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Could macular degeneration explain your poor vision?


Macular degeneration (AMD) is a common condition that affects your central vision. If you have AMD, you're not able to see fine details both close-up and at a distance.


AMD generally affects people as they get older. Although it doesn’t cause complete blindness, it can make day-to-day activities such as reading and recognising faces difficult.


What are the causes of macular degeneration?


The exact cause is unknown, though it has been connected with smoking, high blood pressure, being overweight and having a family history of AMD.


What are the symptoms?


AMD affects the middle part of your vision, not the edges (the peripheral vision). You can develop it in one eye or both – the first symptom is usually a blurred or distorted area in your vision. If it worsens, you may have difficulty seeing anything in the middle of your vision. The condition can also make it difficult to read, watch TV, drive or recognise faces.


Other symptoms of AMD include:

• Items seeming to be reduced in size

• Colours appearing to be faded

• Perceiving straight lines to be crooked or wavy

• Experiencing hallucinations


AMD isn't painful and doesn’t affect how your eyes look. Make sure to get routine check-ups with your optician, as the condition can be detected before you experience symptoms.


How is it diagnosed?


Your optician or GP may refer you to a specialist called an ophthalmologist. They will use a light to check your vision and inspect the back of your eyes. To make it easier to spot any problems, they may put drops in your eyes.


When should you get an urgent optician's appointment?


You should make an optician's appointment as soon as you can if:

• Your eye is sore and red

• Your vision suddenly becomes worse

• You have a dark 'curtain' or shadow shifting across your vision

• You suddenly notice that straight lines appear wavy


These can be a sign of other serious eye conditions that need urgent treatment.


What's the difference between dry & wet macular degeneration?


Dry AMD is more common and is caused by a build-up of a fatty substance at the back of the eyes called drusen. It usually gets worse gradually – this can be over several years. Treatment is usually unnecessary unless it becomes wet AMD.


Wet AMD is caused by the growth of abnormal blood vessels at the back of the eyes. It’s less common and can get worse more quickly – in some cases, this can be days or weeks. Treatment can help prevent vision from becoming worse.


What are the different types of treatments for macular degeneration?


Treatment will depend on which AMD you have. If you have dry AMD, there isn’t a treatment available, but vision aids can help to improve vision. For wet AMD, you may need regular eye injections and in some cases, a light treatment called photodynamic therapy that stops your vision from worsening.


Eye injections are given directly into the eyes every one to two months for as long as necessary. But though this sounds painful, don't worry – drops are used to numb your eyes before treatment and most people don't experience much discomfort. Injections stop vision from getting worse in nine out of 10 people and improve vision in three out of 10 people.


Light treatment, or photodynamic therapy, is when a light is shined at the back of the eyes to destroy abnormal blood vessels that cause wet AMD. It usually needs to be repeated every few months and may be recommended along with eye injections if injections alone don’t help. Side effects may include temporary vision issues, and sensitivity to light for a few days to a few weeks.


Research into new treatments for AMD is ongoing. Your specialist can keep you informed of any studies you may be able to participate in.


What are some coping methods for those living with macular degeneration?


Ask your eye specialist about a referral to a low-vision clinic if you’re having difficulty carrying out everyday activities. Staff at the clinic can give you advice and support. For instance, they can talk to you about:

• Devices such as magnifying lenses

• Mobile apps and software that can make technology easier to use

• Changes you can make in the home, for example installing bright lighting


If you have poor vision in both eyes, your specialist may recommend a type of training called eccentric viewing training. This involves methods that help make the most of your remaining vision.


If you have AMD, it’s also important to stay healthy by:

• Quitting smoking if you smoke

• Losing weight if you're overweight or obese

• Eating a healthy diet

• Doing regular exercise


There’s also some evidence that suggests certain health supplements may help, though you should speak to your GP or specialist if you’re considering taking supplements for AMD.


AMD can also make it unsafe for you to drive. Talk to your specialist about whether they think it's safe for you to be driving.


You’re legally required to tell DVLA about your condition if:

• You have it in both eyes

• You have it in only one eye, but your remaining vision is below the minimum standard requirement for driving


Make sure to schedule regular check-ups with a specialist to keep track of your condition. Contact your specialist as soon as possible if your vision worsens or if there are new symptoms.


If your vision continues to decline, you may want to register your sight loss. Doing so could make it simpler to claim financial benefits, such as help with health costs. If you meet the requirements to be registered, your specialist can complete an official certificate.


Living with AMD can be difficult, and some people may find it comforting to join a support group. In addition to seeing a specialist, you can join groups such as The Macular Society or RNIB.


Next steps


• If you're experiencing symptoms of AMD, such as seeing straight lines as wavy, then visit a GP or optometrist

• Depending on the type of AMD, your specialist may recommend treatment such as eye injections or light treatment

• If you have AMD, you can learn to cope with the condition by staying healthy, seeking advice from a low-vision clinic, making sure to schedule regular check-ups, not driving and registering your sight loss

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