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Age-Related Macular Degeneration (AMD)

Age-Related Macular Degeneration (AMD)

What It Is

Age-Related Macular Degeneration (AMD) — often called macular degeneration — is a chronic, progressive eye disease that affects the macula, the small central area of the retina responsible for sharp, detailed vision.

The macula allows us to read, drive, recognize faces, and see fine detail. As it deteriorates, central vision becomes blurry or distorted, while side (peripheral) vision usually remains clear. AMD is the leading cause of vision loss in adults over 55 in North America.

Types of Macular Degeneration

Dry AMD

  • The most common form of AMD (90% of cases).
  • Occurs when light-sensitive cells in the macula gradually break down.
  • Early stages are often symptom-free but may show drusen — small yellow deposits visible during an eye exam.
  • Over time, people may notice blurred or distorted central vision and difficulty seeing in dim light.

Wet AMD

  • Less common (about 10% of cases) but more aggressive.
  • Caused by abnormal blood vessels growing under the macula that leak fluid or blood.
  • Leads to rapid and severe central vision loss if untreated.
  • Timely referral and treatment with specialized injections can halt or slow the disease.
  • Optometrists play a critical role in early detection, monitoring, and referral to preserve vision.

Who It Affects / Risk Factors

AMD can affect anyone, but certain risk factors increase your likelihood of developing the condition:

  • Adults over 55 👵
  • Smokers or those exposed to secondhand smoke
  • Family history of AMD
  • High blood pressure, arteriosclerosis, or high cholesterol
  • Obesity or poor diet
  • Light-coloured eyes
  • Long-term UV exposure
  • Diets low in antioxidants and high in fat, sugar, or processed foods

Symptoms to Watch For

In the early stages, AMD may cause no noticeable symptoms and can only be detected through a comprehensive eye exam. As it progresses, symptoms may include:

  • 👁️ Blurred or distorted central vision
  • 🌀 Straight lines appearing wavy or bent
  • ⚫ Dark or blank spots in the center of vision
  • 📖 Difficulty reading or recognizing faces
  • 🌙 Trouble seeing in dim light

AMD is painless and not visible to others — regular exams are the best defence.

How It’s Diagnosed

Optometrists use several painless diagnostic tools to detect AMD and determine its type and severity:

  • Retinal imaging and OCT (Optical Coherence Tomography) – uses infrared light waves to create detailed cross-sectional images of the retina, showing drusen or fluid buildup.
    • Normal macula: smooth, uniform layers.
    • Dry AMD: visible drusen (waste deposits).
    • Wet AMD: fluid or blood leakage beneath the retina.
  • Amsler grid test – detects wavy or missing areas in your central vision.
  • Visual acuity
  • Dilated retinal exam – allows your optometrist to assess the macula directly.

Early detection is essential — changes can occur silently before vision loss is noticed.

How AMD Affects Your Vision

AMD primarily affects central vision, which is vital for seeing fine detail.

  • In the early stages, a slightly blurred spot may appear in the center of vision that glasses cannot correct.
  • As it progresses, the blurred area may grow larger, making reading and face recognition difficult.
  • Straight lines may appear wavy or distorted, and dark spots may obscure parts of your view.

Peripheral vision typically remains intact, but quality of life can be severely impacted without treatment.

Can AMD Be Prevented?

While there’s no guaranteed prevention, lifestyle changes can significantly reduce risk:

  • 🚭 Quit smoking and avoid secondhand smoke.
  • 🕶️ Wear UV-protective sunglasses outdoors.
  • 🥦 Eat a nutrient-rich diet: leafy greens, orange and yellow fruits, fish, and whole grains.
  • ❤️ Control blood sugar, blood pressure, and cholesterol.
  • 🏃 Exercise regularly to support circulation and eye health.

Can You Stop AMD From Progressing?

There is no cure for AMD, but early detection and intervention can slow progression.

💊 Nutritional Supplements (Dry AMD)

  • Optometrists may recommend AREDS2-formulated ocular vitamins, shown to slow certain stages of AMD.
  • Supplements cannot reverse vision loss, but they can reduce the risk of progression from dry to wet AMD.

💉 Treatment for Wet AMD

  • Anti-VEGF injections delivered directly into the eye can stop abnormal vessel growth and leakage.
  • Early referral and consistent treatment offer the best chance of preserving vision.

🔍 Monitoring & Support

  • Amsler grid testing at home helps detect changes early — report any new distortions immediately.
  • OCT scans allow optometrists to monitor subtle retinal changes over time.

Low Vision Rehabilitation

For individuals with advanced AMD, optometrists can connect you with low-vision rehabilitation services to maintain independence and quality of life.
This may include:

  • Magnifying devices and assistive technology
  • High-contrast lighting and reading aids
  • Training and mobility strategies to optimize remaining vision

When to See Your Optometrist

Adults over 55 should have a comprehensive eye exam every year.
Book an appointment immediately if you notice:

  • Sudden blurred or distorted central vision
  • Straight lines appear wavy
  • Dark or missing spots in your vision

Early detection is the most effective way to protect your sight.