How Macular Degeneration Changes What You See

Medically reviewed by Andrew Greenberg, MD

Age-related macular degeneration (AMD) is a condition that causes loss of central vision but doesn't affect peripheral (side) vision.

Dry AMD and the even more serious wet AMD both cause vision changes that, along with affecting your central vision, can make it difficult to clearly see shapes or figures, distinguish colors, or see in low lighting. The severity of symptoms depends on how far AMD has progressed.

This article will examine what those with AMD might see and not see, how the AMD stage can affect vision, ways to slow or stop AMD from progressing, and how to cope with AMD.

Macular Degeneration Vision: What People See and (Possibly) Can't See

AMD can affect the appearance of things and cause missing spots in your vision. The two types of AMD are dry AMD and wet AMD. How much your vision is affected can depend on if you have dry AMD or wet AMD.

Explainer

Macular degeneration is the most common cause of severe eyesight loss in people age 50 and older.

Dry AMD

AMD begins as the dry form, when a part of the light-sensing retina called the macula begins to deteriorate. The macula is the central area of the retina that helps a person see shapes, contrast, colors, and details.

What you see and might not see with dry AMD includes:

• Blurry central vision, which worsens as the condition progresses

• Gaps or dark spots in vision, especially first thing in the morning

• Colors that are hard to distinguish from each other

• Straight lines that appear wavy, distorted, or bent

• Objects in front of you that appear to move or change shape, size, or color

• Inability to read or see well in low light

Progression From Dry to Wet AMD

About 10% to 15% of people with dry AMD will have it progress to wet AMD.

Wet AMD

Some cases of dry AMD progress to wet AMD, a condition in which blood vessels start to grow under the retina, causing it to bulge or pucker. Dry AMD can turn into wet AMD at any stage,

If you have wet AMD, you may experience:

• Serious or complete loss of central vision
  

• Objects appearing distorted or twisted like you're looking in a curved mirror

• Severe blind spots, waviness, or distortion, especially as the disease progresses
  

Visual Hallucinations With AMD

Up to half of people with AMD may experience Charles Bonnet syndrome (CBS), or visual hallucinations due to sight loss. The hallucinations can range from seeing simple flashes of light or color to complex geometric patterns or shapes. CBS is more likely to occur if both eyes are affected by AMD, and after sudden worsening of vision.

Does Macular Degeneration Affect Distance Vision?

AMD affects both near and distance vision. The loss of central vision and distortion of lines, shapes, and colors can make it difficult for those with AMD to recognize faces.

AMD can also make it harder to participate in everyday activities that require distance vision, such as watching TV, driving, engaging in hobbies or recreation, or going to a sporting event, movie, or play.

How AMD Stage Affects Vision

AMD is a progressive disease, meaning that symptoms often worsen over time. Vision changes aren't always noticeable in the early stages, especially if only one eye is affected, because the healthy eye will try to compensate for the damaged eye.

Dry AMD has early, intermediate, and advanced stages, and symptoms usually progress slowly over several years. Often, dry AMD doesn't cause noticeable symptoms in its early stage.

If dry AMD progresses to the intermediate stage, you may begin experiencing mild symptoms of blurry central vision, straight lines appearing warped, or trouble seeing in low light or distinguishing colors.

About 10% of cases of dry AMD progress to wet AMD, which can worsen much quicker than dry AMD. In both wet AMD and late-stage dry AMD, symptoms like blurry or wavy vision and loss of central vision are more severe. If left untreated, wet AMD can cause central vision loss severe enough to result in legal blindness.

Can You Slow AMD Vision Changes?

There is currently no treatment for early AMD. But the AREDS 2 dietary supplement available over the counter (OTC) has been shown to reduce the risk of intermediate-stage AMD turning into late-stage AMD. For those with AMD in one eye, the supplement might help keep AMD from progressing in the healthy eye.

The formula of AREDS 2 consists of:

• 500 milligrams (mg) of vitamin C

• 400 international units (IU) of vitamin E

• 80 mg of zinc oxide

• 2 mg of copper

• 10 mg of lutein

• 2 mg of zeaxanthin

Always consult your healthcare provider before starting any dietary supplements.

Lifestyle Changes

While not a treatment, healthy lifestyle changes may help slow vision loss from AMD. These include :

• Eating healthy foods especially dark, leafy greens and fatty fish

• Getting regular physical activity

• Quitting smoking

• Keeping healthy blood pressure and cholesterol levels

Once dry AMD reaches the advanced stage, no treatments are available to prevent vision loss.

However, medical treatments are available to slow or stop vision loss from wet AMD. The most common treatment is an eye injection with anti-vascular endothelial growth factor (anti-VEGF) drugs that helps stop blood vessels from bleeding and leaking.

Photodynamic therapy, a type of laser therapy, is sometimes also given along with anti-VEGF injections.

Embracing AMD Vision Changes

Low vision caused by AMD can affect your quality of life because you may find it difficult or be unable to take part in daily activities you enjoy. Being referred to low-vision services may help maintain or improve the quality of life for those impacted by vision loss.

Vision rehabilitation is a type of low-vision service where a low-vision specialist helps you learn ways to adapt to your vision loss and make the most of the vision you have left. Your eye doctor or healthcare provider can help you decide if vision rehabilitation is right for you and refer you to vision rehabilitation services.

Vision rehabilitation can include help with:

• How to use a magnifying device and other low-vision devices

• Improving lighting around your home

• Setting up your home so you can move around more easily

• Sharing support and coping resources

Summary

AMD is a condition that affects your central vision and how you see fine details and colors. AMD can reduce quality of life, especially if the condition progresses. If you are experiencing any of the symptoms of AMD, it’s important to contact your healthcare provider right away.

Depending on whether you have dry AMD or wet AMD and its stage, there may be treatments or other ways to stop your vision loss from progressing. Even if you have substantial vision loss, vision rehabilitation might be able to help you with ways to adapt to decreased vision and improve your quality of life.

Read the original article on Verywell Health.