Even if you’ve heard about common symptoms of age-related macular degeneration (AMD), understanding just how a person with the condition may experience these symptoms can be difficult. In the early stages of AMD, you may not have any changes in your vision. However, as this eye disease progresses, the symptoms can become more noticeable.

Geographic atrophy is a late stage of AMD. People with geographic atrophy may develop many symptoms that affect their vision. If you have been diagnosed with AMD or want to understand what your loved one with AMD sees, this article will provide you with detailed descriptions and images.

How Does Geographic Atrophy Progress?

Geographic atrophy is an advanced form of dry AMD. Dry AMD is caused by yellow deposits called drusen that build up beneath the retina (the light-sensitive membrane that lines the inside of the back part of your eye). Drusen develop over time. As the deposits grow, they cause the cells in your macula (the central part of your retina) to deteriorate and die. Your macula controls your central vision — what you see when you look straight ahead — so AMD symptoms affect only this part of your vision. In geographic atrophy, larger areas of your macula begin to waste away and die, causing progressively worse symptoms.

Blurry or blind spots in your vision may become larger and more severe as AMD progresses to geographic atrophy.

AMD can affect one or both eyes. You can also have a different type or severity of AMD in each eye. However, if you develop geographic atrophy in one eye, you’re more likely to also develop it in the other eye. Typically, AMD doesn’t affect your peripheral (side) vision.

In the early stage of dry AMD, you may have no symptoms or notice only mild blurriness in your central vision. This means that what you see doesn’t look as clear as it used to.

In the intermediate stage of dry AMD, the area of blurriness can worsen and get bigger. For many people, central vision blurriness is still mild. The symptoms of early and intermediate dry AMD may go unnoticed because the healthy parts of your eye can mask your symptoms.

If dry AMD progresses to geographic atrophy, your central vision loss becomes more apparent and can have a greater impact on your quality of life.

1. Blurriness in Your Central Vision

As dry AMD progresses to geographic atrophy, more and more retinal cells die. This results in an area of blurriness in your central vision that’s larger and less clear than in other stages.

If your central vision is blurry, it may be more difficult to see objects and scenes you’re looking at directly. It may be harder to do activities you enjoy, such as watching television and reading.

2. Blind Spots in Your Vision

In addition to blurry vision, blind spots called scotomas may affect your central vision with geographic atrophy. Although scotomas may begin to develop in intermediate dry AMD, they can become bigger in geographic atrophy.

Blind spots in your central vision can make it difficult to distinguish fine details. This can make it harder to read and to recognize the faces of your friends and loved ones. Blurriness and blind spots in your central vision can make it more difficult to take care of daily needs, such as cooking and cleaning.

3. Loss of Color Vision

Photoreceptors — the cells responsible for telling your brain what colors you see — are primarily found in your macula. If geographic atrophy damages those photoreceptors, telling the difference between certain colors can become more difficult.

Studies have found that people with AMD aren’t able to distinguish between reds, greens, and blues as well as people without AMD. Although geographic atrophy doesn't affect the retinal cells responsible for peripheral vision, people with the condition still see only shades of black and gray in their peripheral vision.

People with geographic atrophy may have trouble distinguishing between colors such as reds, greens, and blues.

The loss of color vision in geographic atrophy isn’t the same as color blindness. Color blindness is the result of a genetic abnormality in otherwise healthy retinal cells. In geographic atrophy, the loss of color vision is caused by the death of retinal cells.

Many everyday tasks, such as cooking, driving, and choosing clothing, can become more difficult if you’ve lost your color vision.

Your eye doctor can look for loss of color vision using a simple test in which you identify a shape made of different-colored dots. If your color vision is fine, the shape is easy to spot. However, people who have trouble distinguishing colors due to geographic atrophy may have problems identifying the shape.

4. Areas of Your Vision That Appear Curvy or Wavy

If you have geographic atrophy, you may notice that parts of your central vision seem to be distorted. This can be more obvious when you’re looking at objects that you know have straight edges, like window blinds, but they look curved or wavy instead.

Since dry AMD symptoms usually develop gradually, your eye doctor may recommend that you use an Amsler grid to check your vision every day. This is a square with a grid pattern and a dot in the middle that helps you track vision changes that may not be obvious.

If straight lines on an Amsler grid appear curved or wavy, you should call your eye doctor right away. When this symptom appears suddenly, it may signal that geographic atrophy is progressing to a type of advanced AMD, called wet AMD. Wet AMD can cause faster vision loss due to the growth of abnormal blood vessels beneath your macula.

If straight edges such as walls or doors appear wavy, it may be a sign of geographic atrophy.

Using the Amsler grid daily can help you identify this symptom early so you can get appropriate treatment.

Coping With Vision Changes From Geographic Atrophy

Vision changes caused by geographic atrophy can affect your quality of life by making it more difficult to take care of yourself, participate in activities you enjoy, and interact with people around you. You may also find it difficult to see while driving or even walking across the street, which can leave you feeling anxious.

However, you can take steps to help manage the symptoms of geographic atrophy. Using brighter lights or a magnifying glass can help you with certain tasks and activities like reading. Visual aids, such as an app on your phone or tablet, may help you better recognize faces and colors. You can talk to a low vision specialist to learn about more ways to cope with vision loss caused by geographic atrophy.

Talk to your eye doctor to learn more about your risk of progressing to geographic atrophy and the best treatment plan for your AMD.

Find Your Team

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 geographic atrophy? Do you have questions about what people with geographic atrophy see? Share them in a comment below or on your Activities page.