Early Signs of Macular Degeneration: What to Watch For

What macular degeneration is

Age-related macular degeneration (AMD) damages the macula, the part of the eye that gives you sharp, straight-ahead vision for reading, driving and recognizing faces. According to the National Eye Institute (NEI):

• Most people have dry AMD, which progresses slowly through early, intermediate and late stages.
• Wet AMD is always a late stage and usually causes faster vision loss.
• AMD doesn’t cause complete blindness, but losing central vision can make it hard to see faces, read or drive.

Signs by stage

• Early AMD doesn’t cause any symptoms.
• Intermediate AMD may cause mild blurriness in the center of your vision or trouble seeing in low light, though many people still notice nothing.
• Late AMD (dry or wet) can make straight lines look wavy or crooked, cause a blurry area near the center of your vision that may grow or turn into blank spots, and make colors seem less bright.

Because the first stage is silent, waiting for symptoms means finding AMD later than you could.

Who’s at higher risk

The NEI says the risk rises with age, and people 55 and older are more likely to have AMD. It’s also higher for people who:

• Have a family history of AMD
• Smoke
• Are white (Caucasian)

Checking your vision at home

Many ophthalmologists recommend an Amsler grid, a simple square of lines with a dot in the center, for people with AMD or at risk of it. The American Academy of Ophthalmology (AAO) describes how to use it once a day:

1. Wear your usual reading glasses and hold the grid 12 to 15 inches from your face, in good light.
2. Cover one eye and look straight at the center dot.
3. Without moving your eye, notice whether any lines look wavy, blurry, dark or missing.
4. Repeat with the other eye, in the same place and lighting each day.

If anything looks new or different, contact your eye doctor right away. One caveat: the AAO has also reported that the grid may not be as reliable as once thought for catching changes, so it’s a useful habit, not a replacement for eye exams.

Already noticing wavy lines? See what it means when straight lines look wavy, including the other conditions that can cause it.

Getting diagnosed

Eye doctors check for AMD as part of a comprehensive dilated eye exam, sometimes adding an imaging test called optical coherence tomography (OCT). The original AREDS trial recommended that people over 55 have a dilated exam to find out their risk of advanced AMD.

If you’re diagnosed

• Intermediate AMD, or late AMD in one eye: the NEI says special dietary supplements can help slow progression. That’s the AREDS2 formula; see AREDS vs AREDS2 for exactly what it contains.
• Wet AMD: treatments include anti-VEGF medicines injected into the eye, and photodynamic therapy. Because wet AMD can cause fast vision loss, report any change promptly.

Lowering your risk

The NEI recommends these steps to lower your risk:

• Quit smoking, or don’t start.
• Get regular physical activity.
• Keep your blood pressure and cholesterol in a healthy range.
• Eat healthy foods, including leafy green vegetables and fish.

Where a supplement fits

The supplement with strong evidence is the AREDS2 formula, and only for people who already have intermediate AMD or late AMD in one eye. The NEI is clear that AREDS and AREDS2 supplements don’t prevent AMD from starting. If you’ve been diagnosed, ask your eye doctor about a formula that matches the tested AREDS2 doses.

If you haven’t been diagnosed and simply want the key nutrients, these two held up best in our reviews. Neither matches the AREDS2 doses.

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