What is Dry Macular Degeneration?
Dry age-related macular degeneration (dry AMD) is a common eye disease in people over 50. It causes a gradual loss of central vision due to the deterioration of cells in an area of the retina called the macula.
The macula is the part of your eye that provides clear vision when looking straight ahead. AMD may cause a loss of central vision, but the peripheral (side) vision may remain intact.
Dry AMD is one type of age-related macular degeneration (AMD), the leading cause of blindness in Americans over 65.1 It’s not called dry AMD because it causes dry eyes, but to distinguish it from wet AMD.
Dry vs. Wet Macular Degeneration
There are two types of age-related macular degeneration, wet and dry. Both types affect the light-sensitive cells in the retina and can occur in one eye or both.
However, there are some key differences:
Dry Macular Degeneration
Dry age-related macular degeneration is the more common, less severe type. About 80% of people with AMD have the dry form.
Dry AMD progresses slowly, leading to gradual vision loss over many years. It’s caused by deposits of a substance called drusen beneath the retina.
Most cases of AMD start as the dry form but can progress to wet AMD or advanced dry AMD. It can affect one or both eyes.
The death of retinal cells causes vision loss from dry AMD and therefore is not reversible.
Wet Macular Degeneration
Wet macular degeneration is less common but more serious. About 10% of people with dry AMD will develop wet AMD.3
Wet AMD is caused by abnormal, leaky blood vessels in the back of the eye that damage the macula.
Wet AMD can cause significant vision loss much faster than dry AMD. However, vision loss may be treatable with injections and laser therapy.
What are the Symptoms of Dry Macular Degeneration?
Dry age-related macular degeneration progresses slowly throughout three stages. The symptoms of dry AMD depend on the stage.
Early AMD usually doesn’t cause any symptoms.
Symptoms of Intermediate AMD
Some people may still have no symptoms at this stage.
Others may notice mild blurriness in their central vision, while peripheral vision remains the same. They may also have trouble seeing in low-light conditions.
Symptoms of Late AMD (Wet or Dry)
Call your eye doctor immediately if straight lines start to look wavy. This is a warning sign of late AMD.
The symptoms of late-stage dry macular degeneration include:
- Blurry spot in the center of the visual field
- Inability to see fine details
- Trouble seeing in low light
- Straight lines appear wavy or crooked
- Blind spots in vision
- Colors appear less bright than before
Over time, the blurry area or blind spot may grow larger. Changes in central vision can interfere with everyday tasks like reading, driving, and identifying faces.
What Causes Dry Macular Degeneration?
While it isn't clear exactly what causes people to develop macular degeneration, age is a leading factor. Over time, the macula starts to thin. This leaves the retina vulnerable to damage, which can cause you to lose central vision.
In addition to age, family history, and lifestyle, environmental factors also play a role in the progression of dry AMD.
Who is at Risk for Dry Macular Degeneration?
People over 60 are at a higher risk for developing age-related macular degeneration.
Risk factors for AMD include:
- Cardiovascular disease
- High blood pressure
- High cholesterol
- Sun exposure without eye protection
- Poor diet
Complications of Dry Macular Degeneration
While the progression of dry macular degeneration differs for everyone, it can lead to complications if not properly managed.
Possible complications include:
- Progression into wet AMD
- Charles Bonnet syndrome (visual hallucinations)
- Retinal detachment (medical emergency)
- Anxiety and depression
- Injuries from falls
Alert your eye doctor right away if you are experiencing any AMD-related complications.
When to See a Doctor
See your eye doctor if you experience any of the following:
- Blurriness or blind spots in your central vision
- Central vision loss
- Double vision
- Halos around light
- Straight lines that appear wavy
- Colors that look faded
- Inability to see fine details
- Other sudden changes to your vision
Routine eye exams can catch eye disorders early. This helps decrease severe symptoms and slow the progression of the disease.
Age-related macular degeneration is diagnosed during a comprehensive eye exam.
