AMD Eye Treatment in Singapore: Age-Related Macular Degeneration Care at LSC Eye Clinic

Age-related macular degeneration (AMD) is an age-related disease affecting the macula, the central part of the retina responsible for sharp and detailed vision. Symptoms associated with AMD are distortions of central vision, such as seeing that words that appear wavy in the central area of a sentence when reading.

The symptoms are blurred central vision, straight lines appearing wavy, dark patches in central vision. AMD can make everyday activities such as reading, recognising faces and driving more difficult.

Some patients may also discover some level of difficulty seeing the central areas of a person’s face clearly. In most cases, peripheral or side vision is preserved.

AMD is generally divided into 2 types: dry AMD and wet AMD. Most cases of AMD are of the dry type, in which deposits called drusen form under the retina, causing thinning of the retina in the macular area, affecting proper function of the macular cells. Visual loss at this stage is gradual, and treatment consists of lifestyle changes such as quitting smoking, protection from UV light, and management of cardiovascular health, particularly for conditions like heart disease, high blood pressure, and high cholesterol. Dietary supplements may be beneficial in helping to control the disease.

Only about 10% of AMD are the wet type. However, some patients with dry AMD may eventually lead to wet AMD, which is often associated with a more sudden drop in eyesight, caused by leakage and bleeding from abnormal retinal blood vessels at the macular area. Wet AMD requires prompt treatment involving photodynamic treatment, laser or injectable anti-vascular endothelial growth factors, to prevent further damage from bleeding vessels, and irreversible central visual loss from macular scarring.

There is no known cause to how one can develop age-related macular degeneration. However, there are certain factors that may increase your risk of developing the disease. These risk factors include:

• Being 50 years old and above
• Having a family history of macular degeneration
• Smoking
• Being overweight or obese
• Having cardiovascular disease, high blood pressure and/or high cholesterol

Macular degeneration often goes unnoticed in its early stages due to a lack of symptoms and typically isn’t recognised until it affects both eyes. The initial indication is blurred vision that is characterized by a dim, blurry spot in the center of your sight, which may enlarge or darken as time progresses. Symptoms of macular degeneration may include the following:

• Difficulty recognising faces and seeing fine details
• Onset of blurred vision, especially in your central vision
• Shadows or missing areas of vision (i.e dark area in the centre of vision)
• Distorted vision, e.g., straight lines may appear wavy
• Problems distinguishing colours, specifically dark colours from other dark colours and light colours from other light colours
• Slow recovery of visual function after exposure to bright light
• Reduced contrast sensitivity, making it harder to distinguish different levels of brightness

If you experience any of these symptoms, see an eye specialist at LSC Eye Clinic as soon as possible.

Not every individual will develop total blindness from AMD, although there may be loss of central vision. The vision loss may significantly impact day-to-day activities such as driving or reading.

Receiving age macular degeneration treatment early can slow down the progression of the condition and minimise vision loss. If you experience any changes in your vision or if you are 50 years old or older, it is important to know your risk for AMD.

With proper care and early management, you can prevent vision loss from AMD. Seek advice from a trusted and experienced eye specialist today.

AMD eye treatment depends on whether the condition is dry or wet, the stage of progression and the patient’s overall eye health. At LSC Eye Clinic, treatment pathways discussed during consultation may include:

• Dry AMD monitoring, with regular review and home monitoring using an Amsler grid
• Dietary and lifestyle support, including AREDS2-based supplements where appropriate
• Anti-VEGF intravitreal injections for wet AMD, used to reduce leakage and abnormal vessel growth
• Photodynamic therapy for selected cases of wet AMD
• Laser treatment in specific AMD subtypes or where abnormal vessels are located away from the central macula
• Low vision support, including aids and rehabilitation strategies for patients with established vision loss

The treatment approach is tailored to the individual based on AMD type, stage and response to any previous therapy.

Dry AMD is the more common form and tends to progress gradually over time. Management typically focuses on observation, lifestyle measures and regular monitoring rather than active intervention in the early and intermediate stages.

Key elements of dry AMD care include:

• Regular monitoring with dilated eye examinations and OCT (optical coherence tomography) scans to track changes in the macula over time.
• Home monitoring using an Amsler grid, which helps patients detect distortion or new central vision changes between clinic visits.
• Lifestyle measures such as quitting smoking, managing cardiovascular risk factors, eating a diet rich in leafy green vegetables and protecting the eyes from ultraviolet light.
• Nutritional supplements based on the AREDS2 formula, which may be recommended for patients with intermediate dry AMD or advanced disease in one eye.

The aim of dry AMD management is to reduce the risk of progression and to catch any conversion to wet AMD early. Patients with dry AMD are typically reviewed at intervals determined by the eye specialist.

Wet AMD is treated primarily with anti-vascular endothelial growth factor (anti-VEGF) injections, delivered directly into the eye. These medications work by reducing leakage from abnormal blood vessels and slowing their growth, which helps preserve central vision and reduce the risk of further damage.

