Symptoms of Geographic Atrophy

Medically reviewed by Dagny Zhu, MD

A blind spot in your central vision is the hallmark of late geographic atrophy, an advanced form of dry age-related macular degeneration (AMD). Early in the disease, there can be a variety of symptoms linked to the progressive loss of light-sensitive retinal cells.

The symptoms of geographic atrophy range from uncharacteristically slow reading speed to problems with contrast sensitivity, which may make it hard to work in dim lighting.

Your symptoms will correspond with where you are in the geographic atrophy disease process. Late indications are much more pronounced than early ones.

This article will look at symptoms that nearly all people with geographic atrophy have as well as the symptoms that only occur sometimes.

Frequent Symptoms

The symptoms of geographic atrophy that you will have will depend on where a blank spot develops on your retina and how large it is. In most cases, cell loss tends to occur near the center of the vision, leaving the side vision unaffected.

While there might be no symptoms early on, as more cell loss on the light-sensitive retina occurs over time, that changes.

Some common geographic atrophy symptoms include:

• Noticing small missing areas in your vision: One of the first problems many people with geography atrophy notice is missing some letters while they're reading. Some people find that they are suddenly unable to see some areas of someone's face.
  

• Needing more light to complete tasks: Since geographic atrophy affects contrast sensitivity, you might start finding it challenging to do something when the lighting in a space is dim.

• Unclear vision that interferes with activities that require sharp central sight: Your central vision is your sharpest vision. As cells in this area die, you may have trouble doing crafts such as needlepoint, reading, cooking, or (in more advanced stages) distinguishing faces.

• Finding colors seem dull: As retinal cells are lost, contrast sensitivity can be affected and colors may not appear as vivid.

• Seeing a dark spot near the center of your vision: As retinal cells in the area break down, it can form a blank area in your vision. It may appear like a dark spot near the center. The spot slowly expands as the condition progresses.

Rare Symptoms

Geographic atrophy usually affects the central retina; therefore, your side (peripheral) vision is not affected. However, the lesion can be located more to the periphery. You may notice a dark spot there instead or in the center of your vision. If your detailed central vision is preserved, this may allow you to do things such as read for longer.

Visual hallucinations are an unusual symptom that may occur in very late geographic atrophy when there is a large blind spot. The condition, which is linked to sight loss, is known as Charles Bonet syndrome.

Hallucinations can vary from simple flashes of light to seeing elaborate vistas. Some people may see facial distortions.

If you're experiencing visual hallucinations from Charles Bonet syndrome, you think they are being caused by a mental health condition, but that's not the case. It's just your brain's reaction to a sudden lack of input. With time, the symptom usually goes away.

Complications

See a retina specialist regularly to monitor your eyes for conversion to wet AMD, which requires urgent treatment with specific medications.

A low-vision specialist can help you learn to use visual aids. These tools can help you continue to participate in some fine sight-related activities that are important to you, such as reading. An occupational therapist can show you ways to adjust to low vision.

Having geographic atrophy can also affect your mental health—for example, it can cause or worsen anxiety or depression. You may need more specific support to make sure you are coping with all of these needs effectively.

In addition to talking to your eye health provider and a mental health professional, joining a support group where you can talk to others with geographic atrophy who might be experiencing many of the same things you are can be helpful. Exercising and doing activities that you love can also lift your mood.

When to See a Healthcare Provider

Get in touch with an eye health provider at the first sign of geographic atrophy. Since the condition typically occurs during the late stage of (AMD), you may already be monitoring your vision at home with an Amsler grid (a tool that can alert you if there are any blank spots in your visual field).

If you have any symptoms you think might be geographic atrophy, contact an eye health provider right away. They can determine if your symptoms are from geographic atrophy and, if so, how large the affected area currently is.

If you've been diagnosed with geographic atrophy, it's important to see an eye provider every six months, if not sooner. An eye provider might be able to recommend lifestyle changes that can slow the progression of the condition and may keep it from affecting the other eye for longer.

Takeaway

In 2023, the Food and Drug Administration (FDA) approved the first treatments for adults who have geographic atrophy cased by AMD: Izervay (avacincaptad pegol) and Syfovre (pegcetacoplan). They are each treatments that are injected directly into the affected eye by a healthcare provider.

Summary

In geographic atrophy, there might not be symptoms at first. With time, you may notice a small blank area, such as a missing letter or number, when you're reading. You may also find that detailed tasks take longer and require more light to complete. Your contrast sensitivity may also be affected, with colors appearing more washed out.

Eventually, you notice a dark area, usually at the center of your vision. While it's not as common, your side vision can also be affected.

If you have geographic atrophy, it's not uncommon to experience anxiety and depression. It can be helpful to talk to others who are experiencing some of the same things as you.

A Word from Verywell

The symptoms of geographic atrophy can be overwhelming, but keep in mind that the condition is usually slow to progress. There are many strategies that can help you to manage your symptoms and vision effectively for some time.

Read the original article on Verywell Health.