Age-related macular degeneration (AMD) is an eye condition that affects vision at the center of the eye and progresses slowly. However, it has three defined stages: early, middle, and late AMD.

AMD is an eye disease that can cause a person’s central vision to become blurry. It typically affects older adults. There are two types of AMD: dry AMD and wet AMD. Dry AMD may progress through three stages as the condition worsens. Doctors do not consider wet AMD to have an early or intermediate stage. Instead, they only regard the condition as advanced stage AMD.

Vision loss becomes a risk in late stage AMD. However, AMD rarely shows symptoms until later stages. Progression also depends on the type, as dry AMD and wet AMD worsen at different speeds.

This article explains the stages of AMD, what they mean for vision, and how to tell when progression has occurred.

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Dry AMD progresses in three stages: early, middle, and late. Any stage of dry AMD can turn into wet AMD. However, healthcare experts always classify wet AMD as late stage AMD.

Early stage AMD

This stage typically causes no symptoms. A person will likely not be aware of early dry AMD unless an eye doctor, such as an optometrist or ophthalmologist, identifies it during a routine eye exam. Regular eye exams are crucial for catching AMD at this stage.

Middle stage AMD

Some people will not experience symptoms once AMD progresses to the next stage. Middle stage AMD can sometimes cause mild blurriness in the middle of the visual field and present issues with vision in low lighting.

Late stage AMD

Around 28% of people with middle stage AMD experience a progression to late stage dry AMD, or geographic atrophy, within 5 years. As it is gradual, those with late stage AMD will have had the condition for years.

The first symptoms of late stage AMD are often gray spots at the center of a person’s vision. Blurriness in the central vision may also develop, and the blurry area may grow over time. Straight lines may appear wavy or lopsided. It might become difficult to see in low lighting, and colors might also become duller over time.

Once dry AMD reaches this stage, vision loss is permanent.

AMD is an eye condition that can cause central vision to become blurry. A 2017 review suggests that around 8.7% of the world’s population has AMD.

There are two types of AMD: wet and dry. Both lead to different changes in the eye and progress at different speeds. However, both affect the macula, which is the area at the center of the retina. The retina is the layer of cells at the back of the eye that detects color, contrast, and accuracy.

Read on to learn more about both wet and dry AMD.

Dry AMD

Over time, the retina and macula get thinner, leading to dry or atrophic AMD. Everyone with AMD starts with this form, which may progress to wet AMD at a later stage. However, dry AMD takes several years to progress to a later stage.

Dry AMD becomes more likely after 55 years of age, but several other factors can increase the risk of getting AMD or losing vision upon developing the condition, including:

  • smoking
  • not exercising much
  • high blood pressure
  • high cholesterol
  • a family history of AMD
  • being white

Currently, there is no treatment for dry AMD.

Wet AMD

In this form, tiny new blood vessels form at the back of the eye. These blood vessels can then leak, damaging the macula. According to the American Macular Degeneration Foundation, 10–15% of people with dry AMD develop wet AMD. Wet AMD can happen at any stage of dry AMD, but it is always late stage when it develops.

People with wet AMD can experience vision loss quickly and severely unless they receive treatment. However, treatments are available and can help those with wet AMD preserve their vision if they receive timely care.

A person with dry AMD may not experience symptoms until the middle or late stages. These might include:

  • central vision loss
  • difficulty seeing at night or requiring a bright nightlight or flashlight to see in the dark
  • issues when reading words, which might become blurry
  • trouble with recognizing faces or facial expressions

AMD can develop in one or both eyes. Around 64.5% of people with AMD have it in both eyes at the same stage of progression. This means an estimated 35.5% of individuals may have different stages of AMD in either eye.

It is also possible for dry AMD to keep progressing along with wet AMD in an eye with both. This is because the dry and wet forms of AMD are not mutually exclusive.

The progression of AMD in the eye at an earlier stage may have a direct effect on whether the condition develops in both eyes. If one eye develops geographic atrophy, it increases the risk of late AMD developing in the other eye. However, it is also possible to protect the other eye.

There is no way to reverse vision loss due to late stage dry AMD. However, diagnosing AMD at an earlier stage means that it may be possible to slow or prevent progression. However, this involves regular eye exams, as early stages are often symptomless.

Specialist eye doctors may recommend nutritional supplements to reduce the risk of AMD progression and vision loss. They may refer to these supplements as AREDS/AREDS 2, which include:

Other lifestyle adjustments that can support slower progression might include:

  • quitting or avoiding smoking, if applicable
  • maintaining a moderate weight
  • controlling blood pressure
  • regular exercise
  • wearing sunglasses that protect the eyes from the sun’s UV rays

Dry AMD progresses through early, middle, and late stages. It can become wet AMD, a more rapidly progressing type, at any stage. Doctors always classify wet AMD as late stage AMD. Both eyes are often at the same stage, but they can have different types and different stages of AMD.

AMD can cause vision loss at a late stage. However, it is possible to prevent late stage AMD by identifying AMD early on, taking certain supplements, and making lifestyle adjustments. For this reason, it is a suitable idea to get regular eye exams to check for early signs of AMD.