Category: The Science Stuff
Welcome!
June 2023 There’s an announcement that since Sue has not written any new journal pages for some time, the site has been archived until we can decide if the work necessary to make sure all information is accurate and up-to-date can be made. In the meantime, you’ll get some pages ‘not found’ or ‘private’ until that decision has been made. The emphasis for several years has been on the Facebook group.
You are here to follow the journey & misadventures of a woman named Sue who became visually impaired with Age-Related Macular Degeneration (AMD or ARMD) seemingly overnight. Join in the tears and laughter. Join in the discussion. Learn more about Age-Related Macular Degeneration. Find resources for your own journey or that of someone you know.
We’re going on a bear hunt….can’t go over it, can’t go under it, got to go through it.
Sue is a psychologist trained in Dialectic Behavior Therapy (DBT) and is using it to help her cope with this vision loss. Her trusted and invaluable friends bring computer, research and occupational therapy skills to this endeavor. Yeah team! We hope you benefit from the fruits of our labors.
We are not offering free psychological therapy. We are not medical people. Please read the disclaimer.
This website is divided into 4 parts:
- If you have just been diagnosed or if you are beginning your research, here’s a place to start in I Have Macular Degeneration…Now What?
- Sue’s journal pages which are like chapters in a book
- Highlights & News which are basically blog posts
- Links to helpful resources (still under construction)
For those of you who aren’t familiar with websites or blogs like this, to ensure that you will be notified when information is added to the website, you must subscribe by email. On a laptop & most tablets, you’ll find the place where you can do this in the right-hand column. On a smart phone, you will find it below the content for the page that you are looking at.
- Get information about our Facebook group
- Find out more about Sue
- Learn who Linda is & how she met Sue
- Find out how we organize our project
- Contact us if you find a problem or need help
We are still learning, we don’t know everything about this challenging disease.
Courses Coming Soon!
Thanks!
Thanks to Lesley B., Sally R., Dave M. and Gerry M. for going through the website looking for links that didn’t work, things that didn’t read well and typos. We couldn’t have done it without you.
Crazy Like a Fox
The day comes for me to go to my second appointment with Regillo. I ‘dress for success’ for these appointments. Some people may think putting on a professional-looking skirt and pantyhose and doing my makeup for a doctor’s appointment is a little crazy, but I think of myself as being crazy like a fox.
I ‘dress for success’ for the appointment with Regillo. Some say I’m crazy but I think of myself as crazy like a fox.
I can be a manipulative little thing when I want to be. People think of manipulation as a bad thing. It has gotten a bad name because people think that manipulation is always for the agent’s own gain and always hurts the person who he (or she) is trying to manipulate. That is far from the truth. There is something called ‘positive manipulation’. Your mother used it on your when she told you “here comes the train! Open the tunnel!” so that you would eat your smashed peas. You have used it yourself. We just don’t like to admit it because manipulative has been paired with words like evil and conniving in our culture. Every one of us is manipulative. Some of us do it with finesse and some are heavy-handed. It is simply a matter of style…and training.
DBT Interpersonal Effectiveness Skills teach us that as long as you are not hurting others, not being dishonest, etc, using finesse and certain strategies is perfectly acceptable to try to get what you want. The goal of interpersonal effective is getting someone to do something for you and that person feeling good about having done it. Win-win. And yes, it is positive – gasp – manipulation.
As long as you are not being dishonest or hurting the other person, manipulation is a perfectly acceptable skill according to DBT.
Another reason I dress up is related – sort of – to the IMPROVE (another acronym) the Moment Skills of DBT Distress Tolerance. I am trying to improve the way I think of myself and the situation. Putting on ‘good’ clothes reminds me I am a professional and have a few strong points. The saying is “clothes make the man”. They also make the woman.
“Clothes make the man” and the women. I’m reminding myself that I am a professional and a few strong points.
So, I dress for success because whether anyone else realizes it or not, this appointment is a job interview. I am interviewing, once again, for the job of lab rat.
I have been anxious about this appointment for days. I am not sure what the decline in my vision will mean –am I no longer qualified for the study?
After the usual round of screenings by technicians, I finally rotate around to the man himself. Regillo confirms there has been significant cell atrophy – read ‘wasting and death’ – since I last saw him in August. He calms my fears that I may have done this to myself. No, this was a natural progression of the disease. No external factors such as sunlight reflected off of the snow or my high blood pressure would have caused this to happen. This is good. I can now at least get rid of one concern. I have been declared not guilty.
Regillo calms my fears that I may have done this to myself. I have been declared not guilty.
Just the same, I still have the worry about the study. Will I still qualify? The study is for those with dry macular degeneration only and this rapid loss of vision suggests I may be developing wet AMD.
Regillo runs an IV and puts beta carotene in my veins. I daresay this is the first time I have ever mainlined ‘carrot juice’! Beta carotene is mostly Vitamin A and your eyes lap it up. By watching where the ‘carrot juice’ goes in your eyes and comparing old imagines with new ones, the technicians and doctor can see if my eyes have been creating new veins.
I daresay this is the first time I have ever mainlined ‘carrot juice’! It’s beta carotene & helps the doctor compare old images with new ones.
Thank God. There are no new veins in either of my eyes. I still fit diagnostic criteria for dry AMD and therefore the criteria for the study.
Regillo suggests I refer myself for low vision therapy – already done – and AGAIN referred me to the study. He suggested that he might be seeing me ‘downtown’. I replied he would definitely be seeing me downtown. Regillo just smiled. Or at least I think he did. Do you think I was too confident?
Regillo just smiled. Or at least I think he did. I still qualified for the study and I am confident I will be in it.
Written in March 2016. Reviewed September 2018.
A Human Doing
Moving ahead in time again, I found myself having taken leave of ….a turn of phrase makes me want to say ‘leave of my senses’ even though that is not how I was thinking when I started this sentence. But maybe I did. People (hello, Lin) told me to pace myself and that this was going to be a marathon and not a sprint, but I am a go-er and a do-er with the proverbial motor in my butt. I do not hang well. I was out of work and pretty much grounded. I am happiest when I have a project so – curse it – I and my vision loss are going to be my project.
