Living With AMD
Meet Cherie, who explains her experience with anti-VEGF injections for AMD
It is possible to have age-related macular degeneration (AMD) without any symptoms. People with early and intermediate stages of AMD rarely have symptoms; in comparison, people with severe or wet AMD usually do have symptoms.1 Symptoms of AMD may occur in one or both eyes, and include2:
AMD is a progressive disease, meaning symptoms usually get worse over time.2 When visual changes occur, AMD is most likely intermediate to severe disease.2 Early detection and referral to an ophthalmologist is important because monitoring and early initiation of treatments to help slow down the progression of intermediate to severe AMD, as well as preserve central vision in wet AMD, can be given.2-4
The American Academy of Ophthalmology (AAO) recommends the following for comprehensive eye exams in adults with no risk factors for AMD or signs of disease; if you are 40 years and older, you should have a comprehensive medical eye evaluation with an ophthalmologist if you have never previously received one.5
People with symptoms or who have risk factors for AMD should have closer follow-up by an eye care professional, and decisions on the number of visits should be made on an individual basis.5, 7 Persons with significant risk factors should see an ophthalmologist; comprehensive evaluation includes a dilated eye exam, a slit-lamp exam to detect the subtle changes seen with the growth of abnormal blood vessels, and possible imaging of the layers of the retina and its blood vessels with technology such as optical coherence tomography (OCT) and fluorescein angiography (FA), helping to detect fluid leakage and vessel damage.7
Not everyone with AMD develops severe AMD or gets it in both eyes.2 For those who do, activities that require fine visual acuity such as driving or reading are hard to do.2 Using assistive devices, such as brighter lights or magnifying lens for specific tasks, can help improve everyday activites.2, 6 Vision rehabilitation specialists can help with learning to live with vision loss, with training on how to use magnifying devices for reading, guidance on home set-up to move around easily, and sharing resources to help cope with vision loss.6
People with early AMD and/or a family history of AMD may be given an Amsler grid to self-evaluate on a weekly basis for any changes in vision, such as missing areas of the grid or distorted/wavy lines.7 See the Figure below for an example of a patient self-evaluation of visual changes using an Amsler grid.
Early recognition and coordinated care between primary care providers and vision specialists will lead to timely management, which may decrease the occurrence of permanent blindness due to AMD.8
- Ayoub T, Patel N. Age-related macular degeneration. J R Soc Med. 2009;102:56-61.
- National Institutes of Health (NIH). National Eye Institute. Age-related macular degeneration. Last updated June 22, 2021. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/age-related-macular-degeneration.
- American Society of Retina Specialists (ASRS). The Foundation Retina Health Series. Age-related macular degeneration. 2022. https://www.asrs.org/patients/retinal-diseases/2/age-related-macular-degeneration.
- Marra KV, Wagley S, Kuperwaser MC, et al. Care of older adults: role of primary care physicians in the treatment of cataracts and macular degeneration. J Am Geriatr Soc. 2016;64(2):369-377.
- Chuck RS, et al. Comprehensive adult medical eye evaluation Preferred Practice Pattern®. Ophthalmology. 2021;128:P1-P29.
- National Institutes of Health (NIH). National Eye Institute. Low vision. Last updated May 5, 2020. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/low-vision.
- Flaxel CJ, Adelman RA, Bailey ST, et al. Age-related macular degeneration Preferred Practice Pattern®. Ophthalmology. 2020;127:P1-P65.
- Cunningham J. Recognizing age-related macular degeneration in primary care. JAAPA. 2017;30(3):18-22.