Diagnosis

If your optometrist or GP suspects you have age-related macular degeneration (AMD) you will be referred to Moorfields Eye Hospital NHS Foundation Trust or your local ophthalmic clinic for diagnosis.

When you come in for your outpatient appointment, you will be examined by one of our ophthalmologists to determine the type of AMD you have. There are two types – 'dry-type' and 'wet-type'. Neither of these terms has anything to do with crying or dry eyes: dry AMD develops very slowly over a number of years with fading in the central areas of vision, while wet AMD progresses more rapidly.

You will have a sight test and then a full eye examination. A powerful microscope called an ophthalmoscope and equipment which helps your doctor look in the back of your eye, the slit lamp, are used.

Eye drops are put in your eyes to make the pupils bigger, helping your ophthalmologist see the back of the eye. Your vision will be blurred temporarily preventing you from reading and there may be difficulty driving. You should always avoid driving on the day of your appointment because your pupils will need to be dilated on each appointment.

You will also need one or more of the following further tests:

• an Amsler grid test, in which you look at a test page to check for blind spots,
• a colour vision test, which involves looking at test pages,
• colour photographs taken with a special camera. These enable the doctor to see and keep an accurate record of what is going on at the back of the eye. They are kept in your records and can be used for later comparisons,
• Fluorescein angiogram. This test is often used. If your doctor does want to use this test, your pupils will be dilated as above. A small injection of yellow dye is injected into a vein in your arm. This dye circulates throughout the body and to the retinal blood vessels so that the network of capillaries can be seen. A series of flash photos will be taken while you are sitting at the slit lamp to show the passage of dye through the vessels in the retina. The dye will not leak out of normal capillaries; if it is leaking it means the vessels are diseased or new vessels have developed.

The results and appropriate treatment will be discussed with you. During angiography occasionally patients will develop nausea and rarely sickness that soon passes. Allergic reactions rarely occur. The dye has the effect of yellowing the skin for 3-6 hours and urine for 24 hours.

If you are diabetic, continue to test your urine in the normal way but test your blood sugar as well because the dye may affect the result of the urine test by turning it yellow.