Symptoms and Complications of Macular Degeneration

Age-related macular degeneration (AMD) is a common eye condition that causes central vision loss. In people with AMD, part of the retina called the macula becomes damaged.^1,2

The retina lines the back of the eye and processes light. The macula is the part of the retina that controls detailed straight-ahead vision. So, damage to the macula can lead to trouble seeing what is right in front of you.^1,2

Understanding the types of AMD

There are 2 types of AMD: dry AMD and wet AMD. In both types, protein deposits called drusen develop underneath the retina. These drusen can prevent retina cells from getting the oxygen and nutrients they need. Without oxygen and nutrients, those cells die off. The result is damage to the macula and vision changes.^2,3

In dry AMD, drusen may grow larger and/or more numerous as you get older. Over time, they cause more and more cells to die, impairing central vision. In wet AMD, new blood vessels begin to grow in response to the drusen. These blood vessels can press on the retina and leak fluid into the eye. Ultimately, wet AMD scars the macula. This can lead to severe vision loss.^2,4

All cases of AMD start as dry AMD. Some people with dry AMD progress to wet AMD, but most do not. About 85 percent of people living with AMD have the dry form, and about 15 percent have the wet form.⁵

Symptoms of AMD

Dry AMD and wet AMD cause similar symptoms. But symptoms of dry AMD usually come on gradually over several years and progress through stages. Symptoms of wet AMD often occur more suddenly, sometimes in a matter of days or weeks. Wet AMD symptoms are more severe and are always considered advanced-stage symptoms.⁵

Early-stage symptoms

In the early stages of AMD, you will likely have no symptoms. But while you may not notice vision changes, your eye doctor (ophthalmologist or optometrist) can already see signs of the condition.^2,5

Your doctor will perform a dilated exam of your eye to look for drusen or damage in your retina. During this exam, they use a special light and magnifying lens that allows them to see all the way to the back of your eye. If your doctor suspects you have AMD, they will do further tests to find out how advanced the condition may be.^2,5

Intermediate-stage symptoms

As you progress through the intermediate stage of AMD, you will likely begin to develop vision changes. AMD usually affects 1 eye at a time, but it is possible to have symptoms in both eyes. Intermediate-stage symptoms may include:^1,3,5

• Mild blurriness in the central part of your vision
• Small dark spots in your central vision
• Trouble seeing in low-light conditions

Advanced-stage symptoms

Over time, dry AMD may progress to wet AMD and/or geographic atrophy (GA). GA is the most advanced stage of dry AMD. In people who progress to GA, areas of dead cells (lesions) develop on the retina and lead to vision loss. About 30 percent of people with dry AMD will develop GA.⁶

In its advanced stages, the symptoms of AMD become more severe. Advanced dry AMD, wet AMD, and GA each can lead to symptoms such as:^1,3,6

• Larger area of blurriness in center of vision
• More trouble seeing in low-light conditions
• Distortion in your vision, such as straight lines appearing wavy or curved
• Large dark or blank areas in your central vision (also known as blind spots)
• Colors appearing darker or more faded

Possible complications

While AMD does not affect your side (peripheral) vision, loss of central vision can severely affect your ability to function. Because of your AMD symptoms, you may have trouble driving, reading, or recognizing faces. Advanced AMD also can lead to other complications, including:^3,4,7-9

• Severe vision loss – AMD typically causes central vision loss that gets worse over time. Eventually, it may even lead to legal blindness (defined as less than 20/200 vision).
• Depression or anxiety – Vision loss from AMD may cause you to lose your sense of independence and feel isolated. Feelings of depression and anxiety are common in people whose quality of life is affected by AMD.
• Falls and fractures – Having impaired vision can make it hard to see where you are walking, especially in low light. This can make you more likely to bump into things or fall down. The result is an increased risk of bone fractures and other injuries.
• Charles Bonnet syndrome – This condition causes people with reduced vision to see things that are not there, called hallucinations. Hallucinations may vary widely. They may look like patterns of light or lines, or they may look like beings such as animals or people. More than 1 in 10 people with AMD develop this syndrome.
• Retinal detachment – This serious complication occurs when the retina pulls away from the tissue that supports it in the eye. Retinal detachment can cause visual symptoms like flashes of light or a dark curtain over 1 side of your vision. Without quick treatment, this condition can lead to blindness in the affected eye.

How are macular degeneration symptoms treated?

Treatment for AMD symptoms differs depending on which stage and type of AMD you have. For example, people with early-stage AMD typically do not receive treatment. But once they are in the intermediate stage, their doctor may recommend a supplement called AREDS2. These supplements may slow down the damage caused by AMD.¹

For those who have progressed to wet AMD or GA, several medical treatments are available:^1,2,6

• Wet AMD – The primary treatment for wet AMD is with medicines called anti-VEGF drugs. These drugs help slow down the growth of abnormal blood vessels in the eye.
• GA – The US Food and Drug Administration (FDA) has approved 2 drugs to treat GA. Though they work differently, both drugs target parts of the immune system to slow down the growth of lesions.

AMD is more likely to occur as you get older and your macula naturally gets thinner. You are also more likely to develop AMD if you have a family history of it. But you can help prevent vision loss from AMD by getting regular eye exams, quitting smoking if you smoke, and staying in good overall health.¹