Amsler Grid Chart

What is Macular Degeneration?

Age-related macular degeneration (AMD) is an eye disease that can blur your central vision. You can develop it as you age due to macular damage. With early detection, you may be able to prevent or mitigate further macular damage.

If you believe you have AMD, consult an eye doctor. They will conduct a comprehensive eye examination, including various tests, to rule out or diagnose the condition.

Different testing approaches include:

• Amsler grid
• Retinal examination
• Fluorescein angiography
• Optical coherence tomography

What is an Amsler Grid Test?

The Amsler grid test is one of the many standard tools used to perform a diagnosis. The grid consists of a single square with a grid pattern and a black dot in the middle. The test helps identify problem spots in your field of vision.

You can perform the test at home or in your local eye clinic.  

How to Use an Amsler Grid Test

If you want to use the Amsler grid test correctly, follow these steps once daily, every day:

• Put on your regular reading glasses if you have them. Hold the grid at eye level at approximately 12 to 15 inches away from your face in good light
• Then, cover your left eye
• With your right eye only (uncovered), look at the dot in the middle and lock your focus there
• While staring at the center dot with your uncovered eye, pay attention to the grid lines in your peripheral vision. If any lines or areas look blurry, wavy, dark, or blank, speak with your eye doctor
• After you have done one eye, switch and perform the same tasks with the other eye

What Does the Amsler Chart Look Like if You Have Macular Degeneration? 

A person with macular degeneration won't see the Amsler grid/chart the same way as someone without eye health issues. The grid could appear to have wavy lines or blank spots if you have AMD.

If this occurs, you must speak with an eye doctor immediately. Early diagnosis could help your eye doctor establish a treatment regimen and prevent further damage.

Are Amsler Grid Charts Effective for Testing Macular Degeneration?

Current best practices will promote using an Amsler grid chart to test macular degeneration.

However, according to a study, the sensitivity of Amsler grids can be less than 50%.³ This means that some people with macular degeneration may not believe they have the condition when, in reality, they do.

Despite this, the Amsler grid chart is still useful. It's economical, and you can perform it at home daily.

Until another adequate replacement comes about, using Amsler grids combined with knowledge of risk factors and clinical history can help with early detection.

What Causes Macular Degeneration?

AMD is a complex disease. Researchers and doctors still don't know its exact cause. Some believe that genetic components and environmental factors play a role in your susceptibility to macular damage.

Here are some risk factors:

• Age. The majority of AMD cases happen in people over the age of 50. 
• Family history. There are specific genes related to AMD onset.
• Race. Caucasians face an increased risk of AMD. 
• Smoking. Smoking or exposure to secondhand smoke raises your likelihood of developing AMD.
• Unhealthy diet. Research suggests that obesity and unhealthy diets may amplify disease severity.
• Cardiovascular disease. You could have a higher chance of developing the wet form of macular degeneration if you have health issues that involve your heart or blood vessels (e.g., high blood pressure or hypertension).

What are the Symptoms of Macular Degeneration?

If you have macular degeneration, your symptoms may vary according to the disease stage. For example, dry AMD has three stages: early, intermediate, and late. Because it's progressive, symptoms tend to get worse as time passes. 

Here is the progression of AMD:

• Early. People with early cases of dry AMD won't show symptoms.
• Intermediate. Some may still not show changes in their visual field at this stage. Others may experience mild blurriness in central vision or have trouble seeing in low-lighting settings.
• Late/Wet. Those in this stage may observe a blurry area in their central vision. This blurry area could increase in size as time progresses, becoming a blind spot. Other effects include dimmer colors, straight lines appearing wavy, and poor vision in low light.

How to Treat Macular Degeneration

Macular degeneration can't be cured. It's a progressive disease. However, early detection can reduce symptom severity and slow disease progression.

Disease type and stage will determine the kind of treatment. In general, though, your healthcare provider may consider the following therapeutic approaches:

Nutritional supplements

Clinical trials found that combining vitamin and mineral intake could slow the progression of dry AMD.² AREDS supplements include:

• Vitamin C
• Vitamin E
• Lutein
• Zinc
• Copper
• Zeaxanthin
• Beta carotene (this is not recommended for smoker,s due to an increased risk of lung cancer) 

Antivascular endothelial growth factor (anti-VEGF)

This treatment for wet AMD includes blocking VEGF production, a protein that contributes to the creation of blood vessels. Your eye doctor will inject anti-VEGF into a numbed eye to delay or stop blood vessel development. Vision could improve as a result. 

Photodynamic therapy (PDT)

A healthcare professional will use both an injectable light-sensitive drug and laser treatment to eliminate extra blood vessels in the eye. You may undergo a combination treatment with anti-VEGF.

Summary

An Amsler grid is a tool that can help eye doctors perform an AMD diagnosis. While the sensitivity of Amsler grids can be less than 50%, it's still useful.

Consult an eye doctor immediately if you experience symptoms of AMD. They can recommend ways to slow the disease's progression.