Macular degeneration is one of the leading causes of vision loss among those over 50, leading to central blindness if left untreated.

Ninety percent of cases can be categorized as dry macular degeneration, where deposits build up behind the macula. Ten percent progress to “wet” macular degeneration where abnormal blood vessels form and lead to bleeding and swelling of the eyeballs.

Dry Macular Degeneration

Macular degeneration occurs slowly over time, as light-sensitive macula tissue thins, leading to changes in central vision that see fine detail in your visual field. Although less common than wet macular degeneration, dry forms still account for around 10% of blindness cases in people over 60 and typically only affects central vision making straight lines appear crooked and does not interfere with color vision or peripheral (side) vision.

AMD typically begins as blurriness that worsens over time as less of the retina’s light-sensing cells can function, eventually leading to gradual central vision loss and distortions of straight objects like clocks. Early treatment increases your chance of keeping at least some or all of your central vision intact.

Photodynamic therapy, a painless laser that targets and destroys abnormal blood vessels under the retina in wet macular degeneration patients, may provide relief – provided they’re in early stages and far enough from macula to be safely destroyed. However, photodynamic therapy should only be undertaken if your condition meets all these criteria.

As it’s an avoidable condition, wet macular degeneration is easily preventable by adopting healthy lifestyle practices such as following a balanced diet, using sunscreen when outdoors and remaining physically active; smoking cessation; not using tobacco products and managing other medical conditions (high blood pressure and heart disease); as well as consulting your ophthalmologist regularly for eye exams can all play an essential part.

Wet macular degeneration occurs when fluid leaks from abnormal blood vessels that form beneath the retina, leading to rapid loss of central vision and scar tissue formation under the retina that further impairs vision. There are two types of wet macular degeneration; wet neovascular age-related macular degeneration and wet advanced dry age-related macular degeneration; the former can be treated using anti-VEGF injections such as Lucentis, Avastin or Eylea; laser surgery may also help slow or stop growth of abnormal blood vessels as these medications and procedures work by stopping new abnormal vessels from growing underneath and avoid leakage from happening underneath.

Early Stages

At this stage, patients begin to notice a gradual loss in central vision caused by an accumulation of yellow deposits called “drusen,” which form under the retina and are detectable during an extensive dilated eye exam. While not as serious as Wet macular degeneration, the accumulation of drusen leads to slow loss of central vision; patients often report symptoms like blurry or hazy images or blind spots developing centrally as well as difficulty adapting to low light conditions and finding it challenging to read, drive, or use computers.

Dry macular degeneration is a progressive condition and it is important to visit an eye care specialist as soon as you notice changes to your vision. Regular examinations allow doctors to detect early symptoms so you can receive drug or laser treatments to slow its progress.

Wet macular degeneration (ARMD) is less prevalent, yet still an acute form of vision loss. It results from abnormal blood vessel formation underneath the retina that leak fluid, leading to displacement of macula from its usual position at the back of eyeball and subsequent distortion or blurriness in vision. OCT angiography or fundus fluorescein angiography may help detect Wet ARMD by revealing patterns of leaky vessels characteristic of this stage of disease progression.

Visudyne injections provide an easy, painless solution for wet macular degeneration. Once administered, laser light shines directly at the retina and activates this medication, dissolving abnormal blood vessels and slowing progression. While effective against wet ARMD progression, they cannot restore vision once lost.

Intermediate Stages

At the intermediate stages of macular degeneration, patients may begin experiencing blurriness in their central vision. This is caused by damage to the macula – the area at the center of retina that collects detailed images for transmission to brain so you can see things directly ahead of you – beginning to break down. Furthermore, multiple medium-sized drusen (white or yellow clumps of protein that form under retina). Although typically not indicative of vision deterioration, larger-sized drusen can cause central distortion that significantly distorting visual distortion.

Your eye doctor can detect changes in the eye through various tests, including an Amsler grid – a checkerboard pattern of straight lines – which measures changes. If straight lines appear wavy or missing early on in macular degeneration, this can be an early telltale sign that it needs managing. Your doctor can assist by providing low vision tools, offering education on coping strategies and referring you to vision rehabilitation specialists as necessary.

As soon as macular degeneration reaches its late stage, you’ll begin to notice blurriness in your central vision, making everyday tasks such as driving, recognising faces or reading more challenging. Wet macular degeneration increases this difficulty as abnormal blood vessels form under the retina that leak fluid resulting in further vision loss.

Macular degeneration may cause serious vision loss, yet rarely results in blindness. People living with advanced macular degeneration often retain useful peripheral (side) vision that they use to compensate and compensate for the fading central vision. Furthermore, numerous adaptive devices have been created that assist daily activities.

UF Health retinal specialists are committed to helping their patients across the region preserve their vision and enhance their quality of life. By scheduling a yearly dilated eye exam, you can ensure your ophthalmologist detects early signs of macular degeneration and prescribe treatments designed to slow its progress.

Late Stages

Macular degeneration progresses until its final stages when its central portion, known as the macula, becomes weak and loses its ability to focus, leading to blurry or distorted straight ahead vision that interferes with reading, driving, recognizing faces or colors and performing other tasks requiring direct line-of-sight vision.

Macular degeneration does not cause total blindness because side or peripheral vision remains intact. Only during late stages will you begin to notice straight lines appear wavy or even disappear altogether and you may experience difficulty seeing in low light conditions.

Later stages of macular degeneration are referred to as wet age-related macular degeneration due to abnormal blood vessel growth beneath the retina which leak fluid and cause bleeding into the eye. Wet macular degeneration affects approximately 10% of people with advanced AMD, leading to rapid visual loss. While this serious condition must be managed carefully, treatment options do exist.

There are various forms of wet macular degeneration, but exudative wet AMD is by far the most prevalent form. At this stage, the macula becomes thin and dry as tiny yellow protein deposits called drusen grow beneath the retina, eventually becoming larger over time until blurry vision in the center of field appears or blind spots become hard to distinguish among faces when reading, driving or recognising people become difficult.

Regular eye examination is of utmost importance during this stage. Your doctor may ask you to look at an Amsler grid chart of straight lines arranged in a grid pattern to assess central vision; any irregular or missing lines could be an early indicator of macular degeneration.

If you suffer from wet AMD, your eye doctor can treat it using Visudyne (Photodynamic Therapy or PDT). In this treatment method, the physician injects Visudyne into your arm before shining a special non-thermal laser onto your retina to trigger chemical reactions which destroy abnormal blood vessels in order to improve central vision while slowing further damage. Often this treatment improves central vision as well as can slow further progression of damage.