I am a go-er and a do-er with the proverbial motor in my butt.
I had made an appointment with my optometrist originally hoping that something as easy as a new pair of specs would solve the problem. I kept the appointment even though I was not holding out a lot of hope for a ‘spec-tacular’ rescue (sorry, could not help being goofy there). I got a few things out of the encounter. One was the information that while I thought my eyes had suddenly and inexplicably self-destructed, the problem was actually part of the continuing process of degeneration.
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According to my optometrist, the drusen had reached the center of my left macula. She explained the macula is set up like a dart board. There are greater values in the middle where acuity/vision would be a 50. When the drusen reached the center of my macula, I lost my ’50 points’ vision. Add to that a progression in my right eye and I was up the proverbial creek.
Eccentric viewing was a skill my optometrist thought I should learn. Now, there are a number of people in my life who have always thought my views were eccentric, but that was not what she was talking about. Apparently, eccentric viewing is using the intact – but not as finely tuned – cells of the rest of the retina to do the jobs of the macula. Many people with central vision loss learn to read with their peripheral vision. Sweet trick if you can master it. I think I need Eccentric Viewing 101. I have been practicing looking out of the corner of my eye or focusing just a bit above and to the right of what I really want to see. Sometimes it works and sometimes it doesn’t. Apparently, this is going to take more than a couple of days to master.
My optometrist also suggested I wait until the Bureau of Blindness and Visual Services (BVS or BBVS) appointment to pursue low vision services. Since I was – and am – planning on going back to work, there was a chance this organization would help me with some of the expenses of equipment.
Wait. Patience. Really???????? You don’t know me too well, do you?
I had already contacted the Bureau of Blindness and Visual Services, a part of the Office of Vocational Rehabilitation (OVR). I had an appointment set up with the vocational specialist they had assigned me. When I first spoke with my BVS counselor I had warned him I am not a patient person. In fact, I am a doggedly persistent pain. I suggested he give me an assignment. It would be self-defense for him and would give me something to do. My assignment? Get copies of my eye evaluations and put together some samples of the work I had done and that I wanted to return to. Yes. I was on the job.
I warned him I am not a patient person. I told him to give me an assignment and he did.
Meeting with my BVS counselor, I signed the usual mess of legal forms and found out I was going to get three different services. One would be low vision support, one would be technology and one would be ‘habilitation services’…whatever that is. I am hoping it has something to do with lighting.
I would get low vision, technology, and rehabilitation services. Let’s go!
Written February 2016. Reviewed September 2018.
A Perfect Storm
January 31, 2016 was a breathtakingly beautiful Winter day. I know it was January 31 because I still have the ski tag on my jacket.
That day I drove to Wilkes-Barre and had lunch with a friend. I was able to read the menu. I was able to navigate the roads.
I left lunch and went to a local ski area where I had a glorious, three-hour session of skiing. The sky was bright blue with not a cloud to be seen. The snow was a glittering white. The air was mild but not mild enough to make ‘spring conditions’ also known as slop.
I wore my sunglasses constantly. Of course I wore my sunglasses. I knew I had macular degeneration and that’s part of the drill. My sunglasses were red and matched my jacket. Even we old ladies with eye problems like to look good on the slopes.
Of course I wore my sunglasses. I knew I had macular degeneration and that’s part of the drill.
Later, my husband insisted it was photostress that destroyed my macula. He believed the day on the slopes and the reflection on the snow was just too much for my eyes to handle. My optometrist and ophthalmologist did not agree but there is that lingering doubt.
A quick detour here to talk about photostress. Photostress is, exactly as the name suggests, the stress that light puts on your eyes. When the photoreceptors make ‘light into sight’, they deplete a chemical, basically a pigment, that has been fed to them by the RPEs. Remember those Servant cells that take care of the photoreceptors? To my understanding, photostress happens when the light is eating up so much pigment that the RPEs cannot keep up replacing it.
If you have ever gone ‘snowblind’ you understand what I’m talking about (although snowblindness is caused by something different).
In the past I have had trouble with photostress. I walked from the car to the building housing a yoga festival. I had forgotten my sunglasses but did not think much of it. I stood in the lobby for five minutes–blind.
There is a photostress test in which they purposely make you go blind and see how long it takes you to recover. It would appear that recovery time is the key variable here.
Recovery time is the key to knowing how serious the photostress is.
If you’re reading this website just because you have nothing better to do or out of curiosity, if you do not yet have a diagnosis of retinal disease and you become blind after coming in from bright light with long periods of recovery, get thyself to a reputable eye doctor. It is very possible you have the beginnings of a retinal disease. That’s the public service announcement.
If you become blind after coming in from bright light with long periods of recovery, get thyself to a reputable doctor.
Written February 2016. Reviewed September 2018.
The Man Behind The Curtain: The Wizard of Wills
For a rock star of retinas, Regillo, was not all that imposing. I finally got to see the man after multiple tests by multiple technicians. Towards the end of the gauntlet, I asked the girl if everyone went through so many tests. She confided in me that many people do not get as far as I got. That was certainly encouraging. My inner voice had been telling me I was on the right track. The stars seem to be aligned. However, this was the first outside confirmation that I had chosen a good path.
I had chosen a good path. The stars seem to be aligned.
When the good doctor came into the room, I was studying the scans of my left eye–not quite sure why, but he appeared to be amused. Perhaps this was highly unusual behavior in a patient with Age-Related Macular Degeneration.
Regillo proceeded to challenge me to tell him what I saw. So I told him. The lower area was Bruch’s membrane. This membrane is the connection to the proverbial greater world. It brings nutrients to the RPEs and takes away the garbage. The level above that contained the RPEs. It also contained yellowish piles of eye poop more appropriately known as drusen. Level above that were the photoreceptors. The divot in the top was geographic atrophy and the reason I was there.I might have impressed him. After all, I am more than just an impaired eyeball.
