The Eye Life

If you’ve just been told you have macular degeneration, your mind is probably racing. What does this mean for your vision? Will you go blind? Can anything be done?

First, take a breath. You’re not alone—millions of people live with this condition—and while macular degeneration is serious, it’s not a complete loss of sight. Most people with AMD maintain enough vision to live independently.

In this guide, we’ll explain exactly what macular degeneration is, how it affects your eyes, what causes it, and what you can do to protect your remaining vision. By the end, you’ll have a clear understanding of your condition and a roadmap for what comes next.

What is macular degeneration?

Macular degeneration—also called age-related macular degeneration or AMD—is a condition that damages the macula, the small central part of your retina. The macula is responsible for your sharp, detailed central vision: the vision you use to read, recognize faces, drive, and see fine details.

When the macula is damaged, your central vision becomes blurry, distorted, or dark. You might notice that straight lines look wavy, or that there’s a smudge or blind spot in the center of your vision.

Here’s what’s important to understand: AMD affects your central vision, not your peripheral (side) vision. Even in advanced cases, most people retain their side vision. This means that while tasks requiring detail become harder, total blindness from AMD alone is rare.

How common is it?

AMD is the leading cause of vision loss in adults over 50 in the United States. About 11 million Americans have some form of AMD, and that number is expected to nearly double by 2050 as the population ages. AMD is more common than glaucoma and cataracts combined.

If you have AMD, you’re far from alone. And because it’s so common, there’s been significant research into treatments and management strategies.

Dry AMD vs. wet AMD: What’s the difference?

There are two main types of macular degeneration, and understanding the difference is important for knowing what to expect.

Dry AMD (atrophic)

Dry AMD is the most common form, accounting for about 85-90% of all cases. It happens when the light-sensitive cells in the macula slowly break down over time.

In dry AMD, small yellow deposits called drusen accumulate under the retina. A few small drusen are normal as you age. But larger or more numerous drusen can be a sign of AMD.

Dry AMD typically progresses slowly—often over years or even decades. Many people with early dry AMD have no symptoms at all. As it advances, you may notice gradual blurring of central vision, needing brighter light to read, difficulty recognizing faces, and a hazy or less vivid appearance to colors.

There’s currently no cure for dry AMD, but research is ongoing, and there are steps you can take to slow its progression.

Wet AMD (neovascular)

Wet AMD is less common but more serious. It occurs when abnormal blood vessels grow under the retina and leak fluid or blood. This leaking damages the macula quickly—sometimes in a matter of days or weeks.

Wet AMD causes more rapid and severe vision loss than dry AMD. Symptoms may include sudden onset of visual distortion (straight lines looking wavy), a dark spot in the center of your vision, and rapid decline in central vision.

The good news is that wet AMD can often be treated. Anti-VEGF injections can slow or even stop the progression in many cases. Early treatment is critical—the sooner wet AMD is caught, the better the outcome.

Important: Dry AMD can progress to wet AMD at any time. This is why regular monitoring is essential, even if your AMD seems stable.

What causes macular degeneration?

The exact cause of AMD isn’t fully understood, but it results from a combination of aging, genetics, and lifestyle factors.

Age is the biggest risk factor. AMD is rare before age 50, but risk increases significantly after 60. By age 75, roughly one in three people has some signs of AMD.

Genetics: AMD tends to run in families. If a parent or sibling has AMD, your risk is higher. Researchers have identified several genes linked to the condition, though having these genes doesn’t mean you’ll definitely develop it.

Smoking is the most significant controllable risk factor. Smokers are two to four times more likely to develop AMD than non-smokers. If you smoke, quitting is one of the most impactful things you can do for your eye health.

Other risk factors include cardiovascular disease and high blood pressure, obesity, light-colored eyes, prolonged sun exposure without eye protection, and a diet low in fruits, vegetables, and omega-3 fatty acids.

Some of these factors are beyond your control. But others—like smoking, diet, and exercise—are areas where you can make a real difference.

Stages of macular degeneration

AMD is classified into three stages based on the size and number of drusen and whether there’s damage to the retina:

Early AMD: Medium-sized drusen present. Usually no vision loss. No symptoms in most cases. Often discovered during routine eye exams.

Intermediate AMD: Large drusen and/or pigment changes in the retina. May have mild vision changes. Some people still have no noticeable symptoms.

Late AMD: Significant damage to the macula. Noticeable vision loss. Can be either “dry” (geographic atrophy) or “wet” (neovascular).

Understanding your stage helps you and your doctor determine the right monitoring and treatment plan.

How is macular degeneration diagnosed?

AMD is typically detected during a comprehensive eye exam. Your eye doctor may use several tests:

Dilated eye exam — Drops widen your pupils so the doctor can examine your retina and macula directly.

Optical coherence tomography (OCT) — A non-invasive imaging test that creates detailed cross-section images of your retina. This can reveal drusen, fluid, and changes in retinal thickness.

Amsler grid test — A simple grid of straight lines used to detect distortion in your vision. You can use this at home to monitor for changes.

Fluorescein angiography — A dye is injected into your arm and photographed as it passes through the blood vessels in your eye. This helps identify leaking blood vessels in wet AMD.

If you’re over 50, regular comprehensive eye exams are important—even if your vision seems fine. AMD often has no symptoms in its early stages.

Treatment options for macular degeneration

Treatment depends on the type and stage of your AMD.

For dry AMD:

There’s no FDA-approved treatment to reverse dry AMD, but you can take steps to slow its progression:

AREDS2 supplements — A specific formula of vitamins and minerals shown in clinical trials to reduce the risk of progression in people with intermediate or advanced AMD. The formula includes vitamin C, vitamin E, zinc, copper, lutein, and zeaxanthin.

Lifestyle changes — Quitting smoking, eating a diet rich in leafy greens and fish, exercising regularly, and managing blood pressure and cholesterol.

Monitoring — Regular eye exams and home Amsler grid testing to catch any progression to wet AMD.

For wet AMD:

Anti-VEGF injections — The primary treatment for wet AMD. Medications like Eylea, Lucentis, and Avastin are injected into the eye to block the growth of abnormal blood vessels. Most patients need regular injections—monthly at first, then potentially less frequently.

Photodynamic therapy (PDT) — A light-activated drug is used to destroy abnormal blood vessels. Less common now that anti-VEGF treatments are available.

Early treatment for wet AMD is critical. If you notice sudden changes in your vision—especially distortion or new blind spots—contact your eye doctor immediately.