High Sheriff of West Sussex, a long-standing GP, explains how the eye condition AMD affects patients

High Sheriff of West Sussex Dr Tim Fooks, in his weekly briefing on projects in the county, talks about the Macular Society and explains how the eye condition AMD affects patients.
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The Macular Society was established in 1987 in order to fund research and to provide information and support to those afflicted by conditions affecting a structure in the eye called the macula, the commonest being macular degeneration.

Since being appointed to the Office of High Sheriff at the end of March, I have been invited to several of the support groups the Macular Society runs around West Sussex and I have been greatly impressed by the enthusiasm of the members and their knowledge and understanding about their condition.

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As you read these words, an image of them is being projected through the lens of each of your eyes on to an area at the centre of the retina called the macula. The retina is a sheet of light-sensitive cells which convert light into nerve signals that the brain can interpret into shapes, patterns and colours. The greatest concentration of these cells is in the macula.

The Sussex Downs through an eye affected by AMDThe Sussex Downs through an eye affected by AMD
The Sussex Downs through an eye affected by AMD

As we age, a condition called age-related macular degeneration (AMD) can develop where the cells of the macula can lose some of their function, which, in turn, leads to a steady distortion and loss of central vision that is not improved by the use of glasses.

In addition, some patients with AMD experience vivid hallucinations, which can be very unsettling, even though there is no connection with mental health problems. This complication is called the Charles Bonnet Syndrome.

AMD affects 1 in 40 people aged over 50, increasing to 1 in 8 over 80 and 1 in 5 over 90. Smoking is a definite risk factor but, as yet, no specific cause or cure has been found.

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About 10 per cent of those with macular degeneration develop a wet version of the condition, in which new blood vessels start to form within the macula, causing the cells to leak into the underlying tissues. This process can be associated with a rapid loss of vision.

Stella Black, the Macular Society’s regional manager in West SussexStella Black, the Macular Society’s regional manager in West Sussex
Stella Black, the Macular Society’s regional manager in West Sussex

Thankfully, wet degeneration can be slowed and vision saved, if it is treated promptly with injections directly into the affected eye. Currently, the NHS spends more than £400million on these treatments.

Understandably, a reduction in central vision affects our ability to read, use a computer, drive or recognise a face and, during lockdown, macular degeneration patients have been more likely to feel lonely and isolated due to their visual disability.

However, the six Macular Society support groups which regularly meet around West Sussex have very successfully continued to meet on the telephone, enabling most members to attend easily.

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Stella Black, the charity’s regional manager in West Sussex, set up these conference calls and she has been delighted how they have proved to be a social lifeline during lockdown.

The society has also set up a volunteer befriending service for those who cannot attend the meetings, which has been very well-received.

But macular degeneration remains a worrying condition, especially in the wet form, and during my years working as a GP it has been very reassuring to be able to link patients into the support that is available through the Macular Society.

Becoming an expert in any condition that afflicts you is always a good strategy and the society enables its members to do exactly that.

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If you have macular degeneration and would like some support, please contact the Macular Society helpline on 0300 3030 111 Monday to Friday, 9am to 5pm.

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