I am more than just an impaired eyeball.
Strange, staccato, conversation followed. I told him I wanted to read the article on the phase 1 results when it came out. It was out and he gave me the citation. I told him I had every intention of being in phase 2. The conversation was a bit of a tennis match. At times we are even finishing each other sentences. I felt as if we were definitely on the same page.
Also, talking to the doctor I felt as if we were in a cat & mouse game and I was the mouse. He seemed overly interested. No, not that way, I felt like I was prey but in a professional, scientific way. It was like he had found a live one. After reading the phase 1 results that were published in Lancet last winter, I figured out why. The mean age of the cohort for the phase 1 study was 77 years of age. The team was planning on doing a 15 year longitudinal follow-up on the study. There was now no confusion in my head as to why Regillo was looking at me as if I were a live one. Hell, in 15 years, with subjects like that, I was going to be the only live one!
The mean age in the phase 1 study was 77 years of age. That means in the 15 years of the study, I was going to be the only live one!
Written February 2016. Reviewed September 2018.
Continue reading “The Man Behind The Curtain: The Wizard of Wills”
Resources
June 2023 There’s an announcement that since Sue has not written any new journal pages for some time, the site has been archived until we can decide if the work necessary to make sure all information is accurate and up-to-date can be made. In the meantime, you’ll get some pages ‘not found’ or ‘private’ until that decision has been made. The emphasis for several years has been on the Facebook group.
2/14/2022 Because of the rapid and constant growth of our Facebook group, I cannot keep this list updated. I have a large amount of information available in the Facebook group in Guides which are like chapters in a book or lessons in a course. Plus, in 3 years, the amount of information in the posts and comments is quite substantial. I recommend that you join us there where you can get the information and the support to help you in your journey. Thanks for understanding. Hope to see you there! Lin/Linda…
I’ve added some pages from that group that might be of interest to you.
Frequently Asked Questions
Click here for the list of Frequently Asked Questions from our Facebook group.
AREDS2-based Supplements
There are several pages on the site that explain what AREDS2 means and who the AREDS2-based products are for. Click here to go to a list of articles.
AREDS2-based Supplements With 0 or 25mg of Zinc
Click here for the list.
Navigating
There are a lot of links here. I’ve set up this page so that when you click on a link (words that are underlined & in blue or green), a NEW tab will open in your browser and this page STAYS WHERE IT IS. When you are done with the new page you opened, just close it. You do NOT need to use the back option. If you click on a link and the new page replaces this one, I’VE MADE A MISTAKE so please let me know by sending me an email at light2sight5153@gmail.com. Let me know exactly which link or links do not open a new tab or window.
Errors: If you click on a link and you get a ‘page not found’ error, please let me know by sending me an email at light2sight5153@gmail.com. Let me know exactly which link or links do not open a new tab or window.
Additions: If you have a link you’d like to add, please email at light2sight5153@gmail.com.
Topics-click below to move to a topic
- Links We Like
- See what vision is like at the various stages of AMD
- What is AMD?
- Glossary
- Websites devoted to AMD and Other Forms of Macular Degeneratin
- Websites containing information about AMD and Other Forms of Macular Degeneration
- Support groups
- Where to find services
- Books & reading materials
- Videos
- Personal stories of living with AMD
- Online newsletters
- What is Stargardt’s Disease?
- Science Stuff
- Symptoms
- Risk factors
- Treatments
- Research/clinical trials
- Coping with vision loss
- Self-maintenance/ self-care
- More to come…
Links We Like
- Click here for a GREAT resource where you answer some simple questions and you get a customized guide based on your responses
- Click here for a great glossary
- Click here for Low Vision Resources: A List of Lists (such as 8 ways to slow AMD, 15 tips for family and friends, etc)
- Videos
- Click here for several videos
- Click here for the UK Macular Society’s Say Hello to Mac
- Click here for one that uses illustrations and animation (explains how wet AMD progresses and how the injections work)
- Click here for a description of dry vs. wet AMD (we are not recommending any products in this article)
- Click here for an article about depression after diagnosis
- Click here for a very comprehensive page about wet AMD
- Click here for a very comprehensive page about dry AMD
- Click here for a FAQ (Frequently Asked Questions) that answers a long list of questions such as ‘will resting help my eyes?’, ‘Can I see for myself if my retina or macula shows any signs of damage before I have symptoms?’, ‘why don’t new eye glasses help?’, ‘what is meant by degeneration?’, ‘is a macular hole the same as macular degeneration’, ‘I have had dry MD for years. Does this mean I’m going to get wet MD too?’, ‘No one else in my family has MD. Why did I get it?’, ‘can drusen be treated?’, ‘I have changes on the Amsler Grid, does this mean I have MD’, ‘I have Wet MD but my Doctor says there is nothing he can do or no treatment available. Why is this?’
- Click here for a short introduction to stems cells, what they are and how they can be used.
See what vision is like at the various stages of AMD
Click here to find ways to see simulations of what vision loss due to AMD is like at various stages.
Glossary
Go to the Top
Websites devoted to AMD and Other Forms of Macular Degeneration
listed in no particular order
- Macular Degeneration Partnership
- Macular Disease Foundation of Australia
- American Macular Degeneration Foundation
- Macula Vision Research
- Macular Society (UK)
- RNIB (Royal National Institute of Blind People; UK)
- RNIB (Scotland) there may be a branch near you.
- BrightFocus also Alzheimer’s & Glaucoma
- Macular Degeneration Association
Go to the Top
Websites containing information about AMD and Other Forms of Macular Degeneration
listed in no particular order
- maculardegeneration.net where you’ll find articles, forums, Q&A, and more for those with macular degeneration. You’ll be interacting with patient and caregiver advocates who are people who have the disease or take care of those with it.
