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Senior woman covering one eye while taking an eye exam
Senior woman covering one eye while taking an eye exam

Age-Related Macular Degeneration (AMD)

If you’ve been diagnosed with age-related macular degeneration (commonly abbreviated as AMD), you’re not alone. AMD is a leading cause of vision loss in the United States affecting millions of Americans 50 years of age and older.

AMD is a condition that occurs when aging causes damage to the macula—part of the eye’s retina (the light-sensitive layer at the back of the eye). The macula is the part of the eye responsible for our most acute vision, which we use when reading, driving and performing other activities that require fine, sharp or straight-ahead vision. Typically, changes in the macula from AMD are gradual, but in some cases, vision loss is faster and more noticeable. With early AMD, you may notice vision loss for a long time or you may not notice anything until your vision is very blurry, which is why it’s important to get regular eye exams.

THINK OF YOUR EYE AS A CAMERA

Light Enters the Eye’s Lens

Just like a camera, your eye has a lens near the front that focuses light. When the light passes through the lens it lands at the back of your eye, the retina.

Light Passes Through to the Retina

Like film in a camera, the retina captures the shapes and colors of the light to make an image for you to see. The macula is the center of the retina, and it’s responsible for the clarity of the image you see and the vibrancy of the colors.

How a Damaged Macula Affects Vision

Having macular degeneration is like using a camera with film that’s partly damaged in the middle. AMD’s effect on your vision depends on the amount of damage in your macula, but, no matter how advanced your macular degeneration is, it mainly affects your central vision. AMD is unlikely to affect your peripheral or side vision.

What Causes Macular Degeneration?

While anyone can develop AMD, some are more at risk than others. This includes people who:

  • Are 50 years of age or older
  • Smoke
  • Eat a diet high in saturated fat (found in foods such as meat, butter and cheese)
  • Are overweight
  • Have hypertension (high blood pressure)
  • Have a family history of AMD
  • Are Caucasian
  • Have heart disease
  • Have high cholesterol

What Is the Difference Between Dry + Wet Macular Degeneration?

In one out of 10 people, dry AMD progresses to wet AMD. Here’s how it happens:

Dry macular degeneration (atrophic AMD): Most people with AMD have dry AMD. This condition occurs when the tissues of the macula get thinner with age and tiny clumps of protein (called drusen) grow. Dry AMD occurs in three stages: early, intermediate and late. It is a progressive disease, meaning the symptoms usually get worse over time. Dry AMD usually progresses slowly over several years. If you have late dry AMD in only one eye, you can take some steps to protect your other eye. Early AMD always starts out as dry, but in some cases it can develop into wet AMD.

Wet macular degeneration (advanced neovascular AMD): This less common type of late AMD usually causes faster vision loss. While any stage of dry AMD can turn into wet AMD, wet AMD is always late stage. It occurs when abnormal blood vessels form under the retina, in the back of the eye, where they may leak blood or other fluids, causing scarring and damage to the macula. Wet AMD progresses far more rapidly than dry AMD, with more severe effects—potentially including complete central vision loss. Fortunately, there are treatment options available for wet AMD.

Your eye doctor can check for early signs of AMD—and identify it before you have or notice any vision problems.

Symptoms of AMD

Symptoms of AMD depend on the type and stage:

  • Early dry AMD usually doesn’t cause any symptoms
  • Intermediate dry AMD sometimes presents with no symptoms, while at other times there may be mild symptoms such as:
    • Mild blurriness in central vision
    • Difficulty seeing in low light
  • Late AMD (wet or dry) symptoms include:
    • Straight lines starting to appear wavy or crooked
    • Blurry area near the center of your vision—over time, this area may get bigger or you may notice blank spots
    • Colors appear less bright or faded
    • Increased difficulty seeing in low lighting

Straight lines appearing wavy is a warning sign for late AMD. If you notice this symptom, see your eye doctor immediately.

Treatment + Management of AMD

Much like the symptoms of AMD, the treatment options depend on the stage and type.

Dry macular degeneration
There is currently no known treatment for early AMD, so your doctor may recommend regular exams to monitor the condition of your eyes. Since peripheral vision is not affected, many people with dry AMD continue in their normal lifestyles with the aid of low-vision optical devices, such as magnifiers.

For individuals with a lot of drusen or with serious vision loss, taking a certain combination of nutritional supplements may prove beneficial. The specific formula of eye vitamins used in the AREDS and AREDS2link-out icon studies has been shown to help reduce the risk of progression in patients with moderate to advanced AMD.*

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

AREDS and AREDS2 are registered trademarks of the United States Department of Health and Human Services (HHS).

Studies show that eating healthy foods (such as dark leafy greens, fish and yellow fruits and vegetables) as well as taking regular exercise are beneficial to individuals with AMD. Talk to your eye doctor about steps you can take and build an action planlink-out icon.

See Also: Healthy Eyes

Wet macular degeneration
These are usually brief and painless outpatient procedures to slow progression of the degeneration:

  • Wet AMD may be treated with medications called anti-VEGF drugs. Anti-VEGF injections can help reduce the number of abnormal blood vessels in the retina and slow any leaking from those vessels.
  • Photodynamic therapy (PDT)—a combination of injections and laser treatment—may be used to treat certain types of wet AMD. Laser treatment also reduces the number of blood vessels while slowing any leaking.

See Also: 40s +50s Eye Exams

Monitor Your Vision

AMD is a condition that should be monitored closely. You can check your vision with an Amsler grid, a tool that helps you watch out for subtle changes in your vision. Click to view or print an Amsler gridPDF icon.

Some changes in your AMD may only be detected by an eye doctor, so it is important to keep your eye doctor appointments as directed.

Instructions:

  • Always use your grid in the same place and with the same lighting
  • Stand at a comfortable reading distance
  • Wear your normal glasses or contact lenses
  • Cover one eye and stare at the center dot—repeat with other eye

Remember, this test is not meant to replace your regularly scheduled eye examinations. The best way to detect and monitor for conditions affecting the macula is for your eye doctor to use special instruments to examine the back of the eye.

Sight Matterslink-out icon is an educational online resource for people living with age-related macular degeneration. With its AMD Action Plan questionnairelink-out icon, patients can receive a personalized plan to understand the changes needed in their daily lives and how to check for signs and symptoms of AMD so they can help reduce their risk of progression.