Age-related macular degeneration (AMD) is a common cause of central vision loss.
AMD can occur in two ways: wet (exudative) and dry (atrophic). Both can interfere with daily activities that require the use of your central vision.
If you’re experiencing the early stages of dry AMD, you might not notice vision changes right away. Dry AMD progresses slowly as macular tissue thins and stops working the way it should.
However, wet AMD progresses rapidly, causing noticeable changes to your vision.
You may wonder whether there are activities you should stop, like driving. It’s possible that you’ll be able to keep driving, but you may need to adapt your routine to keep yourself and others safe.
The macula, a small area of the retina in the eye, is responsible for central vision. AMD is the result of structural changes that interfere with macular function.
Dry AMD features thinning and drying of the macula along with small, yellow deposits of proteins and lipids called drusen. At least 80% of people living with AMD have the dry type. It’s not curable, but you can slow its progression with dietary and lifestyle changes.
An estimated 10% to 15% of people with dry AMD experience a progression to wet AMD.
Wet AMD occurs when abnormal blood vessels grow underneath the retina. These vessels can leak fluid, which leads to macular scarring and vision loss.
Unlike dry AMD which can take years to progress, wet AMD can affect your eyesight in a matter of weeks. Dry AMD vision changes are often gradual, but the impact of wet AMD is more pronounced. However, in some cases, vision loss from wet AMD might be restored using anti-vascular endothelial growth factors (VEGF) injections.
While your peripheral vision remains intact, AMD can cause darkening, distortion, or blurring of the things you look at directly. You might experience difficulty with tasks like reading, recognizing faces, and driving.
Unsafe driving conditions can intensify the impact of AMD.
For example, many drivers living with AMD experience difficulty while driving at night. Driving in unfamiliar locations and in busy traffic can also be challenging with AMD.
You may experience more difficulty with:
- staying in one lane
- maintaining a safe distance from other vehicles
- monitoring traffic lights at intersections
Weather events that reduce visibility can also pose a challenge. Overcast skies that dim available light, driving rain, and fog are examples.
You can reduce the risk of driving mishaps by driving only:
- during the day
- when the sky is clear
- when the traffic is light
- in areas you know well
If you need to travel during rush hour or when visibility is reduced, it might be easier to have a friend or family member drive. Using a paid driving service is another option.
You can also take advantage of delivery services for essentials like groceries, and schedule virtual appointments rather than in person.
For the times you drive, consider using a type of low-vision aid, such as:
- bioptic telescope glasses to make objects look larger
- yellow or orange lenses to improve contrast
- sunglasses to reduce glare
- prismatic lenses to help both eyes work together
As long as you meet the visual acuity and visual field requirements for a driver’s license in your state, you may be able to continue driving during the early stages of AMD.
However, if you have parts of your macula that no longer function, this increases the chance that you have a blind spot in part of your visual field. This type of blind spot might prevent you from seeing an oncoming car, or a child crossing the street.
Even if you have one eye without a blind spot, relying on one eye may reduce your depth perception.
The study included a road test component using dual-brake vehicles so that an occupational therapist could ride along and observe.
Study participants with AMD had more critical errors than those without AMD. Critical errors were defined as driving errors that required the observing instructor to intervene.
Regular eye exams can monitor your vision for changes like blind spots. Your eye doctor can help you decide when it’s time to transition from being a driver to having others provide this service for you.
With treatment, wet AMD can sometimes enter periods of remission. This means you may still be able to drive if your vision meets the legal requirements for driving in your state.
AMD is the leading cause of significant vision loss in people over 50 years of age. The central vision that AMD affects is crucial for safe driving.
Many people continue driving in the early stages of AMD. Prompt treatment for wet AMD can sometimes restore vision enough so that you can continue to drive.
Self-imposed restrictions, such as not driving at night, can reduce your chance of accidents. Low-vision tools such as bioptic telescope glasses can also help.
Regular eye exams and discussions with your eye doctor can help you decide if and when the time is right for you to stop driving.