- Living Well With Low Vision
- Prevent Blindness
- for professionals; also a section on Eye Health for the lay person: American Academy of Ophthalmology (AAO)
- CNIB (Canada)
- Foundation Fighting Blindness
- MD Support: The Eyes of the Macular Degeneration Community
- All About Vision
- American Foundation for the Blind and VisionAware (related)
- Fight for Sight
- Enhanced Vision
- National Eye Institute: Macular Degeneration
- Second Opinion: Macular Degeneration
- Wikipedia: Macular Degeneration
- Mayo Clinic (search for macular degeneration for articles on wet and dry)
- Patient Info: Macular Degeneration
- eyeSIGHT International: Sight for Humanity (links to International, North America and UK branches)
Go to the Top
Support
I’ve not been able to verify if these are kept up to date. Let me know if you find that they are not or if you have one you’d like to add.
- Support by telephone
- Support groups US
- US & International Support Groups in the US and internationally
- UK: Macular Society and RNIB
- Canada: CNIB
Message Boards including ones from
- APH Connect
- Macular Society HealthUnlocked in the UK
- UK’s NHS site for AMD community page
- Facebook: Macular Degeneration Community, Stargardt’s Disease – Macular Degeneration, I’m sure there are others so search by ‘macular degeneration’
- maculardegeneration.net where patient and caregiver advocates are there to help
- Our Facebook page: My Macular Degeneration Journey/al
- Treatment & Charles Bonnet Buddies UK
- BrightFocus Foundation: Share your story, read story of others
By postal mail
I don’t know if these are still accurate.
- Association for Macular Diseases
210 E. 64th Street
New York, NY 10021
(212) 605-3719
– Offers education and information on macular disease through seminars, newsletters, and a hotline. Offers counseling to patients and their families. - Macular Degeneration International
is now a part of Foundation Fighting Blindness
Toll Free Helpline 1-800-683-5555
EMail: MDInfo@blindness.org
– Provides support for people affected by inherited macular degeneration including Stargardt’s disease.
Start Your Own
- Vision Support Group-download video presentations This group provides free information and support through presentations to groups of senior adults affected by macular degeneration and related retinal diseases. You can join & get access to their materials so you can use them in your own group.
On the phone/telesupport
Go to the Top
Where to find services
- In the US: click here to find a low vision center, retina specialist, state agency, ophthalmologist
- In the UK: click here to support services (listed on the right side of the page) such as skills for seeing, counseling, access to treatment…and more
- In the US: click here to search for a wide variety of services (more than the link above)
- In Australia: click here to find an ophthalmologist and optometrist
- Worldwide: click here for resources worldwide
Resources for Students
- Scholarships & Financial Aid for Students with Disabilities – https://www.
accreditedschoolsonline.org/ resources/scholarships- financial-aid-for-students- with-disabilities/ - Higher Education for Students with Disabilities – https://www.
accreditedschoolsonline.org/ resources/best-accredited- colleges-schools-for-students- with-disabilities/
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Books and reading materials
Specific Titles
- not recommendations, just referrals.
- A list of some books available about the prevention, treatment and daily living of macular eye diseases and low vision
- Making Life More Livable: Simple Adaptations for Living at Home After Vision Loss. Also available from AFB as a download, large-print paperback and several e-book formats.
- The First Year: AMD written by patient-expert
- Fiction book called ‘Seeing Things’ about a woman with AMD. Includes information about AMD
- The Complete Guide to Saving and Maximizing Your Sight 2003
- Protect Your Sight: How to Save Your Vision in the Epidemic of Age-Related Macular Degeneration 2006
- Eat Right for Your Sight from the American Macular Degeneration Foundation
Sources of Books
Formats: Braille, large print, e-book and audiobooks
- US Library Service provides ‘Talking Books’ in Braille & audio
- US BARD (Braille and Audio Reading Download) also from the US National Library Service
- US BARD & BARD Mobile: YouTube video talking about the service
- UK RNIB Overdrive: ‘Talking Books’ by digital download
- Worldwide Kindle e-books, click here for sources for international purchases
- Worldwide Kindle e-book readers: which is the right one for people with low vision?
- Worldwide BookShare: free eBooks 300,000+ titles including all current and recent NY Times bestsellers; free for students, $50/year with $25 setup fee
- Worldwide DAISY (Digital Accessible Information System): source of e-books
- Worldwide Overdrive: borrow e-books & audiobooks from local libraries
- Available in many countries, audible.com (an Amazon company) sells audiobooks (click here for specific countries)
- US & Canada Sources of large print & Braille reading materials
- Many countries of the world BookBub: Free and inexpensive e-books covering many genres for various devices
- Similar to BookBub is Early Bird Books a source of inexpensive books for various devices
- Sue’s page about Talking Books and BARD
- Sue’s page about BARD
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Videos
- full length DVD called “Hope & Cope”
- Excellent video & article about the progression of symptoms & treatments for MD
- Quite a few videos covering many aspects of AMD
- DVD videos about wet and dry AMD
- Hope & Cope: Living Well with AMD
- Explores research on treatments and potential cures for age-related macular degeneration (AMD)
- Public Service announcement American Macular Degeneration Foundation
- What is Macular Degeneration by AmerraMedical, a medical communications company
- What is Macular Degeneration, a video from the Macular Disease Foundation of Australia
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Personal stories of living with AMD
- The Experiences of a land surveyor in Australia who lost the central vision in one eye to MD and then 20 years later, lost the central vision of his other eye; lots of links to other webpages
- One of the first people to have a trial retinal transplant (UK) published Feb. 2016
- LONG list of people from all over the world who are living with Stargardt’s Macular Dystrophy which is very much like AMD but usually diagnosed at an early age.
- What Role Does Disability Play in Your Identity?
Go to the Top
Online newsletters
- American Foundation for the Blind provides newsletters for various topics
- WebRN Macular Degeneration News
- American Macular Degeneration Foundation: News about MD
- Lighthouse Guild: E-News
- You’ll need to create an account: VisionAware: Join the VisionAware Community
Go to the Top
What is AMD?
- Click here for “What do I do if I get a diagnosis of AMD?”
- Video: Animation of AMD, wet and dry forms
- from the NHS in the UK: not only a thorough explanation of all aspects of AMD but also real stores, clinical trials and a community group.
