Macular degeneration — protecting central vision

Age-related macular degeneration (AMD) is the leading cause of severe vision loss in older people in the UK. It damages the macula — the small central area of the retina responsible for sharp, detailed vision.

AMD does not cause total blindness — peripheral (side) vision is usually kept — but it can make reading, driving, and recognising faces very difficult.

Dry AMD — slow and common

Dry (atrophic) AMD accounts for roughly 85 to 90% of cases. The macula gradually thins and drusen (yellow deposits) accumulate.

Symptoms develop slowly:

  • Difficulty reading small print
  • Needing brighter light
  • Colours appearing less vivid
  • Gradual blurring of central vision

There is no cure for dry AMD, but progression can be slowed with lifestyle changes and AREDS2 supplements in intermediate-stage disease.

Wet AMD — rapid but treatable

Wet (neovascular) AMD is less common but more aggressive. Abnormal blood vessels grow under the macula, leak fluid, and cause rapid central vision loss.

Warning signs — seek same-day assessment:

  • Straight lines look wavy or bent — check with an Amsler grid
  • A dark or blank patch in central vision
  • Sudden worsening of central vision over days

Anti-VEGF injections into the eye — ranibizumab, aflibercept, faricimab — stop vessel growth and can stabilise or improve vision if treatment starts promptly.

Risk factors

  • Age — most common over 65
  • Smoking — strongest modifiable risk factor
  • Family history of AMD
  • High blood pressure and cardiovascular disease
  • Obesity
  • Prolonged sun exposure without eye protection

Diagnosis and monitoring

Optician or ophthalmologist assessment:

  • Visual acuity testing
  • Dilated retinal examination
  • OCT scan — detailed macular imaging
  • Fluorescein angiography — for wet AMD

Home monitoring — use an Amsler grid weekly. Report any new distortion immediately.

Treatment summary

Dry AMD:

  • AREDS2 supplements — vitamins C and E, zinc, copper, lutein, zeaxanthin — for intermediate dry AMD in both eyes
  • Lifestyle — stop smoking, healthy diet, exercise
  • Low vision rehabilitation — magnifiers, lighting, practical support

Wet AMD:

  • Intravitreal anti-VEGF injections — monthly initially, then extended intervals
  • Photodynamic therapy — selected cases
  • Early treatment gives the best visual outcome

Living with AMD

AMD affects central vision, not side vision. Most people retain enough peripheral sight to move around familiar spaces. Support includes:

  • Low vision clinics — NHS referral for aids and training
  • Registration as sight impaired or severely sight impaired — access to benefits and support
  • Practical adaptations — large-print books, talking devices, good lighting

People with diabetes should also attend diabetic eye screening — see type 2 diabetes — as diabetic retinopathy is a separate threat to vision.

Common questions about age-related macular degeneration

What is age-related macular degeneration?
AMD is an eye condition affecting the macula — the central area of the retina responsible for detailed vision. It does not cause total blindness — peripheral vision is usually preserved — but it can make reading, driving, and recognising faces very difficult. It mainly affects people over 50.
What is the difference between dry and wet AMD?
Dry AMD (atrophic) is most common — gradual thinning of the macula with drusen deposits; vision declines slowly over years. Wet AMD (neovascular) is less common but more serious — abnormal blood vessels grow under the macula and leak fluid, causing rapid central vision loss. Wet AMD needs urgent treatment.
What are the symptoms of AMD?
Gradual difficulty reading small print, needing brighter light, colours seeming dull, and a blurred or empty area in central vision. In wet AMD, straight lines may appear wavy or bent (metamorphopsia) and central vision can deteriorate rapidly over days to weeks.
How is AMD diagnosed?
Opticians and ophthalmologists examine the retina, check visual acuity, and use optical coherence tomography (OCT) — a scan showing macular structure in detail. Fluorescein angiography may be used for wet AMD. The Amsler grid — a simple line grid — helps detect distortion at home.
Can AMD be treated?
Dry AMD has no cure — nutritional supplements (AREDS2 formula) may slow progression in intermediate disease. Wet AMD is treated with anti-VEGF injections into the eye — ranibizumab, aflibercept, or bevacizumab — which stop abnormal vessel growth and can stabilise or improve vision if started early.
Can I prevent macular degeneration?
You cannot prevent all AMD, but stopping smoking significantly reduces risk. Eating a diet rich in leafy green vegetables and fish, maintaining healthy blood pressure, exercising, and protecting eyes from UV light all help. Regular eye tests detect early changes.
Will I go completely blind with AMD?
AMD affects central vision, not peripheral vision — you retain side vision and can usually navigate rooms and remain independent with support. Low vision aids, magnification, good lighting, and social care services help maintain quality of life.

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