Overview | Symptoms | Causes | Risk Factors | Prevention | Diagnosis | Treatments
Has your central vision become blurry? Do you struggle to distinguish faces or see in low lighting? You might be experiencing macular degeneration.
You shouldn’t experience pain with macular degeneration. If your eye is red and painful, or your vision worsens abruptly, seek emergency care. These are not signs of macular degeneration.
What is macular degeneration?
Macular degeneration refers to damage to the macula – the central part of the retina – that can cause permanent central vision loss. Your peripheral (side) vision remains intact. The most common type of macular degeneration is age-related macular degeneration (AMD) which is seen in the elderly. This common condition is progressive, meaning it worsens over time, and it can affect one or both eyes.
Types
There are two main types of age-related macular degeneration: dry and wet. Over 85% of age-related macular degeneration cases are dry.
Dry age-related macular degeneration means your condition progresses slowly over several years.
Wet age-related macular degeneration progresses much faster than dry, over a few weeks or months.
Further on, we discuss the differences between wet and dry and how we can treat each.
Is macular degeneration hereditary?
Certain types of macular degeneration may be hereditary. However, age-related macular degeneration, which is the most common type of macular degeneration, is a condition seen with ageing. Certain genes are related to AMD but the disease is largely due to old age.
Symptoms of macular degeneration
In the early stages of macular degeneration, people often have no symptoms or mild blurry central vision. Due to this, we may find macular degeneration before you show symptoms during a routine eye test.
The symptoms of wet macular degeneration are usually more severe, as this type progresses faster and causes more damage to your vision.
Symptoms include:
- Blurry central vision
- Struggle to recognise faces
- Harder to see in low lighting
- Colours are dimmer the before
- Straight lines appear wavy or crooked
- Dark areas in the centre of your vision
- Problems reading, watching TV or driving
- Hallucinations (Seeing things that aren’t there)
- Difficulty making out details in your central vision
If you notice a change in your eye shape then a different problem may be causing your symptoms. Several other conditions can have overlapping symptoms including glaucoma, corneal disease, cataracts, diabetic retinopathy, retinitis pigmentosa (RP) and other retinal conditions.
Causes of macular degeneration
We don’t yet know the exact cause of macular degeneration. Dry AMD, also known as atrophic AMD, develops over time and is linked to drusen. Drusen is fat and protein that collects under your retina – the retina processes light at the back of the eye. As dry AMD develops, the drusen becomes larger and more numerous, and the macula thins.
Wet AMD, also known as advanced neovascular AMD, is less common and more serious as it progresses faster. With wet AMD, new and abnormal blood vessels grow under the macula, damaging the macula. Blood and other fluid may leak into your eye from these new vessels. Dry AMD can turn into wet AMD at any stage, though we always consider wet AMD to be a late stage. Stages of dry AMD are sub-clinical, early, intermediate, and late.
Macular degeneration risk factors
Certain factors increase the risk of age-related macular degeneration.
- Smoking
- Being overweight
- Over 50s and 60s
- High blood pressure
- Cardiovascular disease
- Northern European ancestry
- Unprotected long-term sun exposure
- A family history of macular degeneration
- A diet high in saturated fat and cholesterol and low in certain vitamins and minerals
Preventing age-related macular degeneration
The following may help you lower your risk of macular degeneration.
- Quitting smoking
- Regular physical activity
- Manage your blood pressure and cholesterol
- Maintaining a healthy diet of green vegetables and fish
How do we diagnose it?
Our ophthalmologist (eye specialist) will perform a visual examination, a retinal assessment, and discuss your symptoms with you. We will use eye drops to widen your pupil, making it easier to see the back of your eye. The eye drops may cause your vision to blur more than usual. Wait until your vision returns to normal before driving.
We may also ask you to look at an Amsler grid – a grid made up of horizontal and vertical lines. Using the Amsler grid, you may be able to identify any blank or blurry spots in your vision.
Other tests we may perform include:
- Optical coherence tomography (OCT)
- Fluorescein angiography
Treating macular degeneration
The treatment we recommend will depend on which type of macular degeneration you have. Unfortunately, there is no currently recommended treatment option for dry AMD. However, there are steps you can take to slow its progression, such as dietary changes, vitamin supplements, and quitting smoking.
You may also benefit from using visual aids, and a small number of patients may be able to have surgery. Surgery for dry AMD involves implanting a telescopic lens in the eye to magnify your field of vision. The results of this surgery are not proven and only selected patients may benefit from it.
Low vision rehabilitation is an option to help you adjust to the vision that you have lost. You can learn how to use your side vision in your day-to-day activities to make life easier. There are many low vision tools available to assist with this life change.
People with wet AMD may need regular eye injections containing anti-VEGF medicines. These injections can prevent your vision from worsening. We may need to give these injections every 1, 2, or 3 months.
Another treatment option for people with wet AMD is photodynamic therapy (PDT). This involves injecting a light-sensitive medication. Then, we use a laser light to activate it in your eye, damaging your abnormal blood vessels. We usually need to repeat this treatment every few months. A similar treatment for wet AMD is photocoagulation.
Book an appointment
If your central vision has become blurry, you may be experiencing macular degeneration. Our experienced ophthalmologists (eye specialists) can assess your eyes and perform a series of tests to determine the cause.
Visit Oculase for high-quality service from our compassionate experts. We can holistically manage complex eye conditions to deliver the best care for our private patients. Read and listen to our patient testimonials to gain a better understanding of the world-class care we offer.
Book an appointment with our Consultant Ophthalmic Surgeon, Mr Ayoub, to discuss your symptoms, arrange tests, and discover treatment options.
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