Age-related macular degeneration (AMD) is a progressive eye disease that can lead to a condition known as geographic atrophy. This serious condition can cause a variety of symptoms, including poor night vision. Geographic atrophy damages the retina — the layer of light-sensitive cells at the back of the eye — making it difficult to see in low light.

This article discusses the links between poor night vision and geographic atrophy, which you can discuss with your eye doctor in more detail. It’s important to understand your risk factors for this form of AMD and what you can do to help reduce your risk and protect your eye health.

What Is Geographic Atrophy?

Geographic atrophy is the most severe form of late-stage dry AMD. Dry AMD causes the macula to break down and can lead to more serious eye diseases, such as wet AMD and geographic atrophy. The macula is the part of the retina that produces detailed vision directly in front of you — also known as central vision.

Geographic atrophy damages the retina — the layer of light-sensitive cells at the back of your eye.

As geographic atrophy progresses, wider areas of the macula atrophy, or die off. The damaged sections of the retina form atrophic lesions that, to an ophthalmologist doing an exam, look like regions on a map, giving the condition its name: geographic atrophy.

Along with poor night vision and problems seeing in low light, other symptoms of geographic atrophy can affect visual acuity (clarity) and limit your area of vision in other ways. You may experience:

• Trouble reading, driving, or doing any activity that requires central vision
• Loss of central vision or blind spots in central vision (known as scotomas)
• Blurry or distorted vision
• Difficulty seeing shades of colors or seeing less color

“I made an appointment with my ophthalmologist, as my eyes seem to be suddenly worse,” wrote one member of myAMDteam. “The world looks a little darker, and words on my computer are blurry.”

Geographic atrophy can occur in one or both eyes. Having the condition in one eye increases the risk of developing it in the other eye. About 20 percent of legal blindness in North America is caused by geographic atrophy.

Contact your doctor or eye specialist immediately if you experience any impairment of your vision.

Geographic Atrophy and Poor Night Vision

The retina contains photoreceptor cells, which detect light. Geographic atrophy damages cells in the retina that allow you to see in dim light, which causes poor night vision.

“The world looks a little darker.”

— A myAMDteam member

The eye contains two types of photoreceptor cells — cones and rods. Cones detect color and detail, and rods provide vision in low light or at night — that’s why night vision has very little color. Rods make up about 95 percent of photoreceptor cells. Rods also help the iris adjust to changes in light by enlarging the pupil in dim light and making the pupil smaller in bright light.

Poor dark adaptation — when eyes don’t adjust well to darkness — can occur in earlier stages of AMD due to damage in photoreceptor cells. However, people with AMD who have better night vision and dark adaptation in the early stages are less likely to develop geographic atrophy.

Other Causes of Poor Night Vision

If your night vision is poor, it may be due to geographic atrophy or another eye condition. It’s also possible to have more than one eye problem that makes it harder for you to see at night.

Other eye conditions that can affect night vision include:

• Cataracts
• Glaucoma
• Retinitis pigmentosa (a disease that affects the retina)
• Outdated corrective eyeglasses or the need for corrective eyeglasses
• Side effects of vision correction surgery, such as LASIK or photorefractive keratectomy

Even if you’ve been diagnosed with AMD, your eye doctor may want to test you for other retinal problems that may be affecting your night vision.

Geographic Atrophy Treatment Options

Damage caused by geographic atrophy is permanent, but certain treatment options can slow the progression of geographic atrophy and vision loss. The U.S. Food and Drug Administration (FDA) has approved two drugs — avacincaptad pegol (Izervay) and pegcetacoplan (Syfovre) — to help slow eye damage from geographic atrophy. These drugs are injected into the eye.

Geographic atrophy may also be managed with visual aids and surgery that combines cataract surgery (removing your cloudy lens) with implanting a miniature telescope. In clinical trials, researchers are also working to develop new treatment options.

Steps To Help Protect Your Eye Health

Some risk factors for developing age-related macular degeneration and geographic atrophy can’t be controlled, including aging — AMD mostly affects people over 50 — and a family history of the condition. However, you can help reduce your risk of developing dry AMD and geographic atrophy by taking steps to protect your eye health and quality of life.

There are treatment options for geographic atrophy, and you can take steps to protect your eye health and quality of life.

To protect your eyes from the vision loss and damage that can be caused by advanced forms of AMD, such as geographic atrophy, you can do the following:

• Avoid smoking.
• Eat a healthy diet that includes fruit, vegetables, whole grains, and omega-3 fatty acid sources such as fish and algal oil.
• Manage your blood pressure.
• Get regular exercise.
• Protect your eyes from sun exposure by wearing sunglasses and hats.

It’s also important to have regular eye exams so that you can be monitored for problems such as AMD. If AMD is detected, you’ll be monitored with follow-ups to determine which treatment options may be appropriate for you.

Always let your doctor know if you have any concerns about your eye health. Symptoms such as poor night vision can be a sign of a more serious eye condition, and your health care provider can help you find the best treatment plan.

Talk to Others Who Understand

On myAMDteam, the social network for people with age-related macular degeneration and their loved ones, more than 1,300 members come together to ask questions, give advice, and share their stories with others who understand life with AMD.

Do you have problems with night vision? Have you been diagnosed with AMD or geographic atrophy? Share your experience in the comments below, or start a conversation by posting on your Activities page.