Age Related Macular Degeneration

Overview

Age-related macular degeneration (AMD) is a common eye condition that affects the central part of the retina, called the macula. The retina is the light-sensitive layer at the back of the eye, and the macula is responsible for sharp, central vision – the vision you use for reading, driving, and recognising faces. In AMD, the macula becomes damaged over time, causing blurred or missing areas in the centre of your vision. It is not the same as cataracts and it does not affect your peripheral (side) vision.

Yes, it is one of the most common causes of sight loss in older people. In the UK, around 1 in 10 people over 65 have some signs of AMD, and the number increases with age.

AMD mostly affects older adults – it is rare before age 50. It is more common in white people, slightly more common in women, and you are more likely to develop it if a close family member has it or if you smoke.

Symptoms

Common symptoms

• Blurred or fuzzy central vision – for example, words on a page look smudged.
• Difficulty reading, especially in low light, even with glasses.
• Straight lines, like door frames or text, look wavy or bent.
• A dark or empty spot appears in the centre of your vision.
• Colours look less bright or duller than before.

Symptoms in children

• This condition does not affect children. Very rare inherited forms of macular degeneration exist, but they are different from age-related macular degeneration. If a child has any vision problems, see a GP or eye specialist.

Symptoms in older adults

• Same symptoms as above, often starting in one eye.
• A gradual or sudden change in your ability to see details, like reading a book or noticing facial expressions.
• You may find bright light uncomfortable or need brighter light to see clearly.

Causes

Main causes

• Age-related wear and tear on the macula – over time, the cells in the macula become damaged or die.
• Deposits called drusen that build up under the retina – these are a common early sign and can sometimes cause vision loss.
• In wet AMD, abnormal blood vessels grow under the retina and leak fluid or blood, which damages the macula quickly.

Risk factors

• Getting older – the biggest risk factor.
• Smoking – it doubles your risk of AMD.
• High blood pressure or heart disease.
• A family history of AMD.
• Being overweight or having a poor diet (low in fruit and vegetables).
• Spending a lot of time in bright sunlight without eye protection (may increase risk).

When to see a doctor

See a doctor urgently if:

• If you suddenly notice any of the ‘urgent’ symptoms above – like new waviness, a dark spot, or rapid blurring in one eye – contact an eye clinic or optometrist straight away. Prompt treatment can save sight.

Book a routine appointment if:

• If you are over 50 and haven't had an eye test in the last 2 years, book one. Even without symptoms, an eye test can pick up early signs of AMD.
• If you notice gradual changes in your central vision, like needing more light or words looking blurry, make an appointment with an optometrist.

Diagnosis

AMD is diagnosed by an eye specialist – usually an optometrist in a community setting or an ophthalmologist in a hospital eye clinic. They will examine the back of your eye after putting drops in to widen (dilate) your pupils. These drops take about 20–30 minutes to work.

Tests that may be done

• A simple eye chart test to check your visual acuity.
• A dilated eye exam – using a special lens to look at the retina and macula.
• Optical coherence tomography (OCT) – a scan that takes detailed cross-section pictures of your retina to spot fluid or damage.
• Fluorescein angiography – a dye is injected into your arm, then photographs are taken to see if abnormal blood vessels are leaking.

What to expect at your appointment

The eye drops may sting briefly and can make your vision blurry for a few hours. Your eyes may be sensitive to light, so bring sunglasses and arrange someone to drive you home. The results of the scan are usually ready the same day. If you are diagnosed with AMD, your specialist will explain the type and what happens next.

Treatment

There is currently no cure for AMD, but treatments can slow down sight loss, and for wet AMD they can sometimes improve vision. The right treatment depends on the type and stage. Dry AMD is managed with lifestyle changes, low vision aids, and monitoring. Wet AMD is treated with regular injections into the eye to stop abnormal blood vessels leaking.

Self-care at home

• Attend all follow-up appointments and monitor your vision at home with an Amsler grid.
• Stop smoking – it's the single best thing you can do for your eye health.
• Protect your eyes from bright sunlight with good-quality sunglasses.
• Use aids like magnifiers, brighter lighting, and large-print books to help with daily tasks.
• Tell your optometrist about any changes in your vision between check-ups.

Medical treatments

For wet AMD, the main treatment is a medicine injected directly into the eye. This medicine blocks the growth of abnormal blood vessels and helps reduce leaking. The injections are given in a clinic and usually need to be repeated over time. For dry AMD, there is no specific medical treatment yet, but there is some evidence that certain nutritional supplements may help slow progression – your eye specialist can advise you whether this is right for you.

When is surgery considered?

Surgery is not a standard treatment for AMD itself. However, if you also have cataracts, cataract surgery may improve your overall vision. In rare cases, surgery may be considered for complications like a bleed, but this is uncommon.

Living with this condition

Living with AMD means adapting how you use your eyes. Using task lighting, reading with a magnifier, or listening to audiobooks can help. You can ask your optometrist about low vision aids, and your GP can refer you to a low vision clinic. It's also important to stay socially active and tell friends and family how they can support you.

Lifestyle tips

• Keep active – gentle exercise like walking can improve circulation and overall health.
• Stop smoking – smoking is the biggest controllable risk factor for AMD getting worse.
• Protect your eyes from UV light with sunglasses, especially outdoors.
• Keep other health conditions like high blood pressure and diabetes well managed.

Diet and exercise

A balanced diet rich in leafy green vegetables, fruits, oily fish, nuts, and whole grains supports eye health. Foods high in antioxidants, such as spinach, kale, and berries, are especially good. Regular exercise helps keep blood pressure and cholesterol in a healthy range, which also protects your eyes.

Mental health and emotional wellbeing

Losing central vision can feel frustrating and frightening. It's normal to feel anxious, angry, or low. These feelings are understandable, but you don't have to face them alone. Talk to your GP or eye clinic team about support, and consider joining a support group to connect with others experiencing the same challenges.

Prevention

You can't always prevent AMD, but you can lower your risk and slow its progression. Not smoking, eating a healthy diet, protecting your eyes from sunlight, and having regular eye tests are the most effective steps you can take. If you have early signs, your specialist may suggest monitoring at home.

Screening programmes

There is no national screening programme for AMD in the UK, but regular eye tests are recommended. If you are over 60, have an eye test every year or two, even if you haven't noticed any problems. Ask your optometrist about using an Amsler grid at home to check your vision regularly.

Complications

If left untreated

• Progressive loss of central vision, making reading, driving, and recognising faces difficult.
• Increased risk of falls and accidents, especially in unfamiliar places.
• Reduced independence in daily activities, such as shopping, cooking, and managing medications.
• Emotional strain, including frustration, anxiety, and social isolation.

Long-term outlook

Most people with AMD do not lose all of their vision. Your side vision usually remains, which lets you continue to be independent. With regular monitoring, healthy lifestyle changes, and, for wet AMD, timely treatment, many people keep useful vision for years. New research and treatments continue to improve the outlook.

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