Macular degeneration

Macular degeneration is an eye condition that affects the macula, a part of the retina at the back of your eye. It alters your central vision, which you use to see details when looking straight at things, such as reading or watching television. It typically affects people in their 50s and 60s, so it’s also known as age-related macular degeneration (AMD).

You can be diagnosed with macular degeneration in one eye and then develop it in the other.

AMD isn't painful, doesn’t affect peripheral vision (side vision), and won’t cause total loss of sight. But the loss of central vision it causes can make day-to-day life harder, and you may become eligible to register as having a sight impairment. Sometimes, people with advanced macular degeneration and significant sight loss can experience visual hallucinations as their brain adjusts to the loss of vision.

It's natural to worry about how you’ll cope if you or someone you love is diagnosed with macular degeneration. Practical and emotional support can help you adjust to daily life with AMD and make the most of your vision.

Dry macular degeneration

Dry AMD is the more common type of AMD, caused by a fatty substance called ‘drusen’ that builds up yellow deposits at the back of the eyes. Dry AMD usually progresses over years, and there is no treatment. It doesn't affect peripheral vision, so while it can cause a blind spot in the centre of your vision, it doesn't lead to total sight loss.

Some people with dry AMD may develop wet AMD, so it's essential to speak to your ophthalmologist if you notice any sudden changes to your sight.

There are lots of ways to make the most of your vision when living with dry macular degeneration. These include using different lighting and other visual aids and using services such as low vision clinics.

Wet macular degeneration

This type of AMD is less common, with 10-15% of people who have dry macular degeneration going on to develop it (Source: Macular Society).

It’s caused by abnormal blood vessels growing at the back of the eye. These new blood vessels can cause swelling and bleeding, damaging the macula. Wet macular degeneration can develop quickly, rapidly affecting your central vision in a matter of weeks or even days.

There is treatment for wet AMD if diagnosed promptly, so it’s essential to seek medical advice as soon as you notice any changes to your sight. Getting treatment can stop scarring to the macula and further damage to your vision.

Macular degeneration treatment

There’s no treatment for dry macular degeneration, but it alone rarely causes total blindness. Visual aids, tools, and coping strategies can help you make the most of your vision and maintain your independence.

Wet macular degeneration can be treated to help prevent further loss of vision. Several drugs are used to treat wet AMD and are known as anti-VEGF, which stands for vascular endothelial growth factor. The drugs are given in a series of eye injections every one or two months for as long as necessary. On rare occasions some people may be offered laser therapy.

Getting a test for macular degeneration

Your optician (also known as an optometrist) can check for many eye diseases, including AMD, during an eye exam. They may also use an optical coherence tomography (OCT) scan to take a detailed image of the back of the eye. This is a straightforward, non-invasive test.

Macular degeneration causes

The exact causes of age-related macular degeneration (AMD) aren't known for certain, but your risk of AMD is influenced by:

• Age – AMD is more common in older people, usually in their 50s and 60s (Source: NHS).
• Lifestyle and diet – obesity, smoking, and high blood pressure are risk factors, as is a poor diet.
• Exposure to ultraviolet (UV) radiation – the retina is highly susceptible to photochemical damage from continuous exposure to light (Source: NIH).
• Family history – your genetics are thought to play a role, so a family history of AMD is a risk factor.

When to get medical advice

If you’re worried about your sight, see your optician or GP as soon as possible. The NHS recommends having an eye test at least once every two years. Regular eye exams help diagnose a range of eye conditions so you can get tests, treatment and support.

The optician may refer you to hospital for confirmation or follow up if they think you have macular degeneration. If they think you have wet age-related macular degeneration, this referral should happen very quickly.

Living with macular degeneration

Because AMD affects the central vision we rely on for seeing details, reading, and many other activities, it's easy to feel discouraged if you're diagnosed with this common eye disease. One of the most valuable things that can help, especially in the early stages, is hearing from other people living with macular degeneration. They can share tips for day-to-day life and their feelings on coming to terms with a diagnosis.

Frequently asked questions