If you’ve noticed changes in your vision as you have gotten older, you may just assume that it’s a normal part of aging. But if you’ve been diagnosed with dry age-related macular degeneration (AMD), you might have experienced changes that don’t usually happen in healthy aging eyes.

In this article, we’ll discuss normal ways vision can change as you get older and how they differ from vision changes in dry AMD. We’ll also discover what drusen are and how they contribute to dry AMD and vision changes. Finally, we’ll talk about steps you can take to help preserve your vision.

How Does Normal Aging Affect Vision?

It’s normal to experience some vision changes as you get older. For example, you may have trouble:

• Seeing objects up close
• Distinguishing contrast between colors
• Adjusting to different light levels
• Seeing in low light or at night

Seeing Up Close

One of the most common vision changes people experience as they age is difficulty seeing up close, known as presbyopia. With presbyopia, nearby objects appear blurry, leading people to hold reading materials like books and newspapers farther away to see clearly. This condition may also cause eye strain or headaches, especially after prolonged reading. Presbyopia typically becomes noticeable in people when they reach their 40s. It can be corrected with glasses or contact lenses.

Distinguishing Colors

As people age, distinguishing between certain colors, like blue and black, can become more difficult. This challenge may make everyday tasks, such as reading or matching clothing, more complicated.

Adjusting to Light Levels

People may also notice that it takes longer to adjust to changes in levels of light, such as when walking into a dimly lit restaurant or a movie theater. This slower response to light changes can make everyday activities, like driving or moving between rooms, more difficult.

Navigating in Low Light

As people age, it is common to experience difficulty seeing well at night, which can make tasks like driving in the dark more challenging. These changes are a normal part of aging. Wearing glasses designed for nighttime driving and improving lighting at home can help make daily activities easier.

How Does Dry AMD Affect Vision?

Some symptoms of dry AMD can be easily confused with the vision changes that occur due to normal aging. For instance, people with dry AMD may have trouble reading books due to blurry vision. They may also struggle to adjust to changes in lighting, much like people with normal age-related vision changes. These similarities between normal age-related vision changes and dry AMD can make it difficult to tell the difference between the two conditions.

Central Vision Loss

However, there are other vision changes common in dry AMD that are not symptoms of age-related vision change. One of the most common symptoms of dry AMD is called central vision loss. Dry AMD is caused by damage to an area of the eye called the macula. The macula allows people to see fine details. When the macula is damaged, it leads to blurriness or dark spots in the center of vision.

Loss of central vision can make common tasks such as reading, driving, and recognizing faces difficult. However, these changes affect only the central vision, while peripheral vision — the ability to see objects at the edges of your visual field without looking directly at them — typically stays normal.

Straight Lines Appear Wavy

Another common symptom of dry AMD is that straight lines look wavy. This change is particularly noticeable when looking at a grid, such as the Amsler grid. The Amsler grid is a square grid pattern with a dot in the middle. When a person with AMD looks at an Amsler grid using one eye, they may notice that some of the lines look wavy, blurry, or dim.

Ophthalmologists sometimes recommend that people with AMD use the Amsler grid to monitor vision changes. However, recent research has shown that this test doesn’t work as well in the early stages of AMD or dry AMD compared to wet AMD.

Progression and Wet AMD

Dry AMD is a progressive condition, meaning it gets worse over time. It can develop in either one or both eyes at the same time. People with early dry AMD generally don’t have any symptoms. However, those with intermediate or late-stage dry AMD will have vision problems like central vision loss and difficulty with low lighting.

It’s also important to note that dry AMD can progress to wet AMD. Wet AMD happens when abnormal blood vessels grow beneath the retina. Blood and fluid can then leak from these blood vessels and cause damage to the macula. Vision loss is much slower with dry AMD than with wet AMD.

Read more about the differences between wet and dry AMD.

What Are Drusen and How Are They Related to Dry AMD?

If you’ve been diagnosed with dry AMD, your doctor may have already mentioned drusen, which are yellow or white spots beneath the retina. These spots are made up of lipids and proteins.

Drusen deposits form when there is a problem with the disposal of waste products from the cells of the retina. Normally, waste from the retinal cells is cleaned up by immune cells. However, if the retinal cells produce too much waste or the immune cells don’t clean it up well, the waste materials can accumulate and form drusen.

What’s Normal? What Indicates AMD?

Drusen can be small, medium, or large, and a person can have many beneath the retina. Ophthalmologists can detect drusen using a dilated eye exam or by taking pictures of the retina using a test called optical coherence tomography. It’s common for people over 50 to have small drusen deposits, but it doesn’t always signal AMD.

However, the size and number of drusen are related to the risk of developing AMD. People with larger and more numerous drusen are more likely to develop dry AMD and vision loss. Having a large drusen or many small drusen is considered an early sign of dry AMD.

People with early AMD may not have any symptoms and are often diagnosed when a doctor sees medium-sized drusen during an eye exam. However, vision changes may start to appear as dry AMD progresses to later stages and more drusen accumulate in the retina.

Which Comes First?

Scientists don’t completely understand the connection between drusen and AMD. Some drusen accumulation is a normal part of aging and generally doesn’t cause symptoms. However, larger drusen accumulations can sometimes cause vision changes, such as waviness when looking at an Amsler grid. More research is needed to tell if drusen deposits directly cause dry AMD or if they’re just a sign of AMD.

Steps You Can Take To Preserve Your Vision

Being diagnosed with dry AMD can be scary, but there are steps you can take to help preserve your vision and slow the progression of dry AMD. You may want to:

• Manage medical conditions.
• Stop smoking, if you smoke.
• Eat a healthier diet.
• Talk to your doctor about supplements.

Manage Medical Conditions

Certain medical conditions put you at higher risk of developing AMD. Hypertension (high blood pressure), heart disease, and high cholesterol levels are risk factors for dry AMD. Managing these health conditions can help reduce the risk of developing dry AMD and potentially slow disease progression. Work with your doctor to manage these conditions with lifestyle changes and medication.

Stop Smoking

Research has found that smoking doubles the risk of developing AMD. If you smoke, talk to your health care provider about ways to stop smoking. Living in an environment with lots of air pollution may also increase the risk of AMD, so try to avoid pollution when possible.

Eat a Healthier Diet

People who have a higher body weight and those who eat a diet high in saturated fat are at increased risk of AMD. To reduce this risk, it’s important to maintain a healthy weight and get regular physical exercise. You can also reduce the amount of saturated fat you eat by limiting foods like meat, butter, and cheese. Doctors recommend eating a diet with lots of fruits and vegetables, because these foods have antioxidants that can reduce your risk of AMD. Finally, omega-3 fatty acids (found in fish and nuts) may help lower the risk of AMD.

Talk to your health care provider for recommendations on lifestyle choices you can make to preserve your vision. You can also ask your health care team to recommend resources if you need help starting new habits.

Ask Your Doctor About Supplements

Research shows that certain vitamin and mineral supplements can help slow the progression of AMD. Your doctor may recommend the AREDS2 formula, which includes specific doses of vitamin C, vitamin E, lutein, zeaxanthin, zinc, and copper. This combination has been shown to slow the progression of AMD in some cases.

However, it's important to talk with your health care provider before starting any supplements to ensure they are safe and appropriate for your individual health needs.

Find Your Team

On myAMDteam, the social network for people with age-related macular degeneration and their loved ones, more than 1,900 members come together to ask questions, give advice, and share their stories with those who understand life with AMD.

Have you noticed vision changes since being diagnosed with dry AMD? Have you made any changes to try to protect your eye health and slow AMD progression? Share your questions and experiences in a comment below or on your Activities page.