Macular degeneration is a common age-related eye disorder that can lead to reduced vision. Early symptoms can be subtle, which is why regular eye checkups are critical.
Macular degeneration, or age-related macular degeneration (AMD), is a degenerative eye disease. It happens when a critical layer of cells beneath the macula breaks down and slowly disappears. The macula, a small region located right in the center of your retina, is essential for crisp, precise vision.
Damage to the macula can cause central vision loss. It doesn’t affect your peripheral vision — what you see on the side when you’re looking straight ahead.
Macular degeneration is common, affecting
There are two types:
- Dry macular degeneration: Dry macular degeneration involves the accumulation of waste products and photoreceptor debris, called drusen, that form under the thinning macula. It’s common, affecting 85–90% of people with macular degeneration.
- Wet macular degeneration: Wet AMD is a less common type that occurs when new blood vessels form under the retina. The vessels can leak fluids and blood, disrupting the complex retinal anatomy, which may result in macular scarring.
The early warning signs of macular degeneration are not obvious. In fact, many people only notice issues when their vision becomes blurry. That’s why it’s important to regularly visit an eye doctor, who can diagnose the condition early.
The early warning signs of macular degeneration can be subtle or nonexistent.
Any early and intermediate macular degeneration symptoms are always for dry macular degeneration. If it progresses, the symptoms can be related to either dry or wet types.
Often, early macular degeneration causes no symptoms. That’s why it’s difficult to catch it in its early stages without seeing an eye doctor.
If early symptoms do occur, you may have difficulty seeing in low light. Your eyesight may appear far more blurry than before, whether seeing near or far. Colors may not seem as bright as before. This is all caused by a gradual loss of central vision.
However, these signs might not be noticeable to some people. Visiting an eye doctor for regular screenings is the best way to know whether you have macular degeneration.
Intermediate macular degeneration might cause some vision loss or vision changes. But again, in many instances, there might be no noticeable symptoms.
In the later stages, macular degeneration may cause symptoms such as:
- lines looking wavy or crooked
- blurriness in the center of your vision
- seeing blank spots
- increased difficulty seeing in low light
- colors appearing less bright
Severe changes may signal the development of wet macular degeneration. If this occurs, it will often cause sudden and significant loss of central vision.
To diagnose macular degeneration, an eye doctor will typically start by asking about your medical history. This can help them consider your risk factors for developing the condition.
Then, your eye doctor can use various tests, such as:
- Amsler grid test: The Amsler grid test is a square-shaped graph with a dot in the center. If you have macular degeneration, some of the lines may look wavy, curved, or absent.
- Dilating eye drops: These drops widen your pupils. Your eye doctor will then examine the inside of your eye using a special lens.
- Optical coherence tomography (OCT): With this test, your eye doctor will use a machine to scan your retina and macula.
- Fluorescein angiography: With this procedure, your eye doctor will intravenously inject fluorescein, an inert vegetable dye, into your arm. This dye highlights the blood vessels in the back of the eye, and time-lapse photography allows the doctor to identify anything unusual in the blood vessels.
What are the risk factors?
Some people may be more likely to develop macular degeneration. Risk factors can include:
- having a family history of macular degeneration
- having hypertension (high blood pressure)
- having high cholesterol
- being over age 50
- being overweight or having obesity
- eating a diet high in saturated fats
- smoking cigarettes
There’s no cure for macular degeneration. But some therapies can help prevent or delay vision loss. The best option depends on the stage and type of macular degeneration.
Early macular degeneration
There’s no treatment for early macular degeneration. Instead, your eye doctor will monitor your eyes during regular exams and recommend lifestyle changes, such as:
- quitting smoking
- eating a healthy diet
- exercising regularly
- maintaining healthy blood pressure and cholesterol
- reducing eye exposure to ultraviolet (UV) light
Intermediate macular degeneration
Your eye doctor might recommend supplements that help prevent the progression to late macular degeneration.
Late dry macular degeneration
Currently, there’s no treatment specifically made for late dry macular degeneration.
Late wet macular degeneration
- Anti-vascular endothelial growth factor (VEGF) drugs are painlessly injected into the eye. These can help stop the proliferation of abnormal vessels.
- Laser photocoagulation uses a laser to seal leaking blood vessels and, beneath the retina, obliterate the source of the abnormal vessels. This treatment has many limitations, so it might not be ideal for everyone.
- Photodynamic therapy (PDT) uses a light-sensitive dye to transform light into chemical energy. The process releases free radicals, thereby causing vascular occlusion and minimal injury to nearby tissue.
Damage from macular degeneration is irreversible. If you’re diagnosed with early macular degeneration, it’s important to continue your regular eye checkups. This can help lower the risk of complications and possibly delay any disease progression.
Treatment will likely involve making certain lifestyle changes to help prevent or slow the progression of macular degeneration. Your doctor will help you understand what types of changes are most important.
For late macular degeneration, your eye doctor can determine if you’re a good candidate for current treatments.
If treatment is delayed, it can increase the risk of vision loss and blindness.
Early macular degeneration usually causes no noticeable symptoms. If they do occur, you may have difficulty seeing in low-light situations. The only way to know if you have the condition is to visit an eye doctor.
Your eye doctor can diagnose macular degeneration using a variety of tests and tools. Damage from macular degeneration is not reversible, but good preventive care can help delay progression and reduce complications.