If your eye doctor thinks you may have age-related macular degeneration (AMD), they’ll order a series of tests to make a diagnosis. This eye condition can be difficult to diagnose in its early stages because many people don’t notice any symptoms of AMD early on, especially if just one eye is affected.

This article will cover the five tests ophthalmologists (doctors specializing in eye diseases) use to diagnose AMD and what you can expect throughout the process. Be sure to talk with your doctor if you notice any new vision problems. You could have signs of AMD or another eye disease.

Taking Your Medical History

Your eye doctor will likely start by taking your medical history. They may ask if you smoke cigarettes or used to smoke and if you have any other health conditions. Your answers may offer clues about your risk factors for developing age-related macular degeneration.

In addition, be sure to give your doctor details such as these:

• Whether you’ve noticed vision loss or changes
• How long you’ve been experiencing symptoms
• How much your vision has changed or been lost
• If one or both eyes are affected

If you already have AMD in one eye, you’re at risk of developing it in the other. With early AMD, you may have blurry central vision (when you look straight ahead) that affects your ability to see objects close to you or far away. As the disease progresses:

• Your eyes have a harder time adjusting to changing light levels, like walking into a dark house after being in the sunshine.
• You won’t be able to see contrasting colors or textures as well.
• Some areas of your vision will become smudged, distorted, or lost entirely (especially in the center of your visual field).
• You’ll need more lighting to go about daily activities such as cooking or reading.
• You’ll have a harder time with depth perception or judging distances between objects.

All these symptoms let your eye doctor know you may have AMD.

Your eye doctor will also ask about your family history of eye diseases. People with parents or siblings who have AMD are more likely to develop it themselves.

After your eye doctor has determined your risk of AMD, they’ll order tests to make a final diagnosis. Here are five tests for AMD.

1. Visual Acuity Test

A visual acuity test checks the clarity of your vision. If you’ve ever been to the optometrist to get glasses or contact lenses, you’ve had a visual acuity test. Your eye doctor will have you sit in a chair and read letters or numbers off of a chart. You’ll keep reading lines of smaller text until you can’t see the characters clearly anymore. You’ll cover one eye and then the other.

Your eye doctor may also use an Amsler grid to check if you have any blank spots in your vision. An Amsler grid uses straight lines that resemble graph paper with a black dot in the center. Your eye doctor will have you cover one eye and look at the black dot. If the lines become wavy or distorted or disappear, you may have AMD.

It’s important to have regular eye exams to check your vision and eye health. This way, your eye doctor can spot the early stages of AMD or other eye diseases sooner rather than later.

2. Dilated Eye Exam

The next step in diagnosing AMD is to perform a dilated eye exam. This test lets your eye doctor look into the back of your eye — specifically, at your retina. The retina is the tissue that sends light signals from your eyes to the brain. The center of the retina is known as the macula, which is what gets damaged in macular degeneration. Your macula is responsible for producing clear, sharp central vision.

Before the dilated eye exam, your eye doctor will put eye drops in both of your eyes. These drops make the pupils (the eyes’ dark centers) larger, which lets in more light. Your eye doctor will then shine a bright light into your eye, focused with a special lens, to check for problems with the:

• Retina, including the macula
• Retinal blood vessels
• Choroid (a thin layer of blood vessels beneath the retina)
• Optic nerve, which sends signals from the eye to the brain

3. Optical Coherence Tomography

Optical coherence tomography (OCT) is a noninvasive test to check how healthy your retina is. This technique uses infrared light waves to create cross-sectional pictures of your eyes. You can think of OCT as taking pictures of the retina’s different layers, like sliced bread. A computer puts these layers together to create detailed images.

Your eye doctor may use OCT while your eyes are dilated to get better pictures. You’ll sit at an OCT machine, put your chin on a rest, and look into an eyepiece while the machine scans your eye with infrared light.

Pictures from an OCT scan let your eye doctor know if you have any:

• Drusen (protein deposits beneath your retina), which are often a sign of early AMD
• Abnormal blood vessels
• Bleeding in the eye
• Thinning in your macula

It’s important to note that having some drusen is common as you age. However, numerous abnormally large drusen can point to an AMD diagnosis.

4. Fluorescein Angiography

There are two types of AMD — dry and wet AMD. In wet AMD, abnormal blood vessels leak fluid into the eye. Fluorescein angiography is a test that checks for leaky blood vessels.

To do this test, your eye doctor first injects fluorescein (a special dye) into a vein in your hand or arm. The dye then travels throughout your bloodstream and to your eyes. A camera takes pictures of your eyes for about 10 minutes as the dye flows through your blood vessels. Leakage of the dye indicates abnormal blood vessel growth beneath the retina, which means you have wet macular degeneration.

Fluorescein is harmless, and your body will get rid of the dye over the next few days. You may notice your skin turning yellow or your urine becoming bright orange or yellow as your body breaks down the dye.

5. Autofluorescence Imaging

Autofluorescence is an imaging technique that uses the body’s ability to create its own fluorescence. The eyes contain specialized structures — known as fluorophores — that light up when you shine light on them. Retinal pigment epithelial (RPE) cells beneath the retina become fluorescent with certain wavelengths of light.

Your eye doctor can use autofluorescence imaging to take a closer look at your retina. In people with dry macular degeneration, the RPE cells wear out over time. Eventually, the cells die off, causing loss of vision. This leads to the advanced stage of dry AMD known as geographic atrophy.

Next Steps After a Diagnosis of Age-Related Macular Degeneration

If your eye doctor diagnoses you with AMD, you’ll work together to decide on a treatment plan. This is important for slowing AMD progression and preserving your vision for as long as possible.

Your treatment plan may include taking certain medications or supplements, or you may undergo eye injections or light therapy treatments. Making lifestyle choices like quitting smoking and following a healthy diet can also help.

Getting an AMD diagnosis doesn’t mean you’re guaranteed to lose your vision. By working closely with your eye doctor and getting appropriate eye care, you can take steps to live a healthier life with age-related macular degeneration.

Talk With Others Who Understand

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? What tests did your eye doctor perform to diagnose it? Share your experiences in a comment below or on your Activities page.