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If you are at high risk for developing advanced AMD—that is, you have intermediate AMD or advanced AMD in one eye (wet or dry)—talk to your health care professional about taking high doses of certain vitamin/mineral supplements. The Age-Related Eye Disease Study (AREDS), sponsored by the National Eye Institute, followed 3,640 participants who had at least early AMD for at least five years. Those at high risk for developing advanced AMD—those with intermediate AMD and with advanced AMD in one eye only—reduced their risk of developing advanced stages of AMD about 25 percent when they took daily antioxidant/mineral supplements containing 500 mg vitamin C, 400 IU vitamin E, 15 mg beta-carotene, 80 mg zinc (as zinc oxide) and two mg copper (as cupric oxide). Smokers should not take this preparation, and all patients should consult their personal physician regarding all vitamin usage.

In addition, a recent study done by researchers at Brigham Young University and Weill Medical College of Cornell University found that when consumed in antioxidant-rich foods like pecans, blueberries and artichokes, antioxidants extend the lifetime of crucial retinal cells and disrupt two processes in the retina that contribute to macular degeneration.

Some cases of the wet form of age-related macular degeneration (AMD) can be treated with laser surgery, but treatment may not restore lost vision. Treatment slows the rate of vision loss and may help preserve some central sight. For treatment to be effective and help protect the vision you have, it is vital that wet AMD be caught early, before it spreads to a part of the macula where treatment is not an option and before it destroys central vision.

Laser surgery destroys the leaking blood vessels that grow under the retina and cause the macula to bulge or lift up in the eye, ultimately damaging it and distorting vision. This treatment works best when the leaky blood vessels have not grown under the macula and are located away from the central part of the macula on which the visual image is focused. Because heat from the laser beam destroys tissue surrounding the site of the beam's contact with the blood vessels, healthy tissue can be lost in the procedure, producing blind spots in vision. To treat leaky blood vessels under the macula with the laser beam would damage the macula as much as the leaky blood vessels themselves. As a result, only a small percentage of patients with wet AMD are eligible for laser surgery, and it is not often performed, according to the National Eye Institute. Early detection of wet AMD before it nears the central part of the macula is important in determining whether it can be treated.

The FDA has approved two drugs for the treatment of wet AMD that can be injected directly into the eye (called anti-VEGF therapy)—ranibizumab (Lucentis) and pegaptanib sodium (Macugen). The National Institute for Health and Clinical Excellence (NICE) issued a technology appraisal in 2008 that recommends ranibizumab for possible treatment of wet AMD but does not recommend pegaptanib. In people with wet AMD, abnormally high levels of a certain protein promote the growth of abnormal blood vessels; both drugs target this protein, thus inhibiting the growth of new vessels and the progression of AMD. Lucentis, a form of the colorectal cancer drug Avastin and approved for treatment of AMD in 2006, requires monthly injections in the eye. Macugen, approved in 2004, requires injections every six weeks. Potential complications associated with these injected drugs include inflammation within the eye and retinal detachment. Bevacizumab (Avastin) works similarly to ranibizumab but it is only FDA-approved for treatment of colorectal cancer; some health care providers prescribe it off-label to treat macular degeneration because it is less expensive than Lucentis.

Verteporfin (Visudyne) was the first drug therapy approved by the FDA for treatment of wet AMD, but newer drugs have largely replaced its use. Visudyne is used in photodynamic therapy, in which the light-activated drug is administered intravenously in the patient's arm. Then, a low-powered laser beam is shined into the eye to stimulate the drug, starting a chemical process that destroys the leaky blood vessels. Like laser surgery, the photodynamic laser therapy cannot restore lost vision. Verteporfin causes sensitivity to light for five days after treatment, as well as other side effects.

Because dry AMD can sometimes progress to wet AMD, regular eye examinations are important. Additionally, there are many types of low-vision devices designed to help you make the most of your sight, such as special high-magnifying eyeglasses and electronic screens that display text in an enlarged form. Your health care professional can prescribe such aids for you, or may refer you to a low-vision specialist. Vision rehabilitation instructors can help you learn new ways to perform daily living tasks, such as:

• marking clothes, groceries and medications so they are easily recognizable

• improving lighting and reducing glare

• modifying the home so it is safe and comfortable

Orientation and mobility instructors can teach you how to move around indoors and outdoors when you have low vision. Various adaptive devices, such as clocks and telephones with large numbers, and large-print books, can help those with low vision manage better by themselves.