The injection itself is given under topical anaesthesia in a sterile clinic environment. Most patients describe the sensation as brief pressure rather than sharp pain. The procedure typically takes only a few minutes.

Anti-VEGF treatment is not a one-off intervention. Most patients require repeated injections over time, with the schedule guided by the response of the disease. Common approaches include:

• Loading phase: Initial injections are usually given at monthly intervals for the first three doses to establish disease control.
• Maintenance phase: Following the loading phase, treatment intervals may be extended based on OCT findings and visual response, following a treat-and-extend or pro re nata (as needed) approach.
• Ongoing review: Regular scans and clinical assessment guide whether further injections are needed.

Early initiation of anti-VEGF treatment in wet AMD is associated with better visual outcomes, which is why prompt assessment matters when wet AMD is suspected.

In selected cases of wet AMD, treatments other than anti-VEGF injections may be considered:

• Photodynamic therapy (PDT): Involves the use of a light-sensitive medication (verteporfin) activated by a specific wavelength of laser light. The activated medication closes off abnormal blood vessels. PDT may be considered for certain wet AMD subtypes such as polypoidal choroidal vasculopathy (PCV), sometimes in combination with anti-VEGF injections.
• Conventional laser treatment: Used in a small subset of cases where abnormal blood vessels are located away from the central macula. The laser seals leaking vessels but is generally not suitable when the vessels are directly under the centre of the macula, as the laser itself may damage central vision.

These treatments are used in specific scenarios rather than as first-line options for all wet AMD. The decision is based on imaging findings, lesion location and the type of abnormal vessel growth identified during assessment.

Specialist-led AMD care is particularly relevant for patients with:

• Wet AMD or suspected conversion from dry to wet AMD, where prompt intervention can affect visual outcomes
• Active leakage identified on OCT or fundus imaging
• Vision changes despite ongoing monitoring or treatment
• Progression of dry AMD to more advanced stages
• Complex AMD subtypes such as polypoidal choroidal vasculopathy
• Suboptimal response to existing treatment

An ophthalmologist tailors treatment based on AMD type, lesion location, imaging findings and overall visual needs. Coordinated care between the patient, specialist and any other treating doctors is particularly important when systemic conditions, such as diabetes or cardiovascular disease, are also being managed.

Several factors influence the choice of AMD eye treatment for an individual patient:

• Type of AMD: Dry AMD is generally monitored and managed conservatively, while wet AMD typically requires active treatment with anti-VEGF injections.
• Stage of condition: Early and intermediate dry AMD may be managed without medication, while advanced or wet AMD usually requires intervention.
• Lesion location: The position of abnormal blood vessels within the macula influences whether laser or photodynamic therapy is appropriate.
• Response to prior therapy: Patients who have not responded fully to initial anti-VEGF treatment may benefit from a change in medication, combination treatment or adjusted dosing intervals.
• Vision needs and lifestyle: Treatment intensity is shaped by the patient’s day-to-day visual demands and ability to attend regular review appointments.
• General eye health: Co-existing conditions, such as cataracts or glaucoma, may influence the treatment plan.

An eye specialist works through these factors with the patient to identify a plan that addresses the condition while remaining sustainable over the long term.

A typical AMD treatment visit at LSC Eye Clinic follows a structured process:

• Clinic review: Assessment of visual acuity, any new symptoms and ongoing eye health.
• Imaging: OCT scans of the macula to identify fluid, drusen or signs of activity, along with other imaging as needed.
• Pre-treatment preparation: For patients receiving anti-VEGF injections, the eye is prepared with antiseptic drops and anaesthetic drops to minimise discomfort.
• Injection or procedure: The injection itself takes only a few moments. For photodynamic therapy or laser, the procedure is performed in a controlled clinic setting.
• Post-treatment guidance: Patients receive instructions on what to expect in the hours and days following treatment, including any signs that warrant earlier review.
• Follow-up scheduling: The next review is booked based on the treatment plan and disease activity.

Patients are encouraged to bring a family member or companion to AMD eye treatment visits, particularly for the first injection or procedure.

Age macular degeneration treatment, particularly for wet AMD, is an ongoing process rather than a one-time event. Long-term care typically involves:

• Regular review visits to assess visual acuity, symptoms and macular health.
• Repeat OCT scans to monitor for fluid, leakage or new areas of activity.
• Treatment adjustments based on disease response, including changes in injection intervals or the addition of other modalities.
• Home monitoring with an Amsler grid between visits, to flag any new distortion or central vision changes early.
• Coordination with the patient’s other doctors when systemic conditions affect overall health.

The frequency of visits depends on the type and stage of AMD. Patients on active wet AMD treatment may be seen monthly to begin with, with intervals extended as the condition stabilises. Dry AMD review intervals are typically longer but still structured to catch any change in status.