Understanding Macular Degeneration
Macular degeneration affects central vision and is the leading cause of vision loss for older Americans, according to the National Eye Institute. Although the condition is more common in older adults, younger people can also develop macular degeneration. Treatment options vary depending on the severity of a person's macular degeneration (AMD), with some forms of the disease being easier to treat than others.
About Macular Degeneration
Macular degeneration happens due to changes in the macula, the center part of the retina. The macula contains photoreceptor cells needed for good central and color vision.
Photoreceptor cells turn light into electrical impulses. The impulses travel to the brain where they're processed into images. If photoreceptor cells in the macula are damaged or die, or abnormal blood vessels grow in the macula, the brain receives incomplete information from the eyes. If this happens, you may notice these symptoms:
- Blurry Central Vision
- A Blank or Dark Spot in Your Central Vision
- Dull Color Vision
- Trouble Seeing Well in Dim Light
Macular degeneration may also cause straight lines to look wavy.
You may be more likely to develop macular degeneration if other people in your family had the condition. Other risk factors include smoking, high cholesterol, high blood pressure, and being overweight. The American Academy of Ophthalmology (AAO) notes that white people and people over 50 are at increased risk for developing macular degeneration.
Age-Related Macular Degeneration
Age-related macular degeneration (AMD) is divided into two sub-types:
- Dry AMD. Dry AMD, the most common type, affects 80% of people who have AMD, according to the AAO. This type of AMD occurs when small yellow deposits called drusen form under the macula. As more drusen form, the macula becomes thinner. Eventually, photoreceptor cells in the macula die, causing vision loss. It takes a while for Dry AMD to cause noticeable symptoms. In fact, your vision may not change for many years.
- Wet AMD. Wet AMD happens when abnormal blood vessels grow under the macula. The blood vessels leak blood or fluid. The leaks scar the macula and blur your vision. Wet AMD may progress faster than Dry AMD and can begin suddenly.
Eye doctors use these stages to classify AMD:
- Early Dry AMD. Vision loss hasn't occurred, although some drusen can be seen.
- Intermediate Dry AMD. Larger drusen form, damaging cells in the macula. At this stage, you may notice mild vision problems. Some people with intermediate dry AMD don't experience any vision changes.
- Late AMD (Both wet and dry forms). Blind or dark spots may form in your central vision.
Other types of Macular Degeneration
Less common types of macular degeneration include:
- Stargardt Disease. This type of macular degeneration is inherited and begins during childhood or adolescence.
- Myopic Macular Degeneration. Myopic macular degeneration affects people who are severely nearsighted.
- Best Disease. Best disease also begins during childhood or adolescence and is inherited.
How Your Ophthalmologist Treats Macular Degeneration
Wet AMD can be treated with anti-VEGF (vascular endothelial growth factor) injections into the eye. The medication stops leaks and slows the growth of new abnormal blood vessels in the macula. In some cases, ophthalmologists use laser therapy to treat leaks and prevent new blood vessel growth.
Dry AMD is more difficult to treat, although taking AREDs supplements could slow the progression of the vision loss. The supplements contain vitamins C and E, lutein, copper, zinc and zeaxanthin.
If you have dry AMD with geographic atrophy, injections of pegcetacoplan or avacincaptad could delay vision loss, according to the AAO. Geographic atrophy happens when cells in the macula die. In November 2024, the U.S. Food & Drug Administration approved LumiThera, a type of light therapy that could reduce vision loss and geographic atrophy and improve vision in people with Dry AMD. As LumiThera is a newer treatment, some insurance companies may not cover it.
Some treatments for wet and dry AMD may also be helpful for other types of macular degeneration.
Early detection is the key to successfully managing macular degeneration symptoms. If it's been a while since you've visited the ophthalmologist, now is the perfect time to make an appointment.
Sources:
National Eye Institute: Age-Related Macular Degeneration (AMD): What Is AMD?, 6/22/2021
American Academy of Ophthalmology: Understanding Macular Degeneration, 10/1/2024
https://www.aao.org/eye-health/diseases/amd-macular-degeneration
American Macular Degeneration Foundation: What Is Macular Degeneration, 2025
https://www.macular.org/about-macular-degeneration/what-is-macular-degeneration
American Academy of Ophthalmology: What Is Stargardt Disease, 9/3/2024
https://www.aao.org/eye-health/diseases/what-is-stargardt-disease
WebMD: New Therapy Brings Hope for Dry AMD Vision Loss, 1/7/2025
U.S. Food & Drug Administration: FDA Roundup, 11/5/2024
https://www.fda.gov/news-events/press-announcements/fda-roundup-november-5-2024
