Blurred or reduced central vision could be a sign of macular degeneration. Find out about symptoms and treatment for this common eye disorder.
Dry macular degeneration is a common eye disorder among people over 50. It causes blurred or reduced central vision due to the breaking down of the inner layers of the macula (MAK-u-luh). The macula is the part of the retina that gives the eye clear vision in the direct line of sight.
Dry macular degeneration may start in one eye before developing in the other eye. It also may develop in both eyes at the same time. Over time, vision may worsen and affect the ability to do things, such as read, drive and recognize faces. But having dry macular degeneration doesn't mean you'll lose all your sight. Vision loss is typically central, and people retain their peripheral vision. Some people have only mild central vision loss. In others, it can be more severe.
Early detection and self-care measures may delay vision loss due to dry macular degeneration.
As macular degeneration develops, clear, typical vision (left) becomes impaired by a general haziness. With advanced macular degeneration, a blind spot forms at the center of the visual field (right).
Dry macular degeneration symptoms usually develop gradually and without pain. They may include:
Dry macular degeneration can affect one or both eyes. If only one eye is affected, you may not notice any changes in your vision. This is because your good eye may compensate for the affected eye. And the condition doesn't affect the side vision, so it does not cause total blindness.
Dry macular degeneration is one of two types of age-related macular degeneration. It can progress to wet macular degeneration, which is when blood vessels grow and leak under the retina. The dry type is more common, but it usually progresses slowly over years. The wet type is more likely to cause a relatively sudden change in vision resulting in serious vision loss.
See your eye doctor if:
These changes may be the first sign of macular degeneration, particularly if you're over age 60.
No one knows exactly what causes dry macular degeneration. Research indicates that it may be a combination of family genes and environmental factors, including smoking, obesity and diet.
The condition develops as the eye ages. Dry macular degeneration affects the macula. The macula is the area of the retina that's responsible for clear vision in the direct line of sight. Over time, tissue in the macula may thin and lose cells responsible for vision.
The macula is located at the back of the eye in the center of the retina. A healthy macula allows for clear central vision. The macula is made up of densely packed light-sensitive cells called cones and rods. Cones give the eye color vision, and rods let the eye see shades of gray.
Factors that may increase your risk of macular degeneration include:
People whose dry macular degeneration has progressed to central vision loss have a higher risk of depression and social isolation. With profound loss of vision, people may see visual hallucinations. This condition is called Charles Bonnet syndrome. Dry macular degeneration may progress to wet macular degeneration, which can quickly cause vision loss if left untreated.
It's important to have routine eye exams to identify early signs of macular degeneration. The following measures may help reduce your risk of developing dry macular degeneration:
Your eye doctor may diagnose your condition by reviewing your medical and family history and conducting a complete eye exam. Other tests may be performed, including:
The appearance of yellow deposits, called drusen, on color photographs of the retina indicates the development of early-stage dry macular degeneration (left). As the condition progresses to the advanced stage (right), the eye may lose light-sensitive cells that make up the macula. This is known as atrophy.
For now, there's no way to reverse damage from dry macular degeneration. However, there are many clinical trials in progress. If your condition is diagnosed early, you can take steps to help slow its progression, such as taking vitamin supplements, eating healthy and not smoking.
For people with intermediate or advanced disease, taking a high-dose formulation of antioxidant vitamins and minerals may help reduce the risk of vision loss. Research from the Age-Related Eye Disease Study 2 (AREDS2) has shown benefit in a formulation that includes:
The evidence doesn't show benefit in taking these supplements for people with early-stage dry macular degeneration. Ask your eye doctor if taking supplements is right for you.
Age-related macular degeneration doesn't affect your side vision and usually doesn't cause total blindness. But it can reduce or eliminate your central vision. Central vision is necessary for reading, driving and recognizing people's faces. It may help for you to get care from a low vision rehabilitation specialist, an occupational therapist, your eye doctor and others trained in low vision rehabilitation. They can help you find ways to adapt to your changing vision.
For selected people with advanced dry macular degeneration in both eyes, an option to improve vision may be surgery to implant a telescopic lens in one eye. The telescopic lens, which looks like a tiny plastic tube, is equipped with lenses that magnify your field of vision. The telescopic lens implant may improve both distance and close-up vision, but it has a very narrow field of view. It can be particularly useful in an urban environment to aid in identifying street signs.
Even after receiving a diagnosis of dry macular degeneration, you can take steps that may help slow vision loss.
Choose a healthy diet. The antioxidant vitamins in fruits and vegetables contribute to eye health. Kale, spinach, broccoli, squash and other vegetables have high levels of antioxidants, including lutein and zeaxanthin, which may benefit people with macular degeneration. Eating foods containing high levels of zinc also may be helpful for people with macular degeneration. These include high-protein foods, such as beef, pork and lamb. Nonmeat sources include milk, cheese, yogurt, whole-grain cereals and whole-wheat bread.
Another good choice is healthy unsaturated fat, such as in olive oil. And research studies have shown that a diet high in omega-3 fatty acids, such as in salmon, tuna and walnuts, may lower the risk of advanced age-related macular degeneration (AMD). But the same benefit is not shown from taking omega-3 supplements, such as fish oil pills.
These tips may help you cope with your changing vision:
Use magnifiers. A variety of magnifying devices can help you with reading and other close-up work, such as sewing. Such devices include hand-held magnifying lenses or magnifying lenses you wear like glasses.
You also may use a closed-circuit television system that uses a video camera to magnify reading material and project it on a video screen.
You will likely need a dilated eye exam to check for macular degeneration. Make an appointment for a complete eye exam with a doctor who specializes in eye care — an optometrist or an ophthalmologist.
Before your appointment:
For macular degeneration, questions to ask your eye doctor include:
Your eye doctor is likely to ask you a few questions, such as: