnosis of AMD cannot be underestimated. It's very frightening to be told you are losing some of your sight. Patient groups such as The Macular Disease Society ( 0845 241 2041) run local groups so you can meet others with the same condition and they provide an excellent telephone counseling service. RNIB's helpline (0303 123 9999) can also give you information about low vision services in your area and their website offers lots of information about adapting to changes in your vision and products that make everyday life easier.

“Your eyesight is probably the sense that people most fear losing yet most of us don't give the healthy maintenance of our eyes a second thought unless something goes wrong. Most people are unaware of the lifestyle factors that contribute to AMD.

Our advice is:

• Have regular eye checks with an optometrist- slight changes in your vision need to be checked as a matter of urgency by an optometrist. Go to a hospital Accident & Emergency department if you experience sudden changes to your vision such as blurring, unexplained sensitivity to light or seeing straight lines as wavy, bumpy or distorted.
• Stop smoking– cigarette smoke increases your AMD risk by two to four times.
• Eat well– there is some evidence that overweight people are more likely to develop AMD and The Age Related Macular Disease Study has found that taking high quantities of Vitamins A.C, E and betacarotene and the minerals zinc oxide and cupric oxide can help slow the progression of AMD.
• Protect your eyes from the sun– Sunlight can damage the retina. Wear dark sunglasses with the CE mark and British Standard BS EN 1836; 1997, which is a guarantee that the sunglasses offer a safe level of protection.”

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