- A comprehensive and more technical article
- American Macular Degeneration Foundation: Learn, Home & Thrive
- AMD Macular Degeneration Partnership: Overview and Statistics
- About AMD
- Medical News
- Taking a Closer Look at AMD (pdf file)
- 8 Things I Wish People Understood About My Vision Loss
Wet Form
- Wet AMD types & risks for developing it in the second eye
- Wet AMD–the whole page is good. There are excellent diagrams that explain the process in the section ‘Wet ARMD – exudative/leak’
- Video that explains how wet AMD progresses and how the injections work.
Dry Form
- Dry AMD–the whole page is good. There are excellent diagrams in the section ‘The Retinal Changes in ARMD’
- There are different types of drusen and they mean different things
- “Arm Yourself for Dry AMD”, January 2017 article for Optometrists; contains the most up-to-date knowledge of dry AMD
How fast does AMD progress?
- A good article about how difficult this is to answer
- Great video that explains why early detection is important especially when detecting the change from dry AMD to wet
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What is Stargardt’s Disease?
Also called Stargardt’s Disease (SD) or Stargardt Macular Dystrophy (SMD) or Juvenile Macular Degeneration (JMD), it’s an inherited, juvenile macular degeneration. The progressive vision loss associated with Stargardt disease is caused by the death of photoreceptor cells in the central portion of the retina called the macula.
- Article with information about risk factors, treatments, etc.
- Macular Degeneration in Young Adults, People & Kids
- Great list of links re. SD
- 2011 Expert Answers on SD‘
- Blog: Living with SD
- One of many YouTube videos on SD
- This article explains the genetic aspect of SD
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The Science Stuff
- Here’s a refresher course in eye anatomy with a diagram and definitions
Role of RPEs
Geographic Atrophy
Go to the Top
Symptoms
- National Eye Institute/NIH: Facts about AMD
- Mayo Clinic: Symptoms and possible causes
- About geographic atrophy
- Good description of the stages
- Explanation of advanced AMD
Charles Bonnet Syndrome/Visual hallucinations
- Chuck Bonnet and the Hallucinations
- Charles Bonnet Syndrome: Why Am I Having These Hallucinations?
- Why am I seeing what I am seeing?
Other problems with vision & AMD
- problems with visual acuity, photostress, blindspots, color vision, sensitivity to light, depth perception
- eye problems that have similar symptoms as AMD:
Go to the Top
Risk factors
- January 2017 published, article “Nutritional and Lifestyle Interventions for Age-Related Macular Degeneration: A Review”
- Diet, Exercise, Smoking Habits and Genes Interact to Affect AMD Risk
- Comprehensive list of common possible causes
- Risk factors you can and can’t change
Age
- Age is a large factor but can start earlier
- Much less common are several hereditary forms of macular degeneration, which usually affect children or teenagers. Collectively, they are called Juvenile Macular Degeneration. They include Best’s Disease, Stargardt’s Disease, Sorsby’s Disease and some others. See Stargard’s Disease section above.
Diet/nutrition (working on this section)
- diet low in various nutrients & high in others have been linked to AMD.
- See Nutrition and Vitamins/Supplements under Self-care/self-maintenance below.
Race
- Caucasians more prone to AMD than African-Americans or Hispanics/Latinos (several references to this but no recent studies).
- 2012 database search ‘AMD by race’
- Study about the higher-than-other-racial-group incidence of AMD in those of Chinese heritage.
Gender
- AMD more common in women perhaps because women live longer than men
Uncontrolled high blood pressure
- Reducing high blood pressure is important but some medications to lower it can make vision loss worse
- List of references to consumer comments about high blood pressure and AMD
- Research study linking hypertension to AMD, risk factor for wet AMD; indicates a person with hypertension 1.5 times more likely to develop AMD than those with normal blood pressure
- Which comes first: high blood pressure treatments or AMD?
Uncontrolled high cholesterol
- High cholesterol linked to AMD, also some evidence that Statins to treat it can help prevent it
- Can statins help prevent AMD?
- A handful of walnuts a day can prevent heart disease, reduces cholesterol.
Smoking
- Biology of Smoking and AMD
- Personal story of person who smoked and had AMD
- Vision loss, blindness and smoking, not only AMD
Blue Light
- Click here for “Why should I be concerned about ‘blue light’?
- What can I do to protect my eyes outdoors? Includes a detailed explanation about the different types of light
- Violet and blue light of the UV spectrum worsen AMD. Sources: sun (main source), computer screen, phone & other mobile device screens, full-spectrum lighting (ie, used to treat Seasonal Affective Disorder (SAD), fluorescent lighting, LED lights, high intensity mercury vapor lamps (for night sports and high-crime areas), and xenon arc lamps.
- Click here for article with references to research on blue light.
- There’s concern for how much time we spend on computer and other digital devices.
- Be careful after cataract surgery since implanted lens may not block UV light as our natural lens.
Eye Color
- People with light-colored eyes (ie light-colored iris) are more likely to develop the dry type of AMD. This is because light-pigmented eyes offer less protection from damaging UV light.
Aspirin & other medications
- for those with wet AMD, aspirin MAY cause them to bleed more because it interferes with clotting. But talk with your doctor before you stop taking it. Many doctors believe that the benefits of taking aspirin outweigh the risks.
- Highlight: Is there a connection between drugs taken for osteoporosis and wet macular degeneration?
Other possible causes
- Biological Process in Wet AMD – some evidence that the photoreceptors are starved by the lack of food (oxygen & nutrients in the blood) and the growth of blood vessels is to compensate for that.
Connection between AMD and Alzheimer’s Disease
- Researchers found link between AMD and AD that is the lack of enough specialized proteins to remove waste products in the retina and the brain. March 2016
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Treatments
- FDA approved options in the US, injections, implantable telescopes, laser treatment (also outside the US)
Injections for Wet AMD
- Recent study (published May 2016) about the status of AMD before and after anti-VEGF injections.
