Central vision, the sharp, detailed vision used for reading, recognising faces and seeing fine detail, depends on a small part of the retina (the light-sensitive layer lining the back of the eye) called the macula. Age-related macular degeneration is damage to this specific area. Early AMD often causes no noticeable symptoms, which is why routine eye examinations matter even before vision changes are apparent. As the condition progresses, symptoms can include wavy or distorted lines, a blurred or missing area in central vision, and increasing difficulty reading or recognising faces, while side vision generally remains unaffected. Macular degeneration can take different forms, and recognising which form is present is important because the appropriate management and treatment can differ significantly between them.
Treatment aims to slow or control further damage to the macula, depending on the type and stage of the condition. It cannot generally restore central vision that has already been permanently lost, although some treatments for wet macular degeneration can improve vision as well as reduce further vision loss.
AMD is commonly described as dry or wet, though the two are not always mutually exclusive: wet AMD may develop in an eye with existing dry AMD, and features of both forms can be present in the same eye. Establishing the type and stage of the condition is therefore an important part of the assessment.
Dry macular degeneration is the more common form and involves gradual changes and loss of retinal cells in the macula. Management depends on the stage of the disease and may include regular monitoring and, for appropriate patients, AREDS2 nutritional supplements. For late dry AMD with geographic atrophy, an intravitreal treatment may be considered for selected adults where the fovea remains intact and lesion growth threatens central vision. Eligibility depends on lesion size, location and overall eye health, assessed individually. Treatment aims to slow lesion progression and does not restore vision already lost.
Wet macular degeneration occurs when abnormal blood vessels grow beneath or within the retina and leak fluid or blood, which can cause more rapid damage to the macula. It is commonly treated with intravitreal anti-VEGF injections (medication injected directly into the vitreous, the gel-like substance inside the eye).
Diagnosis may involve a dilated eye examination and OCT (optical coherence tomography), a detailed imaging scan that shows the layers of the retina in cross-section.
An anti-VEGF medication (a drug that blocks vascular endothelial growth factor, a protein that promotes abnormal blood vessel growth and leakage) is injected directly into the vitreous using a fine needle after the eye has been numbed with anaesthetic drops. The medication acts within the eye to reduce abnormal blood vessel activity and leakage.
In Plain Terms: A small injection is given directly into the eye to reduce the activity of abnormal blood vessels that can leak fluid or blood beneath the retina. The eye is numbed beforehand to reduce discomfort during the injection.
Confirmed wet macular degeneration based on clinical examination and retinal imaging, including OCT, rather than dry macular degeneration, because anti-VEGF injections target the abnormal blood vessel activity associated with wet disease
Recent or active disease where treatment may help reduce further vision loss and, in some patients, improve vision. Early assessment and treatment are important because untreated wet AMD can cause relatively rapid central vision loss
Willingness to attend regular follow-up appointments, as treatment commonly involves repeated injections and monitoring for as long as the disease remains active
The injection appointment itself is brief. Many patients can resume selected routine activities after the appointment, subject to the treating ophthalmologist’s instructions. Driving and other visually demanding activities should be resumed only when vision is adequate and it is considered safe. Mild irritation, a gritty sensation or small floaters may occur for a short period. Injection intervals vary according to the medication used, the activity of the disease and how the individual eye responds. Treatment may begin at relatively short intervals and be extended when the disease becomes stable, while ongoing treatment may be needed when disease activity persists.
As with any intraocular procedure, anti-VEGF injections carry potential risks, which may include infection, inflammation, bleeding, increased eye pressure, retinal complications and injury to the natural lens. Temporary visual disturbances, such as blurring or floaters, are common in the days following injection. Rare, more serious complications, including permanent vision loss, can occur. Repeated injections are commonly required, and treatment does not guarantee visual improvement or prevent all further vision loss in every patient.
Management depends on the stage and type of dry macular degeneration. For patients with intermediate AMD, AREDS2 nutritional supplements (a specific combination of vitamins and minerals) may help slow progression to more advanced disease. Treatment options are also available for some patients with late dry AMD involving geographic atrophy (areas where retinal cells have been lost). Regular monitoring remains important to assess changes in the macula and identify any development of wet AMD, which requires a different treatment approach.
With wet macular degeneration, timely diagnosis and treatment are important because untreated disease can cause significant central vision loss. Identifying the type of macular degeneration and detecting signs of active wet disease early allows treatment to be considered when it is most appropriate.
Dr David Robinson brings more than 28 years of ophthalmic surgical experience to the assessment of eye conditions affecting vision. A detailed retinal assessment can help identify the cause of your vision changes and determine whether monitoring or treatment is appropriate for your eyes.
The interval varies according to the medication, disease activity and response of the individual eye. Treatment often begins with more frequent injections, commonly around once a month, before the interval is adjusted according to how the disease responds.
There is currently no cure for age-related macular degeneration. Treatment aims to slow disease progression and preserve remaining vision, while some treatments for wet AMD may also improve vision in appropriate patients.
The eye is numbed with anaesthetic drops beforehand. Patients may feel some pressure or brief discomfort during the injection, while mild irritation or a gritty sensation can occur afterwards.
AMD primarily affects central vision rather than peripheral vision. As a result, many patients retain peripheral vision even when central vision becomes significantly impaired, although advanced disease can substantially affect activities such as reading and recognising faces.
Yes. Dry AMD can progress to wet AMD, although not every patient develops the wet form. Regular monitoring helps identify changes that may require a different treatment approach.