Alamo City Eye Physicians
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Macular Degeneration

What is Macular Degeneration?

Age-related macular degeneration (AMD) is a degenerative aging process of the retina, which damages the eyesight of 13 million Americans. AMD occurs most frequently in persons over age 55. In fact, it is the most common cause of severe vision loss in this age group.

Depending on the type of macular degeneration, there may be few options for treating the disease. But the good news is: numerous studies and research are being conducted that will, hopefully, offer more solutions in the future.

Located in the center of the retina, the sensitive macula provides us with sight in the center of our field of vision. When we look directly at something, the macula allows us to see the fine details. This sharp, straight-ahead vision is necessary for driving, reading, recognizing faces, and doing close work, such as sewing.


The two common types of macular degeneration are dry and wet. The dry form accounts for 90% of cases and is caused by aging and thinning of the tissues of the macula. It develops slowly and usually causes mild vision loss. People often notice a dimming of vision when they read.

Wet macular degeneration is a much greater threat to vision loss even though it accounts for only 10% of cases. With the wet form of the disease, new blood vessels grow beneath the retina where they leak fluid and blood and can create a large blind spot in the center of your visual field. If this happens, there will be a marked disturbance of vision.


Although it's more common for people over 60, it is possible to develop symptoms in your 40's or 50's. Macular degeneration often runs in families. Symptoms can include:

  • Blurry or fuzzy vision
  • Straight lines, such as sentences on a page, telephone poles, and sides of buildings, appear wavy
  • A dark or empty area appears in the center of vision
If you experience any of these symptoms in either one or both eyes, schedule an appointment with your ophthalmologist for an examination immediately.

How is Macular Degeneration Treated?


Unfortunately, the cause of macular degeneration is unknown. Although your ophthalmologist will be able to readily detect the disease during an eye exam, he or she won't be able to cure it. The goal is to help the patient see better and stabilize the condition.

Although there is no proven treatment for dry macular degeneration, the progression of the disease may be slowed by certain dietary supplements: zinc, beta-carotene, vitamin C, and vitamin E. These supplements are available over-the-counter in a single pill formulation as I-Caps, Ocuvite, or Retinavite. The most benefit has been demonstrated in reducing the progression of dry macular degeneration in patients who already have a moderate form of the disease. The role of these vitamins in preventing the start of macular degeneration has not been established.

Outpatient laser surgery may be an option for people with more severe wet macular degeneration. The laser beam is used to destroy the abnormal blood vessels and works best when these vessels have not grown under the macula.

Laser surgery is less helpful when the abnormal blood vessels have already grown under the macula. In this case, the laser might cause as much damage as the presence of abnormal blood vessels. This is why early diagnosis is so important.

Medical treatment for wet macular degeneration is now available under some circumstances. These medications (Macugen, Avastin, Lucentis) are given by an injection into the eye, and are fairly new to the market. They have been proven beneficial in helping to reduce or eliminate the abnormal blood vessels that are prone to bleeding. Actual improvement in visual clarity has been less impressive but remains promising.

The "good" news about macular degeneration is that even though people who have it experience mild to severe vision loss, macular degeneration does not affect peripheral, or side vision. One does not go blind. With the help of low vision aids, people can continue to enjoy many of their favorite activities and can still lead normal, independent lives.

Most of low vision aids combine magnification and bright lights. But vision aids aren't like glasses, which allow you to see whatever you're looking at when you put them on. One kind of vision aid may be helpful when you read but totally ineffective when you watch TV or focus on something in the distance. People need to try different types for different situations.

What is the Amsler Grid?

Amsler Grid

The Amsler Grid is a chart that can reveal signs of wet macular degeneration. You can get one from your ophthalmologist or print this one and test your vision at home.

Basically, the chart is a tool for monitoring your central visual field. It makes it possible for you to tell if there are disturbances in your vision caused by changes in the retina.

Here's how it works:

  1. Sit in an area with good lighting and hold the chart at eye level at a comfortable distance.
  2. If you wear glasses, keep them on, but cover one eye completely.
  3. Stare with your other eye at the central dot on the grid. At the same time, observe the pattern of vertical and horizontal lines on the chart.
  4. Repeat the test with the other eye.

If you experience any of these changes, make an appointment with your ophthalmologist immediately:

  • Blurring
  • Distortion or curvy lines
  • Holes or spots in some areas of the grid
If your ophthalmologist makes a diagnosis of wet macular degeneration, you should use the grid on a daily basis to check for changes in your vision.