After dilating the eyes, your eye doctor will use an ophthalmoscope to examine your retina. They’ll look for a substance called drusen, tiny yellow protein deposits.
Tests to Diagnose AMD
Your eye doctor may perform a series of tests to diagnose AMD and determine your stage.
Tests may include:
- Amsler grid. A piece of graph paper is used to determine if straight lines appear wavy
- Optical coherence tomography (OCT). Provides detailed images of the retina and macula
- Fluorescein angiography. An intravenous dye that highlights the presence of abnormal blood vessels.
Treatment for AMD
While there is no cure for age-related macular degeneration, treatment can help slow the disease's progression and preserve your remaining vision. Treatment options for dry AMD may include:
Syfovre is the first and only FDA-approved treatment for geographic atrophy, an advanced form of age-related macular degeneration.
Treatment involves monthly injections and has been shown to reduce the growth of lesions that cause vision loss by 36%.9
Taking Nutritional Supplements
The Age-Related Eye Disease Study 2 (AREDS 2) found that a combination of antioxidant vitamins and supplements can help reduce the progression of dry AMD by 25%.8
Nutritional supplements that may slow the progression of dry AMD include:
- Vitamin C
- Vitamin E
Healthy Lifestyle Changes
Along with the AREDS 2 formula, your doctor may suggest dietary and lifestyle changes to slow the progression of dry AMD.
- Avoiding processed foods. Focus on whole foods like fruits, vegetables, protein, and whole grains, instead
- Eating plenty of fruits and dark leafy greens. These foods are high in antioxidants, vitamins, and minerals
- Eating fatty fish. Tuna, salmon, sardines, and mackerel are high in omega-3 fatty acids
- Stopping smoking. Ask your healthcare provider for resources to help you quit
- Controlling other medical conditions. Including high blood pressure
- Staying active. Get regular exercise and maintain a healthy weight
- Wearing sunglasses. To protect your eyes from further damage
- Getting routine eye exams. To monitor changes to your vision and get treatment right away if you have early signs of wet AMD
While vision loss caused by dry AMD is not reversible, low-vision aids can help people adapt to low light and central vision changes.
Examples of low-vision aids include:
- Reading glasses
- Reading lamps
- Large font reading material
- Closed-circuit television that magnifies the screen
- Computer tablets
Vision specialists are also available to help people learn to live with vision loss, remain independent, and provide vision rehabilitation.
Treatment Options for Wet AMD
Treatment is different for wet AMD because it involves the growth of abnormal blood vessels.
Gold standard wet AMD treatments include:
- Anti-vascular endothelial growth factor (Anti-VEGF) medications. These are injected into the eye to reduce the growth of new blood vessels
- Laser surgery. To reduce the number of abnormal blood vessels
- Photodynamic therapy (PDT). A laser with dye to target abnormal blood vessels
Depending on disease progression, these treatments might be administered several times throughout a person’s lifetime to help prevent further vision loss.
Can You Prevent Macular Degeneration?
Routine eye exams that include eye dilation are best for catching AMD early and reducing the risk of permanent vision loss.
While genetics and family history can't be changed, many dietary and lifestyle changes can slow the progression of AMD, including:
- Taking vitamins and nutritional supplements
- Not smoking
- Eating a healthy diet
- Lowering blood pressure
- Wearing sunglasses and eye protection
- Maintaining a healthy weight
Age-related macular degeneration (AMD) is a leading cause of severe vision loss among adults over 60.
There are two types of AMD: dry and wet. Dry AMD is more common, but wet AMD is more severe. In some cases, dry AMD can lead to wet AMD.
Dry AMD typically doesn't cause any symptoms in its early stages. Seeing wavy lines that should be straight is a telltale sign of late-stage AMD and warrants a call to your eye doctor.
The best ways to reduce your chances of developing AMD are by making healthy lifestyle changes and scheduling routine eye doctor visits.
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