Last month, The Parliamentary Friends for Eye Health and Vision Care launched a report, Geographic Atrophy: We Can’t Wait and See, which highlights the urgent need to address the significant impact of geographic atrophy (GA).
Geographic atrophy (GA), an advanced form of age-related macular degeneration (AMD), leads to irreversible central vision loss, often resulting in legal blindness and severely impacting quality of life.
Affecting primarily those over 65, GA can hinder daily tasks like reading and driving. In Australia, GA-related vision loss costs over $1.8 billion annually, with significant healthcare and wellbeing expenses.
Featuring input from Retina Australia and other key vision health organisations, including Macular Disease Foundation Australia, Optometry Australia and Vision 2020 Australia, key recommendations from the report include funding vision support services, raising awareness, ensuring access to new therapies and supporting research to better treat GA.
What exactly is GA?
Geographic atrophy, often referred to as "dry" AMD, occurs when the light-sensitive cells in the retina (called photoreceptors) and the underlying retinal pigment epithelium (RPE), which is a layer of specialised cells located at the back of the eye, just beneath the retina, begin to die.
The macula, which is the central part of the retina responsible for sharp, detailed vision, becomes damaged. Over time, this leads to a gradual, painless, but permanent loss of central vision.
Unlike its counterpart, "wet" AMD, which involves sudden bleeding or fluid leakage in the retina, GA progresses slowly. It’s a chronic condition that, if left untreated, will eventually result in significant vision impairment.
How common is GA?
In Australia, it’s estimated that between 75,000 to 100,000 people are living with GA.
The condition is particularly common in people of European descent and becomes more prevalent as we age, with the likelihood of developing the condition increasing significantly after the age of 50.
What causes GA?
The development of GA is influenced by a mix of genetic, environmental and age-related factors:
- Certain gene variants related to the immune system and inflammation have been linked to a higher risk of developing GA
- Smoking, alcohol consumption, poor diet and excessive UV light exposure can increase the risk of GA
- As we age, the cells in the retina deteriorate, leading to the cellular damage associated with GA
How is GA diagnosed?
GA can be detected through a routine eye exam by your optometrist.
Using specialised imaging technology, such as a retinal photograph, they can identify thinning areas of the retina and regions where photoreceptors and RPE cells have died.
These areas often form a distinct pattern, giving GA its name due to the “geographic” or map-like appearance.
What are the symptoms of GA?
In the early stages of GA, symptoms may not be obvious, particularly if only one eye is affected.
However, as the condition progresses, individuals may notice:
- Gradual loss of central vision that impacts activities like reading, driving, and recognising faces
- Blurred or distorted vision, where straight lines may appear wavy or objects may seem unclear
- Blind spots or gaps in your central vision may start to appear
- Difficulty seeing in low light, making night driving or reading in dim lighting more challenging
- Decreased contrast sensitivity or more difficulty in differentiating between similar colours or shades
Regular eye exams are essential for early detection and monitoring of GA, especially since early symptoms can be masked by the unaffected eye.
Living with GA
The impact of GA extends beyond vision loss. Everyday tasks such as reading, watching television or recognising loved ones' faces can become challenging.
This can lead to frustration, anxiety and a sense of dependence on others. Vision impairment is also linked to physical risks, such as an increased likelihood of falls, especially among older adults.
GA can significantly affect quality of life, reducing independence and limiting participation in social or work-related activities. The emotional toll is real and many people with GA experience feelings of isolation or depression.
What can be done?
While there is currently no cure for geographic atrophy, managing the condition is key to maintaining as much independence as possible.
Early detection and monitoring through regular eye exams are crucial and research is ongoing to develop new treatments that may slow down or prevent vision loss.
For those affected by GA, there are support services available.
Organisations like Retina Australia, Macular Disease Foundation Australia and Vision 2020 Australia offer resources to help individuals cope with vision loss and maintain their quality of life.
A final thought
By staying informed, seeking regular eye care, and making lifestyle changes where possible, it’s possible to manage the impact of GA. If you or a loved one are experiencing any symptoms, find your closest optometrist here to book in an eye examination today.
