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Blurry Central Vision

Macular degeneration is a common condition of the eye and is a main cause of vision loss in people age 50 and older. It damages the macula, which is close to the middle of the retina and is the area of the eye necessary for central vision.1 There are several types of macular degeneration, including age-related macular degeneration (AMD), Stargardt disease, and myopic macular degeneration. Knowing the symptoms of macular degeneration when they do appear can help you get prompt attention and treatment, helping you protect your remaining vision and maintain eye health.

How does the eye work?

One of the first symptoms that people tend to notice among the types of macular degeneration is blurry vision, namely blurry central vision. This occurs because of how the eye and brain work together to enable one to see. If the eye is like a camera, the retina is like the film, and the macula is at the center of the retina. When you see an object, the macula absorbs all of the information about the object and then this information is transmitted to the brain, via the optic nerve, to generate an image.2

Damage to the macula

When the macula is damaged in any way, the signals that the brain receives are altered or missing. In early AMD especially, when the light sensing cells of the retina are not significantly damaged, vision may seem normal or any differences may be barely noticeable. As AMD starts destroying cells of the macula, central vision may become blurred, shadowy, or there may be a dark spot in the middle of your vision. As the condition progresses, your vision may continue to deteriorate.

Treatment

While there is no standard, universal “treatment” per se for blurry vision, you can use adaptive equipment to help you see better and help you with everyday activities. These include reading glasses with high-powered lenses, handheld magnifying devices, large-print reading materials, computers with software that enables large-print or attaching magnifying devices to the screen, talking clocks, and audiobooks. Tablets and E-readers with a backlight may also improve contrast and magnify text, allowing one to read faster and with greater comfort.3

Surgical options

For some individuals with bilateral end-stage dry AMD with corrected vision of 20/160 to 20/800, there is an FDA-approved surgical option called an implantable miniature telescope (IMT).2

Implatable miniature telescope procedure

Prior to the surgery, patients need to show a 5-letter improvement on visual acuity tests using an external telescope in order to assess the benefits of going through the surgery.2 The surgery consists of removing the natural lens of the eye and then implanting the IMT instead of the usual plastic intraocular lens that is normally provided during cataract surgery. Working with a low vision therapist and an occupational therapist is required prior to surgery as well as after surgery. This is because the surgery affects depth perception and causes tunnel vision; it takes time and training to adjust to these visual changes and adapt one’s behavior to the new visual field.

Talk to your doctor

The surgery is not right for everyone. If you’re interested in it, ask your doctor whether it’s appropriate for you, and what the specific risks and benefits are.

Management plan and adaptive tools

Blurry central vision can be distressing at first, but there are ways to manage it and adjust to it. Talk with your doctor as soon as you notice any symptoms of blurry central vision, so she can help provide you with adaptive tools and referrals to low vision specialists or occupational therapists who can show you ways to maintain independence and still do the things you enjoy, despite your vision changes.

Jaime R. Herndon | December 2018
  1. National Institutes of Health: National Eye Institute. Facts About Age-Related Macular Degeneration. 2015. https://nei.nih.gov/health/maculardegen/armd_facts. Accessed October 18, 2018.
  2. American Macular Degeneration Foundation. What is Macular Degeneration? n.d. https://www.macular.org/what-macular-degeneration. Accessed October 18. 2018.
  3. Feng HL, Roth DB, Fine HF, Prenner JL, Modi KK, Feuer WJ. The impact of electronic reading devices on reading speed and comfort in patients with decreased vision. J Ophthalmol. 2017. Doi: https://doi.org/10.1155/2017/3584706.