Macular degeneration symptoms and treatment

Early macular degeneration symptoms include problems seeing details such as small print when reading, with your central vision becoming blurry.

Also called age-related macular degeneration (AMD), there are two types; dry and wet. Dry AMD symptoms progress slowly, and there's no treatment available, but you can get support to help you deal with changes to your vision. Wet AMD symptoms can develop rapidly, but treatment can stop its progression and prevent further damage to your sight.

If you have any concerns about your sight or notice possible signs of AMD, see your optician or GP for advice.

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Macular degeneration symptoms

Macular degeneration is an eye disease that affects the macula, part of the retina at the back of the eye. It's not painful, but it blurs or distorts the central vision we use to look straight at things when reading or watching television.

Symptoms include:

Straight lines appearing wavy or with bumps in them
Being more sensitive to bright light
Noticing your sight isn’t as clear as it was before
Having a dark patch or blind spot in your vision
Objects ahead seeming smaller or even appearing to move or disappear
Colours appearing washed out

Dry macular degeneration symptoms

The dry form of AMD tends to develop gradually over months and years. It can sometimes be detected during an eye test before you notice any symptoms. If you do experience changes to your sight, see your optician for an eye test.

In the later stages of AMD, it’s possible to experience visual hallucinations as a symptom if you have significant sight loss. This can understandably feel scary but is how the brain naturally adjusts to a substantial loss of vision.

Wet macular degeneration symptoms

Wet AMD can develop very quickly, in a matter of days or weeks. It’s essential to see your optician or specialist if you notice a sudden change in your sight, particularly if you already have dry AMD.

Although the conditions are called ‘dry’ and ‘wet’, these names don’t refer to the kind of symptoms you’ll experience. Wet AMD describes internal changes to the eye (the growth of blood vessels behind the macula) and doesn’t mean you'll experience tearing or watery eyes.

Dry AMD progresses very slowly over years. It can lead to central vision loss, but this happens gradually, giving you time to adjust to the changes in your sight. The wet form of AMD can develop very quickly - your optician or ophthalmologist should check out any sudden changes in your vision. Neither condition affects peripheral vision, which provides the field of vision we rely on for moving around. This means AMD doesn't cause total blindness.

With later AMD, some people experience visual hallucinations, also known as Charles Bonnet syndrome. This is a normal way for the brain to deal with sight loss, by trying to compensate for the loss of visual stimulus by creating images that appear real to you. These hallucinations aren’t a sign of mental illness, and tend to improve with time.

Macular degeneration treatment

There's currently no known dry AMD treatment, but support can help you manage the condition and get the most from your vision. Practical ideas to make everyday life easier include changing to brighter lights in your home, using visual aids like magnifiers, and technology like e-readers and tablets.

Find out more about living with macular degeneration, and the support people find most useful, for example, low vision assessments.
About 10-15% of people with dry AMD develop wet AMD (Source: Macular Society). There are treatments for this type of AMD that stop further damage and leakage:

Eye injections - you may be given a medicine called anti-vascular endothelial growth factor (anti-VEGF) via an injection into your eye. You’ll have anaesthetic eye drops beforehand to reduce your discomfort. Lucentis, Eylea, Beovu or Avastin injections are typically given each month for a few months, then for as long as needed. This treatment prevents the condition from worsening in the vast majority of people. For three in ten people, their sight improves (Source: NHS).

Laser therapy - very rarely, in certain circumstances, laser treatment may be used. This is only suitable in some situations, depending on the nature of the damage to the retina, and it has more risks than anti-VEGF treatment.

Getting help as soon as possible for wet AMD will help prevent scarring and further loss of sight. Always seek medical advice if you’re concerned about any changes to your vision or eye health.

Macular degeneration symptoms test and diagnosis

See an optician if you notice problems that could be the early signs of macular degeneration. These include difficulty seeing details, for example, reading small print or if straight lines such as wall tiles start to look wavy. Minor changes to your vision can be hard to notice, so tools like an Amsler grid can help you check if your sight is distorted. The Amsler grid is like a piece of graph paper with straight vertical and horizontal lines. By looking at it with each eye, in turn, you can tell whether the lines look distorted or wavy.

An AMD test will start with your optician looking closely at the back of your eye to check for signs of ‘drusen’ (yellow dots) on the retina. These can occur as a normal part of ageing but can also be a sign of AMD. They may use an optical coherence tomography (OCT) scan to take detailed images of the back of the eye. This is a painless, non-invasive test.

If you have wet AMD your optician will refer you urgently to a hospital eye clinic for treatment. If they suspect dry AMD but need confirmation of your diagnosis, they may also refer you to a hospital eye clinic, although less urgently.

Eye exams and macular degeneration

Regular eye examinations are important for detecting a range of eye conditions, sometimes before any symptoms develop. The NHS recommends having an eye test at least once every two years.

If you have a family history of an eye condition such as AMD, make sure you mention this to your GP, eye doctor or optician. They may recommend you have further tests or more frequent eye exams to help spot any early symptoms.

If your optician thinks you have AMD, they may refer you to an ophthalmologist for confirmation and specialist support. They may even put you in touch with a dedicated AMD service.

Preventing macular degeneration

Age is the leading risk factor for AMD. The condition usually first develops in people in their 50s and 60s (Source: NHS). As women tend to live longer, it’s more common to see AMD in women than men.

While you can't necessarily prevent AMD, you can do something about lifestyle risk factors. Evidence strongly suggests that stopping smoking is a positive step to reduce the risk of developing AMD (Source: British Journal of Ophthalmology). Having an active lifestyle and a healthy diet rich in antioxidants is good for your eye health as well as your overall wellbeing.

Frequently asked questions

Medically reviewed by: The Royal College of Ophthalmologists on 28/07/2022

Edited by: Nick Astbury FRCS FRCOphth FRCP
Clinical Associate Professor
LSHTM

The Royal College of Ophthalmologists champions excellence in the practice of ophthalmology and is the only professional membership body for medically qualified ophthalmologists. The RCOphth is unable to offer direct advice to patients. If you’re concerned about the health of your eyes, you should seek medical advice from your GP, optometrist or ophthalmologist.

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