Dry age-related macular degeneration: symptoms, monitoring and living well

The Macular Society describes dry AMD as a gradual deterioration of the macula as retinal cells die off and are not renewed. It often begins with small yellow deposits called drusen at the back of the eye. NICE grades early AMD by drusen size and pigment changes into low, medium and high risk of progression.

Dry AMD affects central vision, not side vision, so total blindness is not the outcome, as the NHS notes for AMD generally. It may affect one or both eyes with different severity.

Many people have no symptoms early on and learn they have drusen at a routine optician visit. When symptoms arrive, they can include blurry central vision, difficulty seeing in low light, trouble recognising faces, dark patches in the middle of vision, and difficulty with reading or close work, as the Macular Society lists. Wavy or distorted straight lines suggest the wet type and need prompt checking.

Age is the main risk. The Macular Society says around one in 200 people have AMD at 60, rising to one in five by 90. Family history and gene variants raise risk. Modifiable factors include smoking, which the charity says makes people up to four times more likely to develop AMD, high blood pressure (about one-and-a-half times as likely), obesity and diets high in sugar and saturated or hydrogenated fat.

• Stopping smoking is one of the changes within your own control.

• A diet rich in leafy greens, omega-3 fatty acids and antioxidant foods is suggested; the Macular Society says it cannot reverse damage but may help slow further damage.

• Keeping blood pressure under control and keeping active are also advised.

Dry AMD is monitored rather than treated. Optical coherence tomography (OCT) scans show the layers of the retina, and many high street opticians now have OCT scanners that help diagnose early AMD. The Macular Society says OCT scans of the macula may cost extra even though a free NHS eye test is available to people over 60.

NICE says people with AMD should be told how to seek help with vision changes and should be given information about Charles Bonnet syndrome, driving standards and certification. An Amsler grid test, which picks up wavy or missing lines in the central vision, is among the tests the Macular Society describes.

There is no known cure for dry AMD, and the NHS says there is no treatment for it, though research into new treatments is ongoing and a specialist can say whether a study might be suitable. Supports described by the Macular Society include stopping smoking, regular exercise, vision aids and an antioxidant-rich diet, with AREDS2-type supplements typically recommended for intermediate or advanced dry AMD but only after discussing with a doctor.

Practical help includes magnifiers, large print, screen readers, better lighting and contrast, home adjustments, vision rehabilitation services such as occupational therapy and mobility training, and counselling or peer support groups. Registration as sight impaired can open access to benefits and services.

Many people with early or dry AMD can drive safely, according to the Macular Society, but you must declare to the DVLA if AMD affects both eyes or your vision is below driving standards. Your eye specialist can advise on your own situation.

Early AMD is often found at a community optician and followed there. Private retina clinics offer OCT imaging, supplement advice and low vision assessment, but they cannot offer a proven reversal treatment for dry AMD. Be cautious about any service that promises to restore lost vision, and ask how the clinic would respond if the disease turned wet.