By Ron Edelman, MD; Director, Retina Section

Age-related macular degeneration is the most common cause of legal blindness in the United States, UK, and other developed countries. Over 8 million Americans are affected by this disorder. The incidence of macular degeneration continues to rise as the percentage of elderly persons increases.

Macular degeneration has been classified into two types: Dry (atrophic) and Wet (exudative or neovascular). A majority of patients suffer from the dry type of the disease. The dry type is the milder form and has the better prognosis. Wet macular degeneration is responsible for most cases of legal blindness in this country.

The exact cause of macular degeneration is unknown. The incidence of the disease increases with age. Other risk factors include race (Caucasian), smoking, and family history of macular degeneration. Initially, a patient may not have any symptoms or may have decreased vision. In advanced forms of macular degeneration, patients suffer from profound loss of vision, which may lead to legal blindness.

After following over 3,600 participants for an average of 6.3 years, the Age-Related Eye Disease Study (AREDS), sponsored by the National Eye Institute, published its findings in October, 2001. A statistically significant reduction in the risk of development of macular degeneration was found with the use of antioxidants (vitamin C 500 mg., vitamin E 400 i.u., and beta carotene 15 mg.) plus zinc. The AREDS study concluded that persons older than 55 years should have dilated eye examinations to determine their risk of developing macular degeneration. Those with signs of macular degeneration, and without contraindications such as smoking, should consider taking a supplement of antioxidants plus zinc.