Macular degeneration (AMD): symptoms, treatment, causes and outlook

The NHS says AMD affects the middle part of your vision, not the edges (peripheral vision), and you can get it in one eye or both. The first symptom is often a blurred or distorted area in the centre of your vision. If it gets worse, you might struggle to see anything in the middle of your vision. It can make things like reading, watching TV, driving or recognising faces difficult.

Other symptoms the NHS lists are seeing straight lines as wavy or crooked, being sensitive to bright light, seeing flickering or flashing lights, and seeing things that are not there (hallucinations). AMD is not painful and does not affect the appearance of your eyes. The Macular Society adds difficulty seeing in low light and dark or empty spots in the centre of vision.

Sometimes AMD is found during a routine eye test before you have any symptoms, the NHS says, and the Macular Society says many people do not show symptoms in the early stages.

The Macular Society describes macular degeneration, or age-related macular degeneration (AMD), as a progressive eye condition that affects the central part of the retina called the macula, which is responsible for sharp, detailed vision used in everyday tasks such as reading, driving and recognising faces. It often begins with small changes at the back of the eye, such as fatty protein deposits called drusen.

The condition can cause you to lose your central vision but does not lead to total blindness because side vision is usually unaffected. It can affect one or both eyes with varying severity. The Macular Society says it usually affects people over 50 and is the biggest cause of sight loss in the UK, affecting around 700,000 people, with around one in 200 people affected at 60 and one in five by 90.

There are two forms of AMD. The NHS says the treatment depends on the stage and type of late-stage AMD you have, dry or wet, and that you will be supported by different eye specialists, which may include an optometrist and an ophthalmologist.

The NHS says there is no cure for AMD, but there are treatments and support to help slow down changes in your vision and help you have the best quality of life. For wet AMD, treatments include injections of medicine (anti-VEGF) given directly into the eyes and light treatment to destroy the blood vessels that cause wet AMD. There is currently no treatment for dry AMD.

The Macular Society says the most effective treatment for wet AMD is anti-VEGF injections, which stop abnormal blood vessel growth, and names Lucentis, Eylea, Beovu and Vabysmo. For dry AMD, it says several approaches can help manage the condition and potentially slow its progression, including quitting smoking, regular exercise, vision aids, a diet rich in antioxidants from leafy greens and certain vegetables, and nutritional supplements of the AREDS2 formula, typically recommended for intermediate or advanced dry AMD. Talk to your doctor before taking supplements.

The NHS says research into possible new treatments is ongoing, and your specialist can let you know if there are any studies you could take part in.

The NHS says the exact cause is unknown, but it has been linked to ageing, smoking, high blood pressure, being overweight and having a family history of AMD.

The Macular Society lists age as the main risk factor, family history, smoking (smokers are up to four times more likely to develop AMD than non-smokers, and stopping smoking after developing AMD can help reduce the risk of it getting worse), a poor diet low in fruit and vegetables, obesity, and high blood pressure (people with high blood pressure are one-and-a-half times more likely to have AMD). AMD affects men and women equally.

The Macular Society says diagnosis usually involves a comprehensive eye test including a dilated eye exam to check the retina, an Amsler grid test to detect changes such as wavy or missing lines, an optical coherence tomography (OCT) scan that creates cross-section images of the retina, and sometimes fluorescein angiography, which highlights blood vessels in the retina.

It says many high street opticians now have OCT scanners that help diagnose people with early stages, people over 60 are entitled to free eye tests, and an eye test is recommended every two years if you are over 60 and every year if you are over 70. OCT scans may be an additional fee. The NHS says early diagnosis and treatment may help stop your vision getting worse.

The Macular Society says many people continue to live active, fulfilling lives with proper care and support, and lists low vision aids such as magnifying devices, large-print materials and screen readers, vision rehabilitation services, home adjustments such as better lighting and contrast, emotional support and regular check-ups.

On driving, it says many people with early or dry AMD can drive safely, and if you have AMD in both eyes or have been told your vision is below driving standards, you must declare this to the DVLA. It says that while you cannot completely prevent AMD, not smoking, eating well and managing health conditions can lower the risk.

The NHS says to see an optician if you are worried about your vision. Get an urgent opticians appointment or get help from NHS 111 if your vision gets suddenly worse, you have a dark "curtain" or shadow moving across your vision, or your eye is red and painful. These symptoms can be signs of other eye problems that need to be treated straight away.

The Macular Society adds that wet AMD can cause rapid loss of central vision, which is why any new distortion in straight lines should be checked quickly.

On the NHS, an optician spots changes, and a suspected wet AMD is referred to hospital eye services, where specialists provide anti-VEGF injections. NICE guideline NG82 covers diagnosing and managing AMD in the NHS.

Private eye clinics offer OCT scans and may also offer injections. Because the Macular Society notes OCT scans at opticians may carry a fee, ask what is included, and make sure your NHS eye clinic is aware of private findings so treatment is not delayed.