Macular degeneration is related to aging and is called age-related macular degeneration (AMD). Patients with macular degeneration may begin to notice problems with eyesight sometime after age 50. AMD is, in part, hereditary and therefore often runs in families. If you have AMD, your blood relatives should have a retinal examination every year or two after age 50. Macular degeneration is a condition that can cause permanent loss of central (detail) vision. Though it almost never causes total blindness, it is the major cause of reduced vision in people over 50 in our country.
There are two types of macular degeneration, Dry & Wet. Dry macular degeneration is usually treated with supplements and smoking cessation. Most people with wet AMD will receive medications that are injected into the eye.
Monitor for changes in your central vision using an Amsler grid. Look at the central dot with each eye alone, and check for bending or distorted lines. If you note any changes in your vision, you should see your eye doctor promptly.
Download an Amsler grid here.
Why dilate your eyes?
Dilating your pupils with drops allows your ophthalmologist to see inside your eyes.
Age-Related Macular Degeneration (AMD)
AMD usually starts with the appearance of yellow colored spots in the macula. These spots, caused by the build-up of fatty deposits, are called drusen. Drusen do not usually change vision very much and only a few people with drusen develop severe AMD with loss of vision. Patients with drusen should have regular retinal examinations.
When AMD does lead to loss of vision, that loss usually starts in just one eye, but later may affect the other eye. In some, it never affects the vision of the second eye. When a person loses vision from AMD in one eye, the loss of vision may not even be noticed because the healthy eye can still see detail (such as reading, driving, threading a needle). It is only when AMD severely affects both eyes that it will become difficult, or perhaps impossible, to do the kind of work that requires the detailed vision that is provided by the macula.
In general, it is important to discover any change in eyesight as early as possible because the chance that treatment will help is greatest in the early stages of any eye problem. That is why you should test the eyesight in each eye, separately, every day, especially if your doctor has told you that you have drusen or early macular degeneration.
A person with severe macular degeneration, who has lost the ability to see detail with each eye, rarely loss peripheral vision and will still be able to function fairly well. It is very rare for someone with AMD to lose both macular (detail) and peripheral (side) vision. AMD almost never causes total blindness. Almost all people with severe AMD in each eye can see well enough to take care of themselves and continue those activities that do not require detailed vision.
People with severe AMD in each eye usually learn to make use of the areas just outside the macula to see detail better. This ability to look slightly off center usually improves with time, although eyesight will never be as good as it was before the macula was damaged.
Once the macula has been severely damaged, treatment is usually no longer possible. For this reason everyone should test the vision in each eye, separately, every day to catch any vision changes early when they may be treatable.
One way to test the central vision, in order to detect even the smallest changes when they first appear, is to use the Amsler grid. If you note any changes in your vision, you should see your eye doctor promptly.
Instructions on using the Amsler grid:
Wear your reading glasses.
Cover one eye.
Look at the center dot and keep your eye focused on it at all times.
While looking directly at the center dot, and only the center dot, be sure that all the lines are straight and all the small squares are the same size.
If you should notice any area on the grid that becomes distorted, blurred, discolored, or otherwise abnormal, call your eye doctor right away.
Do this test for each eye separately.
This test should take very little time and should be done daily.
Another way to test your vision is to look at print with one eye at a time. Many people with macular degeneration notice problems with reading fine print more often than when testing with the grid.
In the earliest stages of macular degeneration, vision may be normal. If macular degeneration advances, vision may become blurred for distance or for reading, or both.
A very frequent and important symptom is distortion of vision. Straight lines will not look straight. A telephone pole or a door frame may seem a little bent, crooked, or irregular, as though seen through heat waves on a highway. An area of the Amsler grid may appear distorted and the small boxes in that area will vary in shape and size. Also, you may see a dark gray spot similar to the after effect caused by a flashbulb.
There may be other changes in vision: you may notice that the size of an object appears different for each eye or that colors don't look the same for each eye. These changes in eyesight are important symptoms and anyone who has these symptoms should make sure to see their eye doctor promptly.
If you notice any change in your vision, see your eye doctor promptly, do not assume you simply need a new pair of glasses and wait for an appointment.