Macular Degeneration Explained: Causes, Signs & Care

Macular degeneration is a progressive condition that damages the macula, the small central area of the retina responsible for sharp, detailed vision. While it rarely affects peripheral sight, loss of central vision can make reading, recognizing faces, driving, and other close-up tasks increasingly difficult. Understanding what raises the risk, how the disease presents, and what can be done to slow progression or maximize remaining vision helps people make informed choices about eye health.

What causes macular degeneration and who is at risk?

The precise mechanisms behind macular degeneration are not fully understood, but a mix of genetic, environmental, and health-related factors increases the likelihood of developing the disease. Age is the strongest predictor, with risk rising after age 50. Other well-established risk factors include:

• Family history and genetics: Having relatives with macular degeneration raises personal risk. Specific genetic variants have been linked to increased susceptibility.
• Smoking: Tobacco use is one of the most preventable risk factors and can roughly double the chance of developing AMD.
• Race: The condition is more common in people of European descent but can affect any racial or ethnic group.
• Obesity and sedentary lifestyle: Excess weight and low physical activity are associated with greater risk of progression to advanced stages.
• Cardiovascular disease, high blood pressure, and high cholesterol: Vascular health appears to influence retinal health and AMD risk.
• Poor diet: Low intake of leafy greens, omega-3 fatty acids, and key nutrients like vitamins C and E and zinc may contribute to disease risk.

Some of these factors, such as age and genetics, cannot be changed. However, modifying smoking habits, diet, exercise, and managing medical conditions can reduce risk or slow the condition’s advancement.

Recognizing symptoms

Early stages of macular degeneration often cause no noticeable problems. As the disease advances, common symptoms include:

• Blurry or fuzzy central vision
• Trouble reading small print even with glasses
• Difficulty recognizing faces
• Straight lines appearing wavy or distorted
• A dark or empty spot in the center of vision
• Reduced color vividness
• Greater difficulty adjusting to low light

Because changes can be gradual, many people do not realize vision is worsening until impairment is significant. Regular eye exams are therefore crucial, particularly for people over 50 or with a family history of the disease.

How the condition is diagnosed

Eye care professionals use a combination of tests to diagnose macular degeneration and determine whether it is the dry or wet form. Common diagnostic steps include:

• Visual acuity testing to measure clarity of vision
• Dilated eye examination to inspect the retina and macula
• Optical coherence tomography (OCT) to obtain detailed, cross-sectional images of retinal layers
• Fluorescein angiography in some cases, to visualize blood flow and identify leaking or abnormal vessels

These tools help clinicians identify drusen, pigment changes, fluid, or abnormal vessel growth that characterize different stages of AMD.

Treatment options and what to expect

There is currently no cure for macular degeneration, but treatments can slow progression, control symptoms, and preserve vision depending on the type and stage of disease.

• Dry AMD: Most people start with the dry form. High-dose nutritional supplements based on the AREDS2 formula have been shown to slow progression in certain intermediate-stage patients. Lifestyle measures like smoking cessation, healthy diet, and blood pressure control are also important.
• Wet AMD: This form involves abnormal blood vessel growth beneath the macula, which can leak and cause rapid vision loss. Anti-VEGF injections into the eye reduce vessel growth and leakage and are the mainstay of wet AMD treatment. Some patients may also be candidates for laser therapy or photodynamic therapy in specific situations.
• Low vision support: For people with advanced vision loss, low vision aids, adaptive devices, and rehabilitation strategies can help maximize independence and quality of life.

Costs vary widely by region, provider, and insurance coverage. The figures above are illustrative and not a substitute for professional billing advice.

Lifestyle choices that can help

While not all cases are preventable, several practical habits support retinal health and may reduce the risk of progression:

• Stop smoking and avoid secondhand smoke
• Eat a diet rich in leafy greens, colorful fruits and vegetables, and oily fish high in omega-3s
• Maintain healthy blood pressure, cholesterol, and body weight
• Exercise regularly
• Wear sunglasses that block ultraviolet rays and use hats to reduce direct sun exposure
• Attend routine eye exams and promptly report any changes in vision

Living with macular degeneration

For many people, early detection and treatment allow maintenance of useful vision for years. Low vision specialists can recommend magnifiers, screen readers, high-contrast reading materials, and home modifications to preserve independence. Emotional support and counseling can also be valuable, since vision loss affects daily life and mental well-being.

Understanding the signs, getting timely eye exams, and adopting risk-reducing habits give the best chance of protecting central vision. If you notice any new visual changes, seek evaluation from an eye care professional so appropriate testing and treatment can begin.

This article is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional for personalized guidance and treatment.