Age-related macular degeneration (AMD) is an eye disease that causes a person’s central vision to become blurry. It usually affects people over the age of 60 years. It can worsen over time but does not usually lead to total vision loss.

A woman who has age related macular degeneration sits with her grandsonShare on Pinterest
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Macular degeneration affects the retina, a layer at the back of the eyeball. This layer contains light-sensitive cells that enable a person to see.

Age-related macular degeneration (AMD) affects a person’s central vision. It becomes more common after the age of 60 years. The first sign of AMD is often blurred vision.

Reading, writing, recognizing faces, and driving can become more difficult. However, there is usually enough peripheral vision to allow other daily activities. Total vision loss is unlikely.

This article looks at the types, symptoms, and treatment for AMD.

AMD can be wet or dry.

Dry AMD, also known as atrophic AMD, develops gradually. There is no treatment, but a person can learn strategies to cope with it. This type accounts for 85–90% of cases.

Wet or exudative AMD, also known as advanced neovascular AMD, happens when new blood vessels develop under the macula. These can cause blood and fluid to leak. This type tends to progress more quickly and results in more severe vision loss.

In 10–15% of people with AMD, the dry form progresses to the wet form. This can happen at any stage of dry AMD.

Juvenile macular degeneration can affect younger people. It stems from a genetic condition.

What is the difference between wet and dry AMD?

Vision without AMD (left), and how AMD can affect vision (right). National Eye Institute, National Institutes of Health, Public domain, via Wikimedia CommonsShare on Pinterest
Vision without AMD (left), and how AMD can affect vision (right). National Eye Institute, National Institutes of Health, Public domain, via Wikimedia Commons

Doctors do not consider wet AMD to have an early or intermediate stage. They regard wet AMD as advanced stage AMD. In the advanced stage, symptoms are the same for wet and dry AMD.

The table below shows how symptoms can affect a person.

Dry AMDWet AMD
Early stageno symptomsnot applicable
Intermediate stageno symptoms / mild symptoms, including blurriness and difficulty seeing in low lightnot applicable
Advanced stageblurring or blank spots in the central vision
straight lines starting to look wavy or crooked
colors appearing faded
difficulty seeing in low light
as for dry AMD

Doctors do not know exactly why AMD occurs, but genetic and environmental factors may play a role, including oxidative stress.

Features of AMD include:

  • changes in pigmentation
  • drusen, which are fat deposits that appear as pale yellow spots on the retina
  • a thickening of Bruch’s membrane, a layer between the retina and the choroid
  • basal laminar deposits on the retina consisting of collagen fibers and other substances
  • in dry AMD, a thinning of the retina around the macula
  • in wet AMD, new blood vessels form rapidly and incorrectly, leading to lesions, scarring, exuding of fluid, and internal bleeding

Factors that may increase AMD risk include:

  • being aged over 60 years
  • smoking
  • having a family history of AMD, as around 15–20% of those with AMD have a close relative who also has it
  • high blood pressure
  • obesity
  • a diet that is high in fat and processed foods
  • a low intake of certain nutrients, such as antioxidants and zinc
  • exposure to UV rays, for example, from sunlight

There is evidence that AMD and cardiovascular disease (CVD) share some risk factors. Scientists are not entirely sure what links them. However, lifestyle choices that reduce CVD risk may also help reduce the risk of AMD.

If vision problems start to occur, a person should contact an eye doctor, an optometrist, or an ophthalmologist.

The doctor will give the person some eye drops to dilate the pupil and then examine the eye.

They may also recommend:

  • Optical coherence tomography: Special light rays scan the retina and take an image. The image can show if the macula has any unusual features.
  • Amsler grid: The person looks at a grid with vertical and horizontal lines. If AMD is present, some of the lines on the grid may seem distorted, broken, or faded.
  • Fluorescein angiography: The doctor may recommend this if they suspect wet AMD. The doctor injects a dye into the person’s arm and examines their eyes with a special magnifying device. They can take pictures of the eye that show whether the blood vessels behind the macula are leaking.

Treatment for AMD cannot restore vision, but it can slow vision loss.

Dry AMD

There is no treatment for dry AMD, but tips that can help a person manage it include:

  • choosing larger print books or increasing the font size on screens
  • using magnifying devices
  • changing the lighting

Wet AMD

Some treatments can help slow the progression of wet AMD.

