Dry Age-related Macular Degeneration

This leaflet is for patients who have been diagnosed with Dry age-related macular degeneration (AMD). The aim of the leaflet is to help you and your family/carer understand your eye condition and to know the differences between Wet AMD (neovascular AMD) and Dry AMD (geographic atrophy or AMD).

What is age-related macular degeneration?

AMD is an eye condition that causes changes to the macula (the central part of the retina at the back of the eye), which may result in loss of central vision. AMD normally occurs in people over 60 years old, but may develop earlier than this.

The common initial symptom of AMD is either blurred, distorted central vision or a loss in colour contrast. This may progress to a blank or dark patch (scotoma) predominantly in the centre of your vision. This can make activities like driving, reading and detailed work difficult.

AMD can affect both eyes. One eye may be affected before the other, which can lead to a delayed diagnosis, as the good eye compensates for the affected one. This means patients may not notice the problem at first.

There are two main forms of AMD, both which can be identified by an Ophthalmologist or Specialist Ophthalmic Allied Healthcare Professional:

● Dry (geographic atrophy) AMD

● Wet (neovascular) AMD

What is dry AMD?

Dry AMD is the more common type of AMD (around 75 - 90% of cases). It is irreversible and is mainly characterised by thinning and atrophy (breakdown) of the macular layers at the back of the eye, which ultimately results in gradual visual impairment or vision loss. This condition develops slowly over years to decades and, in most cases, causes mild loss of central vision. However in advanced Dry AMD, the central vision loss can be severe. An individual who has dry AMD can also develop wet AMD, which may require treatment. There is no treatment for Dry AMD.

Causes of AMD

Factors associated with the development of this condition include:

● Age: the main risk factor.

● Genetics: family history of AMD will increase the chance of having the same condition.

● Smoking: smokers are up to four times more likely to develop AMD than non-smokers.

● Diet: a diet poor in fruit and vegetables may increase the risk of AMD. Alcohol, obesity, and a diet high in sugar and fats also increase the risk.

● Blood pressure: High blood pressure is known to increase the chances of developing AMD.

● Sunlight: Cell damage from blue light may cause deterioration of the macula.

Symptoms

In the early stages of AMD, changes to your vision might not be noticeable. As the condition progresses or if it starts to affect both eyes, the symptoms below can occur:

● Gaps or dark spots, especially first thing in the morning.

● Objects might change shape or disappear.

● Colours can fade.

● Bright light can be glaring or difficult to adapt to when moving from dark to light environments.

● Words might disappear when reading.

● Straight lines such as door frames and lampposts may appear distorted or bent.

● Visual hallucinations (Charles Bonnet syndrome): Images of people, animals, landscapes or patterns that are not real. This is not a sign of mental illness, but a normal response of the brain to sight loss. Not everyone with vision loss will experience it but it is common.

Amsler grid

It is important to monitor the vision regularly to identify early signs of dry AMD becoming wet AMD or wet AMD becoming more active.

Use an Amsler grid weekly to monitor your vision.

Put your usual reading glasses on and hold the grid at about 12 inches or 30cm away from your face, in good lighting.

Cover each eye, in turns, and look at the central dot.

If you have been diagnosed with or have developed AMD, the lines of the grid may already appear wavy, broken, with blurred patches or missing on the chart. This suggests that a diagnosis is required for you to see disrupted lines, which is not the case.

If you notice any new changes or if they are worse than they were before, you should contact your opticians or ophthalmologist immediately.

Support for your macular condition

If you have been recently diagnosed with this condition and would like further information and guidance, please speak with your doctor and / or any medical retina specialist nurse.

Eye Clinic Contact Numbers and voicemail services

AMD clinic coordinator: 01223 254662

Medical retina specialist nurse: 01223 256672

Eye clinic liaison officer: 01223 216577

Emergency eye clinic: 01223 217778 (Monday to Friday, 09:00 - 16:00)

Please leave a message on the voicemail service with your name, date of birth and hospital number, plus a brief description of your concern, and we will contact you as soon as we can.

Out-of-hours: Attend the emergency department.

The organisations below provide further information and support. Please note that Addenbrooke’s Hospital is not responsible for the quality or accuracy of any information or advice provided by these organisations:

Macular Society

Crown Chambers
South Street
Andover
Hampshire
SP10 2BN

Helpline telephone: 0300 3030 111
Helpline email

General enquiries telephone: 01264 350551
General enquiries email

Macular Society website (opens in a new tab)

National Institute for Health and Clinical Excellence (NICE)

MidCity Place
71 High Holborn
London
WC1V 6NA

Telephone: 0845 0037780

NICE website (opens in a new tab)

The Royal College of Ophthalmologists

17 Cornwall Terrace
London
NW1 4QW

Telephone: 02079 350702

The Royal College of Ophthalmologists website (opens in a new tab)

Royal National Institute of Blind People

105 Judd Street
London
WC1H 9NE

Telephone: 0303123 9999

Royal National Institute of Blind People website (opens in a new tab)