Age-related macular degeneration (AMD)

Age-related macular degeneration (AMD) involves damage to the macula and affects central vision

Summary

Age-related macular degeneration (AMD) is the leading cause of vision loss in individuals over 50 years old. The macula is the central part of the retina, the light-sensing tissue which lines the back of the eye, and is responsible for sharp, detailed central vision. In AMD, the macula becomes damaged, resulting in blurred central vision while peripheral (side) vision remains unaffected.

AMD impairs the visual precision required for everyday activities. Driving, reading, recognising faces, and viewing details up close or at a distance become challenging as the disease progresses. For example, an individual with AMD may see the shape of a clock but be unable to see the hands to tell time.

Early diagnosis and treatment can slow progression of AMD. Regular eye exams, awareness of risk factors, and prompt medical attention to changes in vision are important for preserving sight. With proper management, people with AMD can maintain effective vision.

Types of AMD

Age-related macular degeneration (AMD) has two main types: early AMD and late AMD.

Most people with AMD, about 75%, have early, also known as dry, AMD. It develops when waste products build up under the macula and the retina thins in that area. Vision loss is usually gradual and mild with early/dry AMD. with most having near normal vision or slight sight loss.

A small number of people with early/dry AMD progress to late/wet AMD, which can cause severe vision loss. 

The most common form of late stage AMD is wet AMD. It occurs when abnormal blood vessels grow underneath the retina. These fragile and unhealthy vessels can leak fluid and blood, damaging light-sensing cells in the retina and preventing them from working properly. Eventually the bleeding and scarring can lead to severe permanent loss of central vision, but the eye is not usually at risk of complete vision loss as peripheral (side) vision remains.  

There is a less common form of late AMD called geographic atrophy, where vision is lost through severe thinning or even loss of the macula tissue without any leaking blood vessels. Unfortunately, antiangiogenic medicines cannot help this form of late AMD.

Wet AMD progresses more rapidly than early/dry AMD. Regular eye exams are important to detect wet AMD before extensive vision loss occurs.

Symptoms of AMD

Age-related macular degeneration (AMD) symptoms can occur in one or both eyes and affects your central vision. They are not painful and do not affect eye appearance.

Early symptoms of AMD include distorted areas or blurring of your vision. As it worsens, you may be unable to see things in the middle part of your vision and will lose the ability to see fine details, both close-up and at a distance.

Your side, or peripheral, vision usually remains normal. For example, when those with AMD look at a clock, they may be able to see the outline of the clock but be unable to tell the exact time. Similarly, people with AMD will gradually lose the ability to recognise individual faces.

Other AMD signs and symptoms include straight lines appearing wavy, colours appearing less bright than before, and objects appearing smaller than they are.

Causes of AMD

The exact causes of age-related macular degeneration (AMD) are unknown, although there is evidence that certain groups are at a higher risk of developing AMD. These include smokers, people who are overweight or have high blood pressure, and people with a family history of macular degeneration.

It is recommended that those with AMD stop smoking, exercise regularly and eat a well-balanced diet to maintain a healthy weight and lifestyle. Certain supplements with antioxidants and zinc may also be able to stop the progression of AMD, although the benefits of these AMD supplements have not been definitively proven. Consult with your GP if you’re considering taking any supplements for your condition.

Make sure you have regular eye checks with an optician, as this can lead to an early age-related macular degeneration diagnosis and ensure you get the treatment you need.

AMD frequently asked questions

To help provide more information on AMD, we have a list of our frequently asked questions. If you cannot find the answer to your question here, please contact our eye care experts who will be delighted to help you.

What is the macular?

The macula is the part of the retina responsible for central, detailed vision. It’s located in the centre of the retina at the back of the eye. The retina converts light entering the eye into visual images.

Light first passes through the eye's lens, then strikes the retina. The macula contains densely packed light-sensitive cells called cones and rods that enable you to see colour and shades of grey. Healthy macular cells allow for sharp central vision.

The macula provides the keenest vision within the retina. It enables you to focus on objects directly in front of you. Damage to the macula, known as macular degeneration, impairs central vision while peripheral or side vision remains unaffected.

 

How can I reduce the risk of AMD?

Regular eye exams can detect macular changes early. Quitting smoking, maintaining healthy nutrition, exercising, and protecting eyes from sun damage may reduce macular degeneration risk. Treatment can slow vision loss, especially when started promptly. Preserving macular health is key to retaining clear sight needed for daily activities.

 

What should I do if I have AMD symptoms?

If you notice any issues or changes in your vision, see your optician as soon as possible.

 

Where else can I get advice and support on AMD?

The Macular Society has information you might find useful. It also has a helpline on 0300 3030 111.

Age-related macular degeneration (AMD) treatment is available at Moorfields Private

You can self-fund or use private medical insurance to fund your treatment.

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