The center of your retina has an area called the macula, which processes your central vision. The transformation of a light impulse works under high metabolic requirements that create a lot of oxidative stress over time.
Efficient heat and waste management are essential to maintaining good vision.
As the human eye ages, the retina and macula get thinner. Lipid and protein deposits called drusen can begin to build up beneath the macula, and this can damage the light-sensitive photoreceptor cells that help you see.
Drusen deposits combined with macula thinning can lead to a condition called age-related macular degeneration (AMD).
AMD can cause blurring or loss of central vision. You might not notice any changes in the early stages. However, as the condition progresses you might experience trouble with central vision tasks like reading or recognizing faces.
There are two types of AMD:
- Dry AMD: Dry AMD progresses slowly, as the macula thins and drusen deposits accumulate. Vision loss isn’t reversible, but you can slow its progression with lifestyle changes like smoking cessation, exercise, and dietary changes.
- Wet AMD: Wet AMD occurs when abnormal new blood vessels appear from the choroid and grow beneath the retina, and leak fluid or blood. This is called choroidal neovascularization. This can cause sudden changes to your eyesight. There are treatments for wet AMD that may restore some of your vision.
Dry AMD can progress to wet AMD. This can happen at any stage of dry AMD. In fact, some people may have had dry AMD for years, never visited the eye doctor, and never experienced any visual symptoms until the onset of wet AMD. That alone is a good reason to schedule routine eye exams.
The choroid is a layer under the retina that contains a network of blood vessels that draw heat away from the retina. As AMD progresses, the density of the choroidal blood vessels decreases.
To make up for this blood vessel loss, a substance called vascular endothelial growth factor (VEGF) causes new blood vessels to grow. This is called
As these new blood vessels grow abnormally, they break through the barrier between the choroid and the retina. When these new and abnormal blood vessels leak blood or fluid, dry AMD becomes wet AMD.
Wet AMD always begins as dry AMD.
Wet AMD is an advanced form of AMD and is always considered
It’s possible to have both wet and dry AMD
AMD can affect both eyes, or only one. For example, you can have both dry and wet in one eye but only dry in the other. It’s also possible to have dry AMD in only one eye.
Regular eye exams are a key part of preventing wet AMD. This is important even if you don’t notice any changes to your vision.
You can slow the progression of AMD by managing its contributing factors, which include:
- high blood pressure
- cardiovascular disease
- atherosclerosis (arterial plaque buildup)
- excess body weight
- tobacco use
- alcohol use
- excess sun exposure
- a diet high in saturated fat
If you smoke, quitting smoking is the most important step you can take to protect yourself from getting AMD. Changing your diet and staying physically active are two more ways you can reduce your risk and slow the progression of AMD. Cutting back on tobacco and alcohol use also helps.
Dietary changes that may help delay the progression of dry AMD include foods
- vitamin C
- vitamin E
- vitamin D
- DHA and EPA
There are other lifestyle factors beyond diet and exercise that affect AMD prevalence. For example, a 2021 study found evidence of a link between wet AMD and sleep duration.
The study found that people who slept fewer than 6 hours or more than 8 hours each night had a greater chance of developing wet AMD.
Wet AMD isn’t reversible, but it is treatable. Treatment can partially restore vision loss from leaking blood vessels.
Wet AMD treatments include:
This is the most common treatment for wet AMD. An ophthalmologist administers anti-VEGF medication via injection into the eye, or by using an eye implant. This medication blocks new abnormal blood vessel growth.
Anti-VEGF injections must be done at regular intervals. Your eye doctor can recommend a dosing schedule appropriate for your case.
This treatment uses laser energy to activate a photosensitizing drug that destroys abnormal choroidal blood vessels in your eye. You may need several treatments.
This is a stronger type of laser treatment that destroys new and unwanted blood vessels. This treatment may leave permanent blind spots, so it’s important to discuss the risks vs. benefits with your doctor.
Living with low vision is easier with the right skills and tools.
Vision rehabilitation can help you learn skills to remain independent even with AMD vision loss. A certified low-vision therapist can help in areas such as mobility, modifying your environment, and using adaptive equipment and low-vision devices.
You might use low-vision aids such as:
- tablets and computers
- large print reading material
- telescopic lenses
- magnifying devices like glasses, screens, and stands
- high-intensity reading lamps
- closed-circuit TVs to magnify reading material
AMD is a common cause of vision loss and affects about
Only about 15%–20% of people living with dry AMD progress to wet AMD. Yet wet AMD accounts for 80% of significant vision loss and remains
AMD isn’t reversible, but it is treatable. Regular eye exams can help you catch dry AMD in its early stages so you can slow its progression with diet and lifestyle changes.
Wet AMD always follows some form of dry AMD even if the dry AMD was never found. Wet AMD causes the most significant amount of vision loss, but there are treatments that may restore some lost vision.
With the right support, it’s possible to live independently with low vision. Routine follow-up eye care, visual rehabilitation, and low vision aids can help you remain self-reliant and maintain your autonomy.