Treatment improves for age-related sight loss

Peter Miller was a high-powered businessman who owned several electronic security firms when he was diagnosed with age-related macular degeneration in 1999.

Like so many people who lose their central vision, Miller couldn't imagine life without the full use of his eyes and spent several months feeling blue.

But to his surprise, Miller continued his work and active lifestyle thanks to rehabilitative help from the Chicago Lighthouse, a nonprofit agency that assists people who are blind or visually impaired, and laser surgery for cataracts.

He searches the Web or scans his email with help from a portable device that takes pictures of printed material and he uses a video magnifier for letters and books — both purchased from the agency.

Though he can no longer drive, Miller has three children who often transport him and offer emotional support.

"It's a major blessing for those who are visually impaired and blind," said Miller about the help of family and friends. "Without this and the fabulous help from which I benefited at the Lighthouse, things would be rather bleak," said Miller.

Eye specialists say patients with age-related macular degeneration (AMD) need not despair over the diagnosis because there is help out there. Even patients in their late 90s can be busy at their computers or enjoy their daily newspaper, with help from adaptive devices, surgery and medication.

In AMD, there is a deterioration of the macula, which is in the center of the retina, and loss of central vision results.

A new book by philanthropist Lindy Bergman and Lighthouse staff offers tips on ways to remain independent, optimistic and functional with AMD. The book, which is published by the American Foundation for the Blind (800-232-3044), outlines services available from the Lighthouse, including a low-vision exam, rehabilitation and optical devices. It is an updated and expanded version of a book published previously in 1998 by The University of Chicago Hospitals.

Bergman, who has AMD, describes her own dismay when she received her diagnosis but also how she has remained upbeat and maintained some independence through adaptive technology. She also advises readers to know their limits and take advantage of any help offered by friends and family.

"It's a major emotional adjustment," said Janet P. Szlyk, president and executive director of the Lighthouse, who wrote the book's prologue. "That's really what inspired our whole comprehensive model," said Szlyk.

That model includes the Bergman Institute for Psychological Support — named after the book's contributor and benefactor — where patients receive individual, group and family psychotherapy to help deal with the frustrations, anxieties and possible feelings of worthlessness that accompany a diagnosis.

Szlyk, who is also adjunct professor in the departments of Ophthalmology and Visual Sciences, Bioengineering and Psychology at the University of Illinois at Chicago, said in her research studies on vision loss that she saw many patients who were very depressed, making psychological support essential.

Help for people with age-related macular degeneration is becoming increasingly important because of the larger number of baby boomers being diagnosed with the disease, said Dr. Kirk Packo, chairman of the Department of Ophthalmology at Rush University Medical Center.

"In fact, as the baby boomers are now getting to 65 years and older, we're going to be approaching a real epidemic of AMD in the next decade," said Packo, adding there are about 300,000 to 400,000 new cases of wet macular degeneration each year.

Packo said about 85 percent of people with AMD have the dry form, which blurs or creates a blind spot in the central vision. The wet form, which involves swelling caused by leaking blood vessels that affects the center of the retina, is more severe.

Many patients with wet AMD get injections of a drug called Lucentis, which can actually improve eyesight. The medication, which blocks abnormal blood vessel growth and leakage in the eye, became available in the past decade, noted Packo.

Ellen Freedman, 70, who has little sight in her left eye because of AMD, began losing sight in her right eye a few years ago. She has received eye injections of Lucentis and other drugs, which have vastly improved her vision. She also had cataract surgery with a special intraocular lens implant. Before her right eye improved, she benefited from adaptive devices purchased from the Lighthouse.

"It really saved the day," said Freedman of her injections.

Rush will be working with the Lighthouse on a telescopic implant program this spring for patients age 75 and older who have dry AMD. A device that magnifies images will be implanted into the front part of patients' eyes at Rush, followed by rehabilitation at the Lighthouse.

"The goal is to try to give patients back independence again," said Packo.

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