- Medications injected into the eye and lasers to seal abnormal blood vessel growth only
- Comparing the medications used in injections
Telescopic implants
- UK Implant of tiny telescopic lenses
- US Implant of telescopic lens for those with advanced stage wet or dry AMD. Candidates have to qualify including no longer be candidates for medications.
Are there new treatments in the pipeline?
- Click here for a summary of AMD research and developments in the past 12 months (posted June 2016)
- Are there new treatments coming? March, 2016: for wet AMD, researchers are working on a slow-release medication and possible new drugs.
- Sustained release treatments
- Article from 2014 with overview of advances to that point & discussion of what was in the pipeline then
Vitamins (see Self Maintenance/Self Care section below)
- Warning about zinc in the AREDS formulas Individual reactions to zinc, it can cause vision to worsen in people with certain genetic makeup (there’s a test available) March 2016
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Research/Clinical trials
- Click here for a summary of AMD research and developments in the past 12 months (posted June 2016)
- Summary of Research & Developments 2017
- Research in the UK into earlier detection and treatment
- Click here for a 28-page brochure from the National Eye Institute (NEI) called “Clinical Trials in Vision Research: Information for Volunteers
- Click here for more information about ongoing clinical trials for dry AMD.
- Click here for more information about ongoing clinical trials for wet AMD.
- Sustained-release treatments for wet AMD (after you read this article, if you are interested, do a search on the link above to ‘more information about ongoing clinical trials for wet AMD’.
- Study where drug in an injection would last longer than current drugs for wet AMD.
- Article CNN March, 2016, article about ongoing clinical trial in London which has had encouraging results. In addition to information about the study, it includes a simulation of vision loss due to AMD, a description of the disease process, and a good explanation about how stem cells work for AMD and other diseases.
- Click here for a description of the Audacious Goals Initiative (AGI) and what it is. Briefly, it started as a contest to come up with the most innovative goal for improving vision. The ‘winning’ goal is “to regenerate the neurons and neural connections in the eye and visual system.”
- Key Research including AREDS, AREDS2, Blue Mountain Eye Study, The Beaver Dam Study, and others
How can I become a part of a clinical trial?
- A list of sources of information about clinical trials and how to find out for you to participate in.
- You can search for clinical trials from the links above
- There are registries where you sign up and enter information about the status of your eyes. Researchers will use this information to find people that match their research and contact you. Click here for more information about these registries in the US and elsewhere
Gene Therapy
Bionic Eye/Retinal Implants
- What is a bionic eye? It’s also called retinal implant or retinal prosthesis. Implant is put in retina, camera worn by person sends image to implant which stimulates optic nerve
- Click here for overview of retinal implants including videos of how it works & interviews with people who have them.
- March 21, 2016 UK Bionic eye being tested
- Here’s an article about one being developed at Carnegie Mellon institute in Pittsburgh, PA.
Nutritional Supplements
- See Vitamins/Supplements section below.
Stem Cells
- Video: what are stem cells and what can they do?
- 9 things to know about stem cell treatment
- Article from Australia, good description of where stem cells can come from
- Article Oct. 2015, success with stem cell transplant in UK clinical trial
- Stem cell clinical trials in the UK
- Stem cell surgery successes and legislation in the US
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Coping with low vision
Low Vision Aids
- Click here for a video which is an overview of assistive technology
- Click here for “Top 10 Low Vision Aids for AMD”
- Click here to go to computer/tablet/phone aids/apps
- 5 Ways to Browse the Web if you Are Blind or Visually Impaired
- Guide to buying low vision aids
- What kinds of low vision aids are available?
- Be My Eyes is an iPhone app where you connect to a ‘live’ person to help you
- A great overview of assistive technology for those with low vision from IPAT (North Dakota Interagency Program for Assistive Technology).
- Top 10 Products for Independence
- What you need to know about magnification
Wearable Technology
- coming soon!
Suppliers of low vision aids
- Enhanced Vision, you can have a catalog sent to you
- Suppliers of low vision products
- Zoomax assistive technology for those with vision impairments.
Financial Help
- A comprehensive list of sources for help including from companies who make Avastin and Lucentis.
- Help from the company who makes Eylea.
- An organization called GoodDays in the US
- In the US, you may qualify for Social Security Disability. Click here for the details.
- Financial help for injections: Patient Access Network (PAN)
- Click here for information about financial help for injections
- How can I get a free exam and glasses in the US?
Sunglasses
- Type of sunglass lenses: UV filter (blue blocker), clip-on, regular, wear over glasses
- What can I do to protect my eyes outdoors? includes an explanation about the various types of light
- Search results amazon.com ‘sunglasses filter out blue light’
- Things to look for in sunglasses
- This site says that they will give you a free pair of Cocoon sunglasses for participating in their study (I haven’t checked them out)
- Finding blue-blocking sunglasses in the UK
- Find online at Amazon for the UK. Cocoons are available, other brands as well often called ‘driving glasses’
- Serengeti Technology sunglasses can be ordered online
- Oakley is another brand that can be ordered online & possibly in the stores
- Another source for Haven and other brands
Lamps
- Better lighting for AMD, best types of light and hints for using them
- New technology lamps
- More lamps, better bulbs
- Lots of tips for better lighting
Transportation
- A website for the US where you enter your zip code and transportation options for your area will be shown.
Bioptic Driving
Depression
- AMD & Depression
- Reduce Depression
- Rehabilitation helps prevent depression for people with age-related vision loss
- Dialectical Behavior Therapy (DBT) used successfully by the author (Sue) of the pages on this website.
Checking vision
- Overview of how to check your vision regularly “How do I know if my vision changes?”
- “When should I get my eyes checked?”
Amsler Grid
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Self maintenance/self care
- An overview of self-maintenance
- General hints for coping when reading, writing, using the TV and appliances, etc.
- Coping with one good eye
Low vision rehabilitation
- Overview of types of low vision rehabilitation
- Click here for “Is there any way I can better use the vision that I have?”
- Click here for “Who are the people who will help me?”
