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Age-related macular degeneration (AMD) is an eye disease that causes progressive loss of central vision (straight-ahead vision). You may not notice any symptoms of AMD in the early stages, but symptoms can become more severe over time. Without proper treatment, AMD can eventually lead to severe vision loss in a small number of people.
This article will help you understand and visualize how your vision can change as AMD progresses.
AMD happens because of age-related damage to your macula, which is the part of your eye that controls your central vision. Your macula is the central part of your retina (the tissue at the back of the eye that converts light into images).
Although AMD can result in central vision loss and low vision for some people, it doesn’t cause complete blindness. This is because AMD doesn't affect peripheral (side) vision.
There are two types of AMD — dry and wet. It’s possible to have both forms in the same eye. The condition always begins as dry AMD, and a small portion of patients with dry AMD also get wet AMD.
Most people with AMD have the dry form. In dry AMD, the macula slowly breaks down. Dry AMD is caused by the formation of small protein deposits called drusen that can damage the macula. Over time, dry AMD can progress through different stages, from early dry AMD to intermediate dry AMD. The late stage of dry AMD is called geographic atrophy.
As more macular cells die, the symptoms of dry AMD gradually become worse. Symptoms may include:
If you have wet AMD, abnormal blood vessels begin to grow beneath your macula and cause damage. The symptoms of wet AMD are similar to those of dry AMD, but there are some important differences. The wet form is less common, but the symptoms are more severe. Vision changes with wet AMD often occur faster than in dry AMD — sometimes over a period of days to weeks.
In the early stage of dry AMD, you have only some small or a few medium-size drusen. With just a few drusen, you may not have any symptoms.
If you do notice symptoms, you may see only mild blurriness in your central vision. You may also realize that you need more light when you read. If you have early dry AMD in just one eye, it may help hide vision changes.
If you have intermediate-stage dry AMD, you may have several medium or a few large drusen in your macula. At this stage, you still may not have any symptoms.
If you do have symptoms, you may notice more severe blurriness over a larger area in your central vision. You may also have blind spots in your central vision. These blind spots are called scotomas. In the intermediate stage, you may start to have a difficult time distinguishing between different shades of the same color or similar colors.
In the advanced stage of AMD, called geographic atrophy, large areas of the macula are damaged. As a result, bigger areas of the macula die, leaving patches of dead cells.
If you have geographic atrophy, you may have symptoms such as:
You can see more examples of what a person with geographic atrophy sees in this article.
About 10 percent of people with dry AMD progress to the wet form, which is less common. It’s possible to progress to wet AMD no matter what stage of dry AMD you have, even early AMD.
In wet AMD, new blood vessels form beneath the macula, usually near drusen deposits. The new blood vessels can cause abnormal bulging. When the bulging distorts your macula, you may begin to see distortions in the middle of your vision. For example, objects that you know should be straight, such as window blinds, may look curved or wavy to you.
Additionally, these newly formed blood vessels are fragile and can easily break and leak fluid that damages the surrounding tissue. As the tissue damage in your macula heals, it can leave scar tissue. This may result in larger blind spots and more severe distortion in your central vision.
The symptoms of wet AMD are similar to those of geographic atrophy, including blurry central vision, blind spots, and loss of color vision. If you have wet AMD, you may have more rapid and severe vision changes compared to the dry form.
It’s important to track your AMD symptoms at home so you can recognize vision changes early. It can be especially difficult to recognize the gradual changes that can occur with dry AMD. Tracking your symptoms is also important for recognizing that dry AMD is progressing to wet AMD. Wet AMD treatments work best when given as early in the disease as possible.
Many eye doctors recommend using an Amsler grid every day to track vision changes. An Amsler grid — a square with a grid pattern and a dot in the middle — can help reveal vision changes. Looking at an Amsler grid for about one minute daily can help you recognize changes in your vision that may not be obvious otherwise.
Other home monitoring devices are also available, such as the ForeseeHome Monitor. Clinical trials have found that this device may help people maintain more vision longer compared to the Amsler grid. However, the device may be costly and takes about three minutes per eye every day.
No matter what tool you use to track vision changes, it’s important to alert your eye doctor right away as soon as you notice any changes.
There’s no cure for AMD. However, some AMD treatments can slow or stop the progression of AMD. Your treatment will depend on your type and stage of AMD. With proper treatment, you can maintain good vision for the rest of your life, even if you have wet AMD.
Special supplements, called AREDS2 supplements, may help slow vision loss in people with intermediate dry AMD. Eye injections may slow vision loss in people with geographic atrophy or wet AMD. Laser therapy may be an option for some people with wet AMD, although this approach is rarely used now. There’s currently no treatment for people with early dry AMD. Your eye doctor can help you understand the treatment options available to you based on the type and severity of your AMD.
In addition to AMD treatments, healthy lifestyle changes may help. You may be able to prevent AMD progression if you:
Talk with your health provider to help determine the best approaches for your AMD.
On myAMDteam, the social network for people with age-related macular degeneration and their loved ones, members come together to ask questions, give advice, and share their stories with those who understand.
Are you or a family member living with AMD? Have you experienced vision changes as AMD progresses? Share your thoughts in a comment below or on your Activities page.
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Christopher L. Haupert, M.D.
has 24 years of experience as a vitreoretinal surgeon with Iowa Retina Consultants.
Learn more about him here.
Amanda Jacot, PharmD
earned a Bachelor of Science in biology from the University of Texas at Austin in 2009 and a Doctor of Pharmacy from the University of Texas College of Pharmacy in 2014.
Learn more about her here.
A myAMDteam Member
My Sister gets shots in her eyes, and will have them the rest of her life.
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