Age-related macular degeneration (AMD) is a common and progressive eye disorder. It ultimately leads to central vision loss, which means it affects what you see in front of you when you’re looking straight ahead.
It’s estimated that nearly
AMD is caused by deterioration of the macula, a small area in the center of the retina in the back of the eye.
Your peripheral vision is what you see on the side when you’re looking straight ahead. In most cases, macular degeneration doesn’t cause total blindness because it usually doesn’t affect your peripheral vision. Instead, it typically causes central vision loss.
There are two types of macular degeneration:
- dry macular degeneration
- wet macular degeneration
Dry macular degeneration affects about 85-90% of people with the condition. It occurs due to small yellow deposits called drusen developing under the macula.
Wet macular degeneration affects the remaining 10-15%. It occurs when abnormal blood vessels develop under the retina and macula.
Macular degeneration is a progressive disease. This means that it will get worse over time.
Early warning signs
You may not notice vision problems in the early stages of the disease. You’re also less likely to notice vision changes when they affect both eyes at the same time.
If you do start to show early signs, you may have trouble seeing in dim light. No matter how close or far away you look, your vision may seem less clear than it used to be, and you may not see as much color as before. All of this is due to a slow loss of center vision.
However, these vision changes might not be obvious for each person with the condition.
Later symptoms
As AMD progresses, you will start to experience many of the following symptoms, depending on the type of AMD you have.
Dry macular degeneration
- continued reduction in central vision
- a distortion of straight lines in your field of vision
- the need for brighter lighting
- difficulty adapting to low lights
- blurriness
- trouble recognizing faces
- retinal damage
Wet macular degeneration
Some symptoms of wet macular degeneration resemble those of dry macular degeneration, such as visual distortions and reduced central vision.
Other symptoms of wet macular degeneration you may also experience:
- a blurry spot in your field of vision
- a dark spot in the center of your vision due to blood vessels bleeding or leaking fluid
- hazy vision
- rapidly worsening symptoms
Wet macular degeneration usually
There’s currently no cure available for macular degeneration, but your doctor can recommend options to help slow the progression.
Treatment for wet macular degeneration
If you have vision loss from either dry or wet macular degeneration, you may benefit from working with a low-vision rehabilitation specialist. The specialist can teach you how to adjust to and cope with vision loss.
In terms of treatment, you have the following options:
Medications
Your doctor
These medications are known as anti-vascular endothelial growth factor (anti-VEGF) drugs. They include ranibizumab (Lucentis) and aflibercept (Eylea). It can take several weeks of treatment before you notice a difference.
In addition, two new medications have been approved recently by the FDA to treat dry macular degeneration: avacincaptad pegol (Izervay) and pegcetacoplan (Syfovre).
Photodynamic therapy
Another treatment option is photodynamic therapy. Your doctor injects medication into a vein in one of your arms and then uses a special laser to close leaking blood vessels. This type of therapy can improve your vision, but you may need multiple treatments. It is used much less commonly now.
Photocoagulation
Photocoagulation is another option. This involves the use of high-energy laser beams to destroy abnormal blood vessels. The purpose of this therapy is to help stop bleeding and reduce further damage to your macula. However, the laser can cause scarring and leave a blind spot on your eye. It is rarely used now.
Even if photocoagulation is successful, abnormal blood vessels can regrow, and you’ll have to return for another treatment.
Treatment for dry macular degeneration
If you have dry macular degeneration, your doctor may also suggest that you work with a low-vision rehabilitation specialist. Your doctor may recommend that you take eye vitamins in the AREDS 2 formulation.
In addition, they may recommend surgery to help improve your vision. During the surgery, they’ll implant a telescopic lens known as an implantable miniature telescope in your eye to replace the natural lens. This magnifies your field of vision. There is a set of very strict criteria for patients to qualify for such surgery.
It isn’t known why some people develop macular degeneration, while others don’t. However, certain factors can
These risk factors include:
- having a family history of macular degeneration
- being over 55 years old
- smoking
- being a non-Hispanic, white person
- having cardiovascular disease
It’s important to have annual eye exams even if your vision appears normal. You should tell your doctor about any vision changes you experience, too.
Your doctor can conduct a variety of tests to diagnose macular degeneration.
For example, they can use special eye drops to dilate your eyes and then check the back of your eyes for signs of fluid, blood, or yellow deposits.
Other tests include the following:
- Fundus photography: The doctor takes a picture of the inside surface of your eye with a special camera.
- Fluorescein angiography: Your doctor
injects a colored dye into a vein in your arm. The dye will eventually travel to your eye, allowing your doctor to examine the blood vessels there. - Indocyanine green angiography: Your doctor injects your arm with indocyanine green dye. They can use this test to confirm the results of fluorescein angiography. It can also give the doctor information about the choroid layer of the eye that is not diagnosed with fluorescein angiography.
