World Braille Day is observed every year on 4 January to celebrate the invention of braille. Braille is a tactile reading and writing system comprising raised dots to represent the letters of the alphabet which is used by blind and visually impaired people. It was invented by Louis Braille in the early nineteenth century and has since undergone a series of improvements making it an accessible form of communication and enhancing literacy amongst those who are blind or partially sighted. World Braille Day not only serves as a reminder of the importance of accessibility and independence for them, but also helps to raise awareness of conditions causing sight loss.
Age-related macular degeneration (AMD) is the biggest cause of sight loss in the UK, affecting over 600,000 people with 200 people diagnosed every day. The condition usually affects people over the age of 50 but other risk factors include smoking, high blood pressure, being overweight and having a family history of AMD.
There are two forms of AMD – dry and wet. Dry AMD is most common, affecting 90% of people who have the condition. It is a slow deterioration of the cells of the macula, so for most people it develops over many months or years meaning that they can often carry on living as normal for some time. Unfortunately there is currently no treatment available.
Wet age-related macular degeneration, on the other hand, can develop very suddenly with vision deteriorating quickly over a matter of weeks or months. It occurs when abnormal blood vessels grow into the macula, leaking blood or fluid which leads to the scarring of the macula. The condition causes rapid loss of central vision, blurry or distorted vision and reduces the ability to see colours or make out fine detail. Although people affected by the condition are not usually at risk of losing all vision as the ability to see in the periphery remains, they are often unable to drive, read, watch TV or recognise the faces of their closest friends and family.
Unlike dry AMD, wet AMD can be treated through regular injections of drugs into the eye to stop the growth of the abnormal blood vessels. These injections stop vision getting worse in nine out of ten people and improve vision in three out of ten. Some patients do not respond to the injections and instead may be offered a form of laser treatment. There have also been recent successful trials using new stem cell based treatment which has enabled patients to regain their sight.
However, wet AMD can only be treated successfully if it is diagnosed early and action is taken quickly. In fact, patients can lose their sight within three months if the condition is left untreated. Therefore, the Royal College of Ophthalmologists emphasises the need for urgency in its guidelines which state that suspected wet AMD cases should be diagnosed within one week and treated within a further week. Given that the guidelines stress the importance of early diagnosis and intervention, it is concerning that less than one third of patients receive a diagnosis from a retinal specialist within seven days of first contact with an optometrist or GP and some optometrists are required to refer patients to their GP first which causes significant delays.
Arran Macleod, an associate in Penningtons Manches’ clinical negligence team, comments: “Unfortunately, our ophthalmic sub team sees first hand how those who have suffered from wet AMD require help and assistance due to the impact sight loss has on their daily lives. We receive enquiries from patients who believe that they have experienced delays in referral to a hospital specialist, in the appropriate diagnosis or in starting the necessary treatment following a diagnosis of wet AMD. As a result, many of our clients have poor outcomes including further deterioration in their sight.
“If you, a friend or family member have concerns about the diagnosis and / or treatment of age-related macular degeneration, or indeed the management of any other surgical procedure, please contact our specialist ophthalmology team on freephone 0800 328 9545 for further information.”