- Eccentric Viewing: You can teach yourself how to use your peripheral vision to read the printed page with a technique called Eccentric Viewing
- Click here for what is called the Steady Eye Technique in the UK
- Click here for “How can I adapt my home so I can be safe and independent?”
Vitamins/Supplements
- Post: Should I take AREDS or AREDS2 vitamins?
- Click here for an eye doctor’s experience with a patient who ‘prescribed’ the AREDS2 vitamins himself.
- How much sunlight do I need to get enough vitamin D? Click here and scan down the page to the section Vitamin D.
- Warning about the AREDS supplements from the Macular Degeneration Association
- What you need to know about your AREDS supplements
- Where to buy vitamins, alternatives to the exact AREDS2 formulation
- Research in Ireland into Nutritional Supplement based on plant pigments (carotenoids)
- saffron ‘cures’ AMD in research study, Feb. 2013
Nutrition
- Macular Degeneration Diet and Prevention Plan by Dr. Stuart Richer, OD, PhD, Ocular-Nutrition Laboratory in DVA Medical Center Eye Clinic, North Chicago, IL
- Eyefoods website & Facebook page:
- Eat For Your Sight Cookbook
- Good Nutrition and Eye Health
- Anti-inflammatory diet because inflammation has been linked to macular degeneration
- Food high in Lutein and Zeaxanthin
- Eat right for good general health & eye health
- Good page talking about various dietary recommendations including anti-inflammatory, high Omega-3 and rich antioxidant
- Article warns of eating artificial fats to AMD (talks about risk factors)
Exercise/Activity
- Blind Yoga: CDs for sale
- BlindAlive: audio-described workouts for sale, several delivery methods
More to come, you can check out these posts now
Video: Overview of Assistive Technology for People with Low Vision
Highlight: How do I use Zoom for Apple products?
Highlight: What about Apple’s accessibility features?
News: Top 10 Low Vision Aids for AMD
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Home
Research
Not being one to be told there’s nothing I can do about something, I went back to my research. There seem to be a couple of different avenues of research. They were working on lasers to blast the drusen, aka piles of eye-poop but it looked to me like a hoarder intervention. Somebody comes in and cleans up the mess one time. Problem solved for now but not later. They would have a clean place to live but would eventually start to become messy again. The second thing I found looked more like the Merry Maids that were cleaning up regularly. However, it did not solve the problem of who is going to feed the Master photoreceptors? The third option was to essentially put the RPE Servants that were left on steroids. The live ones would work harder but would that not mean they wear out more quickly?
There’s research focused on cleaning up the ‘eye-poop’ called drusen.
There was one I liked, OCATA, originally known as Advanced Cell Therapy (ACT) , that was trying to replace RPEs. They were actually giving the little guys some help in order to save the Master photoreceptors. The way they were doing this was with stem cells.
There’s research using stem cells to replace the RPEs.
Although some people see stem cell research as cutting up dead babies, this is not the case. There are several lines of stem cells that have been derived from fertilized eggs that were never implanted. Some of these lines of stem cells are 20 years old. They have been massaged and manipulated so that there would never be the possibility that they could become functioning human beings. If they were not being used for research they would be flushed down the proverbial toilet.
Stem cells can be harvested from old fertilized eggs not dead babies.
The research that interested me–and still interests me–involves stem cells that have been developed specifically to become RPE cells. The theory is that replacing RPE cells with new ones and giving the little Servant guys some help will allow more photoreceptors to live and turn light into sight.
So where, pray tell, does one find someone to do this procedure? The problem is that this is very new research. It has worked on rats and other traditional lab animals (and you college psychology students, I am not speaking of sophomores). However, work on human subjects is just beginning. At the time of this writing, hospitals in Florida, Massachusetts, California and Pennsylvania as well as in foreign locales such as London and China have only completed phase 1 research. Phase 1 of any clinical study is the safety and tolerability portion. [Lin/Linda: it’s 2018 & some of these studies have advanced to the next phase or phases. The links before will give you current information]
Warning: there are doctors and clinics in the US that are offering costly stem cell treatments that have NOT been proven safe or effective through research. Before you enter into any stem cell treatment, please do your homework! Click here for an excellent article called Nine Things to Know About Stem Cell Treatments.
Click here for current research using stem cells for Macular Degeneration
Phase 1 results have been extremely promising. For those who are capable of using the web, there is a Lancet article by Schwartz and Regillo that summarizes the study. Essentially, they found the stem cells did not do anything strange or different when implanted in eyes. Preliminary data suggested that it was safe and tolerable. Even more exciting, they found positive therapeutic effects. A great number of the people who had volunteered and participated in the study showed cessation of deterioration and even improvement.
Phase 1 trials using stem cells is VERY promising.
So why not replace the photoreceptors as well as the RPEs? After all, when the RPEs die, the photoreceptors die. Would it not be reasonable to replace them both?
Unfortunately, medical science is not to this point as of yet. They have been successful in growing photoreceptors in the lab. They have been successful in implanting photoreceptors in the eyes of rats. The only problem is that these will not connect into the neural net. It’s sort of like having invented a cell phone without having a tower for it to work through. You can talk on your phone all day but the message goes nowhere.
They can grow photoreceptors in the lab, implanting them in rats but they won’t connect to the neural net.
That said, they are still working on it very diligently. Some of the literature suggests that it will be quite awhile. However, it will be coming.
If you are interested in seeing some of the studies that are being done on eyes and other medical research, I would invite you to go to the clinical trials website. It is a government website that lists all sorts of fascinating things. Many of them are looking for clients.
You will discover that there are dozens, if not more, of studies that are related to eyes. There are multiple studies related to Age-Related Macular Degeneration. So why would that be?
Someone, I am not remembering who at the moment, has launched the Audacious Goal Project. The Audacious Goal Project is aiming to eradicate blindness in the lifetime of some of you younger folks.
Click here to learn more about the Audacious Goal Challenge in Vision Research and Blindness.
Like the name says it is an audacious goal!
Why now?
