Not Every Symptom Is From Macular Degeneration

In my work with those who have macular degeneration, I am frequently asked whether a certain symptom is one of age-related macular degeneration (AMD) or another type of macular degeneration. There are many eye problems that can coexist with AMD or can occur while you have it.

I am not a doctor, so please don't substitute the information you find here for the care you need from your eye specialist. If you have any question in your mind about what a symptom or symptoms might mean, I recommend you call your eye specialist. Better safe than sorry, right?

Symptoms of macular degeneration

We’ll start with the symptoms of macular degeneration. Unless I say that there’s a specific symptom for a specific type of macular degeneration, the symptoms also apply to the others.

Age-related macular degeneration (AMD) and other forms of macular degeneration all affect the central vision. These are some of the symptoms:

• No pain
• Central vision blurriness
• Progressive vision loss
• Need for increased light
• Light sensitivity
• Colors are off or muted
• Fine details are not easily seen
• Problems with depth perception
• Dark adaptation is not good which means that you can’t see well when going from a bright area to a dark one, such as from the bright lobby of a movie theater into the theater
• Distorted central vision where straight things look wavy or like what you would see in a carnival/funhouse mirror. It’s called metamorphopsia
• A spot in the center that looks like a smudge (some say a smudge of Vaseline). It can be a grey spot you can see through or a black spot that obscures vision. This is often called a blind spot or scotoma
• Stargardt disease: Color blindness

Eye and vision symptom emergencies

There are some eye and vision symptoms that are emergencies, especially those that are accompanied by pain, loss of vision, nausea, vomiting, and headache. These don’t always happen during office hours, so I advise you to find out what to do in an emergency BEFORE you might need it. Most eye specialists have emergency phone numbers and instructions.

CNV (choroidal neovascularization)

The first thing I tell anyone with macular degeneration who comes to me with a symptom is that if you have a change in your vision, especially if it is sudden, call your eye specialist as soon as possible. We know that with any type of macular degeneration (AMD, Stargardt disease, myopic macular degeneration, and others), vision can change if there’s bleeding under the macula which is called choroidal neovascularization (CNV). If that occurs, treatment as soon as possible is necessary to preserve vision.

If there is any question in your mind, I advise you to call your eye specialist.

Retinal detachment

If you ever have an obstruction of part of your visual field, that may be a retinal detachment which is another emergency situation. Some people describe it as having a curtain come in from either side, top or bottom of the visual field. That may also be accompanied by flashing lights, bug-like or cobweb-like floaters, and blurriness.

The flashing lights and increase in floaters may be from a posterior vitreous detachment (PVD) which is not an emergency. It happened to me after cataract surgery which is common. I suddenly had cob-web like floaters and flashes of light. At the time, I didn’t know what had happened, so I called to get an appointment with my eye specialist. I was seen the same day. My eye specialist was able to see that it was not a full detachment. He warned me that if my visual field becomes obstructed, to call back.

Glaucoma

Please call your eye specialist as soon as possible if a worsening of your vision is accompanied by severe eye or forehead pain, nausea, vomiting or a headache. These are the symptoms of increased eye pressure from glaucoma. This is an emergency.

Diabetics aren’t the only ones to develop glaucoma. Increased eye pressure can result from an anti-VEGF injection which is why some retinal specialists test eye pressure after an injection.

Eye stroke

Just like a stroke in the brain, an eye stroke is caused by loss of blood to the retina. It’s also called a retinal artery occlusion, and it usually occurs in one eye. There’s no pain. The first symptom is often a sudden loss of or change in vision. Some people may have an increase in floater or blurriness.

Sudden vision loss is always an emergency.

Eye pain

Eye pain may be an emergency depending on how long the pain lasts and what other symptoms accompanies it. As I said above, severe eye pain may be a symptom of glaucoma especially if accompanied by the symptoms above.

Pain by itself or with other symptoms can come from a corneal abrasion or infection, foreign body in the eye, issues inside the eye from trauma, inflammation of the optic nerve, or sinus infection (pain is usually beside or behind the eye).

Temporary eye pain can be a side effect of injections of anti-VEGF medication for bleeding in the macula (wet AMD, CNV in other forms of macular degeneration such as myopic macular degeneration or Stargardt disease).

If the eye pain does not go away, call your eye specialist.

Symptoms of other eye disorders

These are not the only symptoms of eye problems. They are the ones I most often am asked about. You can get more information from the webpage ‘Eye Symptoms’ from American Academy of Ophthalmology (AAO).¹

This is where it gets tricky. You can see that these symptoms can occur in multiple problems:

• Blurriness - If it's central vision blurriness it can be macular degeneration, digital eye strain (comes and goes), a refractive problem (you need to check the prescription on your eyeglasses if you wear them), glaucoma, and quite a few others
• Colors are muted - Macular degeneration, cataracts, second/secondary cataracts
• Depth perception is a problem - Macular degeneration
• Double vision, temporarily seeing double - Digital eye strain (if you’re using electronic devices)
• Double vision in one eye - Macular degeneration, cataracts
• Double vision, ‘ghosting’, overlapping images - Dry eye syndrome, eyeglass problem.
• Double vision both eyes that doesn't go away - Call your eye specialist!! It may be a neurological problem
• Dry eyes - Dry eye syndrome, digital eye strain, and others
• Fine detail, problems seeing - Macular degeneration.
• Floaters and flashes of light - Retinal detachment, PVD
• Flashes of light or ‘zig zags’ in the middle of the visual field - Ocular migraine, migraine headache
• Hallucinations, visual - Charles Bonnet Syndrome (CBS) in those with vision loss
• Halos or starbursts around lights such as street or car lights - Cataracts, second/secondary cataracts
• Itchy and watery eyes - Allergies, digital eye strain, and others
• Light, need for more light - Macular degeneration
• Light, sensitivity to - Digital eye strain, macular degeneration
• Wavy lines and other distortions - Macular degeneration

Summary

I hope I’ve helped to clarify what symptoms are from macular degeneration and what are not. I’ve stressed what symptoms are cause for emergency action. I hope it never happens to you, but I recommend that you find out from your eye specialist what to do in an emergency.

When in doubt, I recommend you call your eye specialist.