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Symptoms and Complications of Macular Degeneration

Macular degeneration is a common eye condition that damages the macula, which is near the middle of the retina and necessary for central vision. Progression can vary among individuals, with some people experiencing a slow loss of vision, and some experiencing more rapid loss of vision. Knowing the symptoms of macular degeneration can help enable you to visit the eye doctor as soon as you become aware of anything abnormal, and being aware of potential complications of the disease is crucial in helping you maintain your eye health and manage your condition.

Symptoms

You might not have any symptoms of macular degeneration at first. In fact, in the early stages of the condition, it is often asymptomatic. An eye doctor can detect changes that are indicative of macular degeneration with an eye exam and various tests and photographs, but you won’t necessarily have any symptoms. This is one reason why regular eye exams are so important, especially as you age.

Initial symptoms

Once symptoms do start becoming apparent, you might start to notice minor changes in vision. This can include1:

Progression

The progression of macular degeneration varies by each individual. An individual with myopic macular degeneration may have slow or sudden progression of visual symptoms. Those with an earlier onset of Stargardt disease tend to have more rapid vision loss. The vision loss in wet AMD may progress more rapidly than in dry AMD – even as quickly as over several days.1 If you start to notice any changes in your vision, call your eye doctor as soon as possible.

Progressive symptoms

As macular degeneration progresses, other symptoms may appear, including1:

  • Significant loss of central vision (it might look smudged or distorted)
  • You have trouble seeing detail and contrast, colors may appear washed out
  • Increasing difficulty adjusting to different levels of light, especially low light conditions
  • You need lights that are brighter and brighter in order to see and do things
  • Trouble with depth perception

Complications

Choroidal neovascularization (CNV)

Choroidal neovascularization (CNV), or the abnormal growth of blood vessels underneath the retina is typical of wet AMD and can be a complication for myopic macular degeneration. If you have wet AMD or myopic CNV, there is a possibility that these blood vessels might leak or bleed. This disrupts the normally flat retina, and can have severe effects on central vision very quickly.2 Intravitreal injections (injections into the eyeball) of medication, typically anti-VEGF treatments, are usually given to help manage wet AMD and CNV in myopic macular degeneration.

Charles Bonnet syndrome

Sometimes macular degeneration and other retinal diseases can cause visual hallucinations, called Charles Bonnet Syndrome. This is more likely to occur in those with more advanced retinal disease. While rare, this does happen and is not caused by a psychiatric condition, metabolic abnormalities, or brain injury.3

Retinal detachment

Retinal detachment is another possible complication of macular degeneration, although it can happen for other reasons, as well. When the retina detaches from the eye, the retinal tissues separate from the blood vessels that previously provided nourishment to those cells, potentially damaging them and causing vision loss.4 Symptoms of retinal detachment can include seeing “floaters” or spots in your vision, flashes of light in one or both eyes, blurry vision, and reduced peripheral vision.4 If you have symptoms of retinal detachment, you need to see your eye doctor immediately.

Depression

Losing your vision, independence, and ability to perform certain activities that you enjoy can cause sadness and feelings of isolation, and in some cases, even depression. Overall quality of life is affected by macular degeneration, and without adequate support systems, depression can result.5 It’s important to address mental and emotional health concurrently with your physical health for overall well-being.

Falls and fractures

Due to low vision, you are also at higher risk of falling, which may result in head injury, bone fractures, and trauma to other parts of the body. Especially in low light, it might be hard to see contrasting objects such as steps or landings, electrical cords, or an upturned carpet, putting you at risk for falling and getting hurt.

Adapting to vision loss

As your vision becomes more impaired, there are many things you can use to adapt to your changing needs. You might need special lenses in your glasses, hand-held or electronic magnifiers, or other adaptive devices.

Support

This is where a good support team comes in: occupational therapists, mobility specialists, certified low vision specialists, and counselors. They can help address practical and physical needs and show you how to adapt your daily activities to your changing visual abilities. They may also help you work through any emotional impacts associated with progressive loss of vision.

Looking out for warning signs

With any chronic condition, as well as progressive conditions, complications are to be expected; it’s how they are dealt with that matters. Knowing the potential complications of macular degeneration and what the treatment options are can help you be prepared for when or if they arise, and it’s always good to know about your health information and options from which to choose. This allows you to be an active part of your healthcare team. Talk with your doctor about various symptoms you should be on the lookout for throughout the course of your macular degeneration, and what signs might alert potential complications. They can let you know about any specific warning signs and what to do if you notice anything abnormal.

Jaime R. Herndon | December 2018
  1. BrightFocus Foundation. Macular Degeneration: Signs & Symptoms. 2018. https://www.brightfocus.org/macular/symptoms-and-signs. Accessed October 16, 2018.
  2. American Macular Degeneration Foundation. Wet Macular Degeneration. N.d. https://www.macular.org/wet-amd. Accessed October 16, 2018.
  3. Jan T, del Castillo J. Visual hallucinations: Charles Bonnet Syndrome. West J Emerg Med. 2012; 13(6): 544-547. Doi: 10.5811/westjem.2012.7.12891. Accessed October 17, 2018.
  4. Retinal Detachment. Mayo Clinic. 2018. https://www.mayoclinic.org/diseases-conditions/retinal-detachment/symptoms-causes/syc-20351344. Accessed February 5, 2019.
  5. Sacconi R, Corbelli E, Querques L et al. A review of current and future management of geographic atrophy. Ophthalmol Ther. 2017; 6(1): 69-77. Doi: 10.1007/s40123-017-0086-6. Accessed October 17, 2018.