Age-related macular degeneration (AMD)

Age-related macular degeneration is a condition in which the macula – the central part of the retina at the back of your eye – gradually deteriorates. The macula is responsible for your sharp, central vision and for perceiving colours and fine details. In macular degeneration, the light-sensitive cells in this area become damaged, causing your central vision to become blurred or distorted.

The condition mainly affects people over the age of fifty and is therefore also known as age-related macular degeneration, abbreviated to AMD. It is one of the most common causes of severe vision loss among older people in Western countries.

Dry and wet AMD

There are two main forms of age-related macular degeneration: dry AMD and wet AMD. Dry AMD is the most common form and develops slowly. In this condition, waste products build up beneath the retina, leading to a thinning of the macula. Wet AMD is less common but develops more rapidly. In this form, abnormal blood vessels grow beneath the retina and start to leak or bleed, which can lead to more rapid damage to the macula.

Symptoms

Early symptoms of age-related macular degeneration include blurred central vision, distorted lines (straight lines appear bent or wavy), difficulty reading or recognising faces, and reduced colour perception. Peripheral vision is usually preserved, which means that AMD rarely leads to complete blindness. The symptoms may start in one eye and later develop in the other eye as well.

Causes and risk factors

The exact cause of age-related macular degeneration is not fully understood, but a combination of factors plays a role. Age is the main risk factor: the older you get, the greater the risk. Heredity also plays a part; if AMD runs in your family, your risk is increased. Other factors associated with a higher risk include smoking, high blood pressure, being overweight, prolonged exposure to sunlight, and a diet low in certain nutrients such as omega-3 fatty acids and antioxidants.

Diagnosis and monitoring

Age-related macular degeneration is diagnosed by an ophthalmologist or optometrist through an eye examination. This may include a visual field test, an examination of the back of the eye using a special lamp, and sometimes additional imaging such as OCT (optical coherence tomography) or fluorescein angiography. Regular eye check-ups are important, especially if you are over fifty or have risk factors.

Living with AMD

If you have age-related macular degeneration, your ophthalmologist or optometrist can advise you on aids and adjustments that make day-to-day life easier. These might include magnifying glasses, special lamps, larger text on devices and adjustments to your home. Your lifestyle can also play a role: giving up smoking, eating a healthy diet rich in green vegetables and fish, and protecting your eyes from bright sunlight are often cited as general recommendations.

Contact lenses and AMD

Age-related macular degeneration does not affect contact lens wear as such, as the condition affects the retina and not the front part of the eye. If you wear contact lenses and have AMD, make sure to continue booking regular check-ups with your optician and ophthalmologist. They can assess whether your lenses still fit properly and whether any adjustments are needed to your prescription or lens care routine.

When to see an optician

If you experience sudden changes in your vision, such as distorted lines, a dark spot in the centre of your field of vision or difficulty reading, have this assessed by your optician as soon as possible. Early detection can be important, particularly with wet AMD. Regular check-ups are also advisable if you have risk factors or a family history of AMD.