Actress Judi Dench says she 'can't even see' due to macular degeneration. Here's what to know about the leading cause of vision loss for people over 50.
Dame Judi Dench has no acting roles lined up and may be on the cusp of retirement because she “can’t even see,” the legendary actress, 89, recently told reporters at the Chelsea Flower Show in London, according to Deadline. In 2012, the Oscar winner shared that she’d been diagnosed with the eye condition macular degeneration, which is the most common cause of vision loss in people 50 and older, according to Johns Hopkins Medicine.
Dench has shared in previous interviews that the condition has affected her ability to read scripts, People reports. "I've had to find another way of learning lines and things, which is having great friends of mine repeat them to me over and over and over again,” she said at a 2021 event. "So I have to learn through repetition, and I just hope that people won't notice too much if all the lines are completely hopeless!"
How common is macular degeneration, and what causes it? Experts explain the condition.
What is age-related macular degeneration?
Macular degeneration happens with age, when the macula, at the center of the retina — “the part of the eye that sees the world for us,” Dr. Vlad Diaconita, a retinal and vitreoretinal surgeon at Columbia University, tells Yahoo Life — starts to get damaged and its photoreceptors begin to die off. The macula lets us see what’s directly in front of us, so most commonly only the center of the vision is affected by macular degeneration.
Early-stage macular degeneration affects about 1 in every 10 Americans ages 50 or older, and risks rise with age, according to the nonprofit Prevent Blindness. The disease is more common in white people and those with lighter eye colors, tends to run in families and has a genetic component, although it is not considered hereditary, Dr. Ananth Sastry, an ophthalmologist with the Cleveland Clinic, tells Yahoo Life. According to the BrightFocus Foundation, you have about twice the average risk of getting macular degeneration if one of your parents develops it.
Some 90% of macular degeneration cases are the slower, “dry” form of the disease, BrightFocus Foundation estimates. In some cases, dry macular degeneration can convert to “wet” degeneration, caused by “bleeding or a leaky blood vessel,” that leads to a much more rapid loss of visual acuity, explains Diaconita.
What are the symptoms?
Most people won’t know they have macular degeneration during the disease’s early stages, says Diaconita. That’s why finding out if you have a family history is so important. If you have relatives — especially parents, siblings or grandparents — with macular degeneration, your eye doctor can start screening you for changes to the retina, using a painless imaging technique and specialized vision tests.
Vision changes typically begin at the intermediate stage of the condition. These may be small blind or blurry spots — “like a thumbprint” — that make it difficult to see what’s at the center of your field of vision, and grow over time, says Diaconita. The disease can also make straight lines appear wavy. These changes make certain tasks, including reading and driving, particularly difficult, but macular degeneration rarely impairs mobility because it doesn’t affect peripheral vision, Diaconita says. People with macular degeneration “may not be able to tell if the dial on the stove is turned to ‘off,’ but they can get to the stove,” he explains.
The more common “dry” form of macular degeneration very rarely leads to total blindness, Diaconita says. But, while “wet” macular degeneration accounts for just 10% of cases of the disease, it’s the cause of 90% of legal blindness, according to the BrightFocus Foundation.
Is there a cure for macular degeneration?
No, there’s no cure. However, there are treatments, lifestyle changes and supplements that may help slow the eye disease’s progression. Injectable monthly treatments can slow its progression, and special supplements containing high doses of antioxidants and zinc may help to delay central vision loss. The supplements — called AREDS 2 — can be bought over the counter, but are intended to be used only by people who have been diagnosed with macular degeneration, and you should talk to your eye doctor first, says Sastry.
How to reduce risks of macular degeneration
Age is the main risk factor for macular degeneration, but you do have some control over other factors that contribute to how soon and how rapidly vision loss begins, say Diaconita and Sastry.
Diaconita advises his patients to quit or cut back on smoking, if possible. “Anything that negatively affects the blood vessels is probably bad,” he says, including “blood pressure that is dangerously low, high blood pressure, uncontrolled heart disease or uncontrolled risk of stroke.” That’s why maintaining a healthy weight, exercising and eating a diet high in vegetables, fruits and fish can help reduce your risks, too, according to the BrightFocus Foundation.
Sastry adds that everyone, but especially those with a family history of macular degeneration, should get screened every year starting at age 50. Once the disease is diagnosed, your ophthalmologist can track you and recommend vitamins or treatments to slow the progression. “Treatment can, at the very least, prevent it from getting significantly worse at a rapid rate and, best case, recover a significant amount of vision and protect it for as long as possible,” Sastry says.