Anti-vascular endothelial growth factor medication

Vascular endothelial growth factor (VEGF) is a chemical that contributes to the formation of new blood vessels in the eyes. In people with wet AMD, anti-VEGF drugs block this chemical and prevent the overproduction of blood vessels.

Examples include:

To deliver the drugs, a doctor will:

  • apply an anesthetic
  • clean the eye, usually with Betadine, to reduce the risk of infection
  • inject the drug into the eye with a very fine needle

The person may need this injection once a month, at least to start with. After this, the intervals may be longer.

Possible side effects include bleeding under the conjunctiva.

In very rare cases, complications can occur, such as:

Photodynamic therapy

Doctors sometimes use this type of laser treatment alongside anti-VEGF injections.

A doctor will:

  • inject the drug verteporfin into the arm
  • numb the eye
  • place a special contact lens on the eye
  • apply a laser light with a specific wavelength to the blood vessels in the back of the eye

This breaks down the blood vessels that are causing wet AMD.

How useful is laser treatment for AMD?

Home and natural remedies

For a person with AMD in one eye, dietary supplements may help prevent or slow the development of AMD in the other eye.

AREDS 2 supplements consist of a special formulation for people who have or are at risk of AMD.

They contain:

A person cannot obtain the right combination of these nutrients from diet alone. Combined in this way, they may help slow the progression of AMD.

A 2020 review suggests that some herbal and natural remedies may help prevent AMD, although there is not enough evidence to show that they will make a difference.

It concludes that some medicinal plants may help, for example:

The following antioxidants may also have benefits:

  • carotenoids, which give rise to vitamin A
  • polyphenol, such as resveratrol
  • flavonoids, such as quercetin
  • anthocyanidins, which give red, blue, and purple plants their coloring
  • vitamin C and E

These antioxidants are present in plant-based foods, such as fruits and vegetables.

Anyone who wishes to try supplements or significantly increase their intake of certain foods should first speak with a doctor. Some herbs, spices, and even foods can interact with certain drugs.

Can supplements help with AMD?

Other options

In the future, the following may be options for people with AMD:

Stem cell therapy

Studies have suggested that human stem cells might enable the retina to repair itself one day.

In 2018, The BMJ reported that two people with very severe wet AMD had recovered their sight after stem cell therapy.

Implantable telescope

A 2016 investigation found that an implantable miniature telescope might improve the vision of people with advanced AMD. Benefits include the recovery of some sight and a greater scope for independence. However, the person would not regain their full field of vision or be able to drive a car.

Can treatment reverse macular degeneration?

Vision loss due to AMD can affect a person’s quality of life and lead to various complications, such as:

However, rehabilitation and support are available for people with AMD. A low vision specialist can help people learn how to use their remaining vision to its maximum potential in their daily activities.

It is not always possible to prevent AMD, but these tips may help:

  • following a diet that contains plenty of fruits and vegetables
  • exercising regularly
  • avoiding risk factors for CVD, as there may be a link
  • quitting or avoiding smoking
  • having regular eye tests
  • wearing sunglasses that block UV rays to protect the eyes from damage

The authors of a 2021 review found evidence that increasing the intake of omega-3 polyunsaturated fatty acids, particularly docosahexaenoic acid and eicosapentaenoic acid, may reduce the risk of an early subtype of AMD. Again, more research is needed to confirm this.

People often ask the following questions about AMD.

Is there any treatment for AMD?

There is no treatment for dry AMD, the most common type. However, anti-VEGF medication can help slow or stop the damage that wet AMD causes. Taking AREDS 2 can help slow the progression of dry AMD.

What are the early warning signs of AMD?

The first sign is usually blurry vision or changes to central vision. A person may not notice any changes in the early stages, but an eye test may detect them.

What causes AMD?

AMD happens as the macula, a part of the retina, degenerates over time. Smoking may increase the risk, and there may be a link with CVD.

The video below explains what macular degeneration is and how it affects vision.

Age-related macular degeneration (AMD) is an eye disease that can affect central vision. It is common among older adults. A person with AMD will not have complete vision loss, but it will become harder for them to read, drive, and do other daily tasks.

Dry AMD is the most common type. It progresses slowly and happens as the macula gets thinner. There is no cure, but some lifestyle remedies can help people manage with reduced vision.

Wet AMD can progress quickly. It happens when blood vessels in the back of the eye start to develop incorrectly.

Anyone who notices changes in their vision should see an opthalmologist. If wet AMD is present, early treatment can help manage it.