Age-related macular degeneration is the leading cause of blindness in people over 60, but it's a very treatable condition, says ophthalmology specialist Dr. David Eichenbaum

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Tim Matheson
Credit: NETFLIX

It's been a challenging time for Doc in the third season of Virgin River.

In addition to worrying about Hope's safety during a hurricane, the town physician, Vernon "Doc" Mullins (Tim Matheson) is suffering from wet age-related macular degeneration.

"Age-related macular generation is the leading cause of blindness for folks ages 60 or older in the U.S.", says Dr. David Eichenbaum, an ophthalmology specialist in St. Petersburg, Florida. "While 11 million people in the U.S. have age-related macular degeneration, only about one million have the more advanced form that the character in Virgin River has — the wet macular degenerative form."

This type is caused by abnormal blood vessels that leak fluid and/or blood into the center part of the retina called the macula, Eichenbaum explains.

"The biggest risk factors are genetics and time," says Eichenbaum. But along with family history and age, the biggest modifiable risk factor is smoking. "There is a clear association between AMD and smoking, which likely has to do with cigarette smoke being directly toxic to certain layers of the retina and to the blood vessels," he says.

Early AMD symptoms include distortion of straight lines or reduced clarity. "Things may look wiggly, says Eichenbaum, adding that it afflicts one eye at a time, and that once a person has it in one eye, about half can get it in the second eye.

That's why early detection is so important. "If you catch it early you can often preserve a lot of vision or reverse some of the loss," he says.

Treatment options include eye injections called anti-VEGF, which temporarily stop the leaking and bleeding from the abnormal blood vessels — but they have to be repeated as often as every four weeks."

While treatment will not completely restore vision that has been lost, Eichenbaum says many patients will see some improvement when they start. "There's often some loss of vision between when it's diagnosed and partial recovery, which is why the poor fellow in the show is evidently not going to be practicing medicine anymore," says Eichenbaum.

"The good news is you can have partial recovery and maintenance, and people can remain independent and not wind up in dependent facilities like they used to."

The key, he says, is early detection.

"The most important thing for folks over 60 is to establish care with a general eye doctor to get annual eye exams. If the eye doctor sees there's a risk for progression for AMD, there are eye vitamins, micronutrients, which slightly reduce the risk in some patients."

"There's a lot you can do to reduce your risk — but it starts with a general eye exam, which everyone should be getting over age 60."