- Optical coherence tomography or fundus autofluorescence: In these tests, the doctor takes cross-sectional images of the retina and checks for swelling, thickening, or thinning.
Q: How often should I get my eyes checked if I have wet AMD? Will I need to see a specialist?
A: There’s no standard follow-up strategy, but many specialists recommend evaluations every 4 to 8 weeks until things stabilize, with those visits extended accordingly.
Wet AMD is a serious eye problem that can lead to severe consequences if treatment is delayed or your current treatment plan isn’t working. That’s because the abnormal blood vessels that emerge underneath the retina in wet AMD leak fluid and blood, which can disrupt the retina’s ability to transmit a clear visual image. Over time, fibrosis and scarring can permanently damage the retina.
Any eye doctor (ophthalmologist or optometrist) may suspect your symptoms could be AMD. But they will likely refer you to a retinal specialist (ophthalmologist) for further evaluation and treatment.
Once wet AMD has been diagnosed and treatment initiated, the specialist develops a personalized follow-up plan based on your response to therapy.
If you’re living with wet AMD and notice any changes to your vision, don’t wait until your next scheduled appointment. Contact your ophthalmologist immediately.
William C. Lloyd III, MD, FACSAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.You should always check with your doctor when you experience any health changes or changes to your vision specifically. However, certain vitamins may help to slow the progression of late macular degeneration affecting only one eye or intermediate macular degeneration.
The National Eye Institute (NEI) sponsored two large studies that examined the role of nutritional supplementation in the disease. The studies are known as Age-Related Eye Disease Study (AREDS) and AREDS2.
In the initial study, researchers found that daily supplementation reduced the 5-year risk of intermediate disease progressing to late disease by
The original AREDS multivitamin formula, based on the findings from the
- 500 milligrams (mg) of vitamin C
- 400 international units (IU) of vitamin E
- 80 mg of zinc
- 15 mg of beta carotene
- 2 mg of copper
Beta carotene is not recommended for people who currently smoke or are used to smoke because it
In 2010, the
- lutein
- zeaxanthin
AREDS2 contains:
- 500 mg of vitamin C
- 400 IU of vitamin E
- 80 mg of zinc
- 10 mg of lutein
- 2 mg of zeaxanthin
- 2 mg of copper
According to a
Important: Always consult with your doctor before starting any new supplements or changing your current intake.
Experts have not determined a way to prevent macular degeneration. However, you can help reduce your risk for the disease by maintaining a health-promoting lifestyle.
This includes:
- quitting smoking if you smoke
- eating a nutrient-dense diet as often as possible
- maintaining a healthy-for-you weight
- exercising consistently, as much as you can
One of the complications of macular degeneration is being unable to perform certain tasks on your own. As the disease progresses, it becomes increasingly difficult to read or complete other activities.
It’s common for people with macular degeneration to be unable to drive a car. If your doctor diagnoses you with macular degeneration, you may have to complete a vision test periodically to ensure you’re capable of operating a car.
Other complications are described below.
Depression and anxiety
Up to 39% of people with macular degeneration experience some form of depression, which can be partially attributed to vision loss.
Anxiety is also common. However, people with the condition and people without the condition ultimately experience similar rates of anxiety.
Speak with your doctor if you’re experiencing the symptoms of depression or anxiety. They can suggest treatments, such as medication, counseling, or a support group for people with vision impairments, to help improve your mental health.
Visual hallucinations
As your vision decreases, your brain may compensate by creating false images or hallucinations. This is not a symptom of a mental health problem, and it usually only occurs with severe vision loss.
Some people with AMD experience hallucinations, according to a
According to a 2020 meta-analysis of 18 studies, there was a
You should discuss your hallucinations with your doctor or a support group. They can help you find ways to cope.
Can you reverse age-related macular degeneration?
It’s not possible to reverse AMD, nor is there a cure. However, treatment can slow the progression of the symptoms.
What are the three stages of macular degeneration?
With AMD, you can experience early, intermediate, and late symptoms. Some people may not experience symptoms in the intermediate stage, whereas in others, the symptoms may first appear in the intermediate stage.
How fast does age-related macular degeneration progress?
Usually, AMD progresses slowly
Macular degeneration is not preventable, but it’s possible to diagnose the condition early with regular dilated eye exams. Early treatment can help slow the disease progression and minimize vision loss.
If you’re experiencing the symptoms of macular degeneration or notice other changes in your vision, make an appointment to speak with your doctor. If you have a family history of ARMD, consider having regular eye exams with an ophthalmologist.