And questioning again, why now? What is happening that vision is such a hot topic that we need a national program to deal with blindness?
The truth of the matter is, the pig through the population python is getting towards the end. We baby boomers from the 50s and the 60s have always presented challenges. We have always been very popular and our hot topics have been the topics of the nation. When I was a little girl, they were building elementary schools left and right. Then everything was sweet 16 and on through my lifespan. Right now, everything is security call buttons and retirement accounts. We drive the economy.
We baby boomers from the 50s and 60s have always presented challenges.
Because there are so many of us, our concerns are essential. One of our big concerns is vision. According to my research, AMD is the leading cause of blindness in the developed world. In the United States alone there are as many as 11 million people who have some form of AMD. They are predicting there will be 22 million by 2050!
This is going to be a massive drain on the country. When somebody suddenly realized what the numbers were going to look like, they decided they had better do something to ameliorate the problem. Thus, all the research.
Click here for more facts & figures from 2016
As many as 11 million people in the United States have some form of age-related macular degeneration. This number is expected to double to nearly 22 million by 2050.
Written in February 2016. Reviewed September 2018.
Blog Posts
We will be regularly adding new information to the Highlights/News section as well as Sue’s Journal pages. To make sure you are notified when that happens, please go to ‘subscribe by email’. On laptops & most tablets, you will find out how to do that in the right-hand column. On a smart phone, it will be after the content.
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The Science Stuff
Now comes the science stuff. Your eye has an area that takes care of the background and an area that takes care of seeing the stuff that you really want to look at. The part that does the seeing of what you really want to look at is called the macula. It is part of the retina which is the inside back layer of the eyeball. The retina converts light and images into electrical signals that are sent to the brain—light into sight.
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The macula is made up of the photoreceptors, rods and cones, and the retinal pigmentation epithelials, RPEs for short. There are other parts of the eye, but this is Age-Related Macular Degeneration for Dummies.
I am not a physician nor a scientist. There is quite a lot of information on the Internet if you’d like more details.
According to what I have read, the photoreceptors have the important job of turning ‘light into sight’. However, they are somewhat prima donnas and not very capable of taking care of themselves. I refer to them as the Masters. The RPEs are the Servants. Their job is to do everything for the Masters that the Masters cannot do for themselves. The Servants (RPEs) go to the store (the blood vessels in the choroid) and bring home nutrients for their Masters (the photoreceptors). They cook up a concoction of pigments and feed their Masters. They also clean up after their Masters.
The photoreceptors are the Masters, the RPEs are the Servants who feed and clean up after the Masters.
The trouble comes when the Servants/RPEs are not doing their job anymore. One of the first signs of AMD is the presence of something called drusen. My reading very nicely indicated that these are fatty, metabolic byproducts of the photoreceptors’ job of turning light into sight. Basically, it seems to me that they are piles of poop. These piles of eye-poop suggest that the RPEs are not functioning as they should.
When the RPE Servants don’t clean up the eye-poop, it piles up & creates all kinds of problems!
As the eye-poop builds up, the environment becomes more toxic to the Masters, the photoreceptors. The Servants, the RPEs, also are not doing an extremely efficient job of feeding their Masters. As a result, both the RPEs and photoreceptors start to die. This causes the vision loss.
The Masters and the Servants die. That’s what causes vision loss in dry MD.
Written in February 2016. Updated September 2018.
Sue’s Journal Pages
June 2023 There’s an announcement that since Sue has not written any new journal pages for some time, the site has been archived until we can decide if the work necessary to make sure all information is accurate and up-to-date can be made. In the meantime, you’ll get some pages ‘not found’ or ‘private’ until that decision has been made. The emphasis for several years has been on the Facebook group.
Update 2024 She HAS been writing about her experience with the APL-2/pegcetacoplan/Syfovre Phase 3 clinical trial, GALE follow-up study, and GARLAND Phase 4 clinical trial.
2024 Most Recent Pages
Sue’s Series on Being a Participant in the APL-2/pegcetacoplan/Syfovre Phase 3 Clinical Trial, GALE Follow-up Study, and GARLAND Phase 4 Clinical Trial
2016
Sue’s first aspiration to be a ‘super lab rat’ was not long after she considers the start of her status as legally blind. You can read about that here: In the Beginning.
2019
It was June 2019 she was accepted into the Phase 3 clinical trial for what was first called APL-2, then pegcetacoplan (Syfovre when it was approved by the FDA in 2023). Finally a Lab Rat. In July of that year, she wrote about her first injection: The Beginning of My Clinical Trial.
2022
In August 2022, before the FDA approved Syfovre (February 2023) and after that she was accepted into the long-term follow-up study, she wrote about her ‘Diabolical Plan’ to be accepted into a stem cell clinical trial while she’s still alive: My Diabolical Plan: Stem Cell Transplant for Dry AMD.
2023
She also wrote about the discussions of the studies: Pegcetacoplan Study Cliffhanger and Pegcatacoplan Side Effect Hunting.
After the drug was approved in February 2023, she revised her article from her perspective of being halfway through the 3-year follow-up study: My Diabolical Plan Revisited March 2023. In this article, you can read about her trip to Wills Eye Hospital in Philadelphia to participate in an interview for a CBS affiliate which ended up being shared internationally about this experience. You can find the link to that broadcast here.
She also wrote What Does Syfovre Mean for You?
She also helped me with the page Questions and Answers – FDA Approved Treatment for Advanced Dry AMD/Geographic Atrophy/GA.
First FDA-approved Treatment for Advanced Dry AMD/Geographic Atrophy/GA: Perspective from Sue.
2024
You can choose:
- To START AT THE BEGINNING and follow the pages from one to another like chapters in a book
- To get a list of ALL pages (some of the more recent ones may not be here yet)
- If you want to access pages by a particular CATEGORY, look to the right of this page or at the bottom and choose a category (for example, Cognitive Therapy, Research, etc)
Sue’s Toolkit – 2 Years Later – Part 1
Sue’s Toolkit – 2 Years Later – Part 2