When you have macular degeneration, your central vision is impaired, meaning that you literally can’t see what’s right in front of you. Age-related macular degeneration (AMD) mostly affects people over the age of 50, and it is the leading cause of vision loss for adults 60 years of age and older. While AMD doesn’t leave you completely blind, losing central vision can make daily life difficult. Here, Cleveland Clinic explains how AMD is treated and managed. *

What is macular degeneration and how does it affect daily life?

Macular degeneration affects the central region of the retina, called the macula, located at the back of the eye. Though the macula deteriorates, compromising central vision, peripheral (side) vision remains intact. Macular degeneration can affect one or both eyes with differing severity.

There are two types of macular degeneration: dry and wet.

• Dry is the most common form, affecting nearly 90% of people with the disease. It happens when minute, yellow deposits of protein and fat (drusen) form under the macula, causing the macula to become dry and thin. Loss of central vision tends to be gradual.
• Wet is more severe and can quickly cause central vision loss. This happens when weaker and abnormal blood vessels form under the retina and macula, and leak blood and fluid. With the buildup of fluid, the macula forms a bulge that can cause dark spots in central vision.

Once dry macular degeneration reaches the intermediate stage, central vision can become blurry or wavy. This can affect reading, facial recognition, driving, cooking, and other activities. Severe AMD can lead to legal blindness.

Treatment and management

While there’s currently no cure, treating macular degeneration early can slow its progression and ease symptoms. Some treatment options include:

• Nutritional supplements
• Medications
• Photodynamic therapy (PDT)
• Laser therapy

Nutritional supplements for dry AMD

Two studies, AREDS (Age-Related Eye Disease Studies) and AREDS2, discovered that combining certain vitamins, minerals, and antioxidant plant compounds may slow dry AMD progression.

• Vitamins C and E
• The minerals zinc and copper
• Lutein
• Zeaxanthin

The nutrients above are part of the AREDS2 formula, which substitutes the carotenoids lutein and zeaxanthin for beta-carotene in the original AREDS version. (Beta-carotene increased lung cancer risk in current and former smokers.)

Medications for wet AMD

Anti-VEGF drugs like Aflibercept (Eylea®) and Ranibizumab (Lucentis®) injected into the eye are the preferred treatment for wet AMD. Numbing eye drops are given prior to injection, and some patients find that their vision improves.

Photodynamic therapy (PDT) for wet AMD

PDT destroys excessive blood vessels in the eye by combining a laser with an injectable light-sensitive drug, creating a chemical reaction that destroys the invasive cells. PDT may be combined with anti-VEGF injections.

Laser photocoagulation for wet AMD

Here, a laser is used to seal and destroy leaking blood vessels. Though this was the first wet AMD treatment, laser photocoagulation and PDT are now used less commonly in favor of anti-VEGF injections.

Potential wet AMD treatment side effects

There are potential complications with wet AMD treatments, such as:

• Eye infections
• Severe vision loss
• Retinal detachment
• Faster cataract onset

Lifestyle matters

Cleveland Clinic offers tips to help prevent macular degeneration:

• Don’t smoke
• Stay physically active
• Maintain a healthy body weight for your frame
• Eat a Mediterranean-style diet
• Keep blood pressure and cholesterol at healthy levels

Disease outlook

You may not have significant loss of vision with AMD. Because AMD can affect just one eye, changes in vision may be unnoticeable. Furthermore, vision loss from dry AMD can take a long time to become noticeable. Even those with severe vision loss may see better with:

• Eyeglasses or contact lenses
• Reading with a magnifying glass
• Brighter lighting

When to contact your doctor

If you have macular degeneration, Cleveland Clinic advises contacting your provider if you experience:

• Painful eye inflammation and light sensitivity
• A sensation of pressure behind your eye
• Eye floaters or flashes

*Cleveland Clinic. (2023, February 14). Macular Degeneration. https://my.clevelandclinic.org/health/diseases/15246-macular-degeneration#management-and-treatment