Focus on age-related macular degeneration

what vision looks like with macular degeneration

Your grandfather had macular degeneration, so you knew there was a chance that someday your doctor might give you that same diagnosis.  Unfortunately, that day has come.

The first sign something was not right was when you noticed blind spots as you were looking directly at someone. With your family medical history, you knew this was something that could not be ignored. After a comprehensive eye exam, your ophthalmologist confirmed your suspicions and diagnosed you with age-related macular degeneration (AMD).

Washington University ophthalmologist Rajendra Apte, MD, PhD, explains, “Age-related macular degeneration is an eye disorder and is the leading cause of vision loss for Americans age 60 years and older. It causes blurred or reduced central vison due to damage to the macular, which is the central part of the retina.

The retina is the camera of the eye and the macula is the part of the retina responsible for central vision. It is the part of the eye required for activities like reading, driving, recognizing faces, and seeing the world in color.

When it is working properly, the macula collects highly detailed images at the center of the field of vision and sends them up the optic nerve to the brain, which interprets them as sight. When the macula deteriorates, images can’t be received correctly.”


There are two types of age-related macular degeneration, dry and wet. The majority of the cases (85-90%) are dry. The remaining cases (10-15%) are wet.

Dry macular degeneration progresses slowly over the years, and although it can affect vision in later stages due to loss of nerve cells in the retina, it does not cause sudden vision loss like the wet form does.

In most cases it affects both eyes.  However, if only one eye is affected, an individual might not notice any vision changes because the good eye compensates for the weak eye.

Symptoms may include:

  • Blurry center vision
  • Difficulty recognizing faces
  • Increased blurriness of printed words
  • Visual distortions (such as straight lines looking bent)
  • Decreased intensity or brightness of colors

As the disease progresses, vision remains around the edges of the central field of vision – called peripheral vision. However, it is not as clear as central vision and can make it difficult to decipher in detail what one is seeing.

Wet macular degeneration is a more advanced form of the disease and causes vision loss when abnormal blood vessels grow behind the retina. In many cases, a person has dry macular degeneration first that progresses toward wet.

Wet macular degeneration is more likely to result in a sudden and severe central vision loss.

It is important to remember that patients can be without symptoms initially, making it critically important to receive periodic evaluation.


Though macular degeneration is associated with aging, researchers do know that certain risk factors may increase your chances of getting the disease:

  • Age: The biggest risk factor for macular degeneration is age. Risk increases with age, and the disease is most likely to occur in those 60 and older.
  • Genetics:  People with a family history of macular degeneration are at a higher risk than those with no family history. It is also well known that alterations in certain genes increase your risk of getting AMD over a lifetime.
  • Race: Caucasians are more likely to develop the disease than other races.
  • Smoking:  Smoking significantly increases the risk of macular degeneration.
  • Other risk factors include uncontrolled high blood pressure.
  • Body weight: Higher BMI has been associated with AMD.

Don’t smoke or if you are a smoker — quit smoking. Smoking can significantly increase your chances of developing macular degeneration. It also speeds the eye damage once you have macular degeneration.

Maintain a healthy weight and exercise regularly. Exercising has surprising benefits for your vision.

Eat leafy greens. They’re high in antioxidants and other nutrients that support eye health.

Limit red meat and junk food. If you have macular degeneration, saturated and trans fats from red meat, whole milk, fried foods, and baked goods may alter serum lipid profiles. This in turn can have adverse effects on body weight and could affect AMD progression.

Get your cholesterol under control. High cholesterol can affect lipid build up in your eyes if you have macular degeneration, and form deposits called cholesterol rich drusen under the retina. This can that affect how well you see and promote more advanced stages of AMD.

Keep your blood pressure low. Your eyes rely on a steady stream of oxygen carried by blood vessels that run through them. High blood pressure can affect AMD progression, partly through mechanisms that we don’t completely understand.

Dr. Apte stresses, “Vision loss from macular degeneration doesn’t happen right away. It is a slow and gradual process. Be vigilant with your eye care visits, and tell your doctor right away if you notice any changes.

While at this time there is no known cure, early detection can lead to early treatment that may slow the progression of the disease. Being alert and tuned in to your vision can help you stop eye damage before it steals your sight.”

For more information or to make an appointment with Dr. Apte, please call 314-362-3937 or 314-273-0020.

Please also visit Dr. Apte’s lab website to learn more about his ongoing research and to find out how you can support the research.

Barnes-Jewish Center for Outpatient Health
4901 Forest Park Ave., 6th floor
St. Louis, MO 63108

Center for Advanced Medicine-South County
5201 Midamerica Place, Suite 2500
St. Louis, MO 63129