Age-related macular degeneration (AMD)

Causes of AMD

AMD affects the middle part of your vision, not the edges (peripheral vision). You can get it in one eye or both.

The exact cause of AMD is unknown. It's been linked to:

• smoking
• high blood pressure
• being overweight
• having a family history of AMD

Without treatment, your vision may get worse. This can happen gradually over several years (dry AMD), or quickly over a few weeks or months (wet AMD).

Symptoms

The first symptom is often a blurred or distorted area in your vision. If it gets worse, you might struggle to see anything in the middle of your vision.

AMD can make some tasks difficult, like:

• reading
• watching TV
• driving
• recognising faces

Other symptoms include:

• seeing straight lines as wavy or crooked
• objects looking smaller than normal
• colours seeming less bright than they used to
• seeing things that aren't there (hallucinations)

AMD isn't painful and doesn't affect the appearance of your eyes. Sometimes AMD may be found during a routine eye test before you have symptoms.

When to see an optician

You should see an optician if you're worried about your vision. If you have a problem with your eyes, early diagnosis and treatment may help stop your vision getting worse.

Get an urgent optician’s appointment if:

• your vision gets suddenly worse
• you have a dark "curtain" or shadow moving across your vision
• your eye is red and painful

These aren't symptoms of AMD but can be signs of other eye problems that need to be treated immediately.

Go to your nearest emergency department immediately if you can't get an urgent appointment.

You may be referred to an eye doctor (ophthalmologist) or specialist AMD service. This is usually only necessary if you'll need to start treatment quickly. You should be referred within a day.

Diagnosis for AMD

You'll be seen by a specialist called an optometrist. They'll look at the back of your eyes and check your vision. They may put drops in your eyes to make it easier for them to spot any problems. These can make your vision blurry for a few hours. Don't drive until your vision goes back to normal.

If you're diagnosed with AMD, the specialist will talk to you about what it is and what the treatment options are.

There are two types of AMD. They are:

Dry AMD

• caused by a build-up of a fatty substance called drusen at the back of the eyes
• common
• gets worse gradually – usually over several years
• no treatment – unless it develops into wet AMD

Wet AMD

• caused by the growth of abnormal blood vessels at the back of the eyes
• less common
• can get worse quickly – sometimes in days or weeks
• treatment can help stop vision getting worse

You'll have regular check-ups with a specialist to monitor your condition. Contact your specialist as soon as possible if your vision gets worse or you notice any new symptoms.

Treatment for AMD

Treatment depends on the type of AMD you have. The health professional looking after your care will recommend the best course of treatment for you depending on your diagnosis. Treatment for the types include:

• dry AMD – there's no treatment, but vision aids can help reduce the effect on your life
• wet AMD – you may need regular eye injections and, very occasionally, a light treatment called "photodynamic therapy" to stop your vision getting worse

Living with AMD

Speak to your eye specialist about a referral to a low-vision clinic if you're having difficulty with daily activities.

Staff at the clinic can give useful advice and practical support. For example, they can talk to you about:

• useful devices – such as magnifying lenses
• changes you can make to your home – such as brighter lighting
• software and mobile apps that can make computers and phones easier to use

If you have poor vision in both eyes, your specialist may refer you for a type of training called eccentric viewing training.

Staying healthy

AMD is often linked to an unhealthy lifestyle. If you have it, try to:

• eat a balanced diet
• exercise regularly
• lose weight if you're overweight
• stop smoking if you smoke

The Macular Society has more on diet and nutrition for AMD.

Driving

AMD can make it unsafe for you to drive. Ask your specialist if they think you should stop driving.

You're required by law to tell the Driver Vehicle Agency (DVA) about your condition if:

• it affects both eyes
• it only affects one eye but your remaining vision is below the minimum standards of vision for driving

• Find out how to tell DVA about a medical condition

Registering as sight impaired

If your vision continues to get worse, you may want to register your sight loss. This can make it easier to claim financial benefits, such as help with health costs. Your specialist can check your vision and complete an official certificate if you meet the requirements to be registered.

RNIB has more on registering your sight loss.

Getting help and support

Living with AMD can be very difficult. As well as getting support from your specialist, you may find it useful to use support groups such as:

• Macular Society
• RNIB

See a GP if you've been feeling low for more than two weeks. They can offer support and treatment.

• Find out more about age-related macular degeneration (AMD) on the NHS website

More useful links

• How to use your health services