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Macular degeneration is classified into two stages: the “dry” (atrophic) form which is characterized by deposits of yellow material (drusen) in the retina and the more severe “wet” (neovascular) form which is characterized by abnormal blood vessel growth in the macula.
In the “dry” type of macular degeneration, the deterioration of the retina is associated with the formation of small yellow deposits, known as drusen, under the macula. This phenomenon leads to a thinning and drying out of the macula, causing the macula to lose its function. The amount of central vision loss is directly related to the location and amount of retinal thinning caused by the drusen.
The early stage of dry age-related macular degeneration is associated with minimal visual impairment. Nearly all people over the age of 50 years have at least one small druse in one or both eyes. Only eyes with large drusen are at risk for late age-related macular degeneration.
Approximately 85% to 90% of the cases of macular degeneration are the “dry” (atrophic) type. “Dry” age-related macular degeneration does not involve any leakage of blood or serum. Loss of vision may still occur. Patients with this “dry” form may have good central vision (20/40 or better) but substantial functional limitations, including fluctuating vision, difficulty reading because of their limited area of central vision, limited vision at night or under conditions of reduced illumination.
The wet form is caused by the growth of abnormal blood vessels, called “neovascularization,” across the macula (the central part of the retina). These abnormal vessels leak fluid and blood into the tissue at the back of the eye, causing a blister to form in the retina, which leads to scar tissue and vision loss. While 10% of macular degeneration is the wet form, it accounts for 90% of the serious vision loss caused by the disorder. The normal course of the disease is the progressive loss of central vision.
In the earliest stages, vision may become blurred for distance and/or reading. An important symptom is distortion. Straight lines will not look straight. A telephone pole or door frame may seem a little bent, crooked or irregular, similar to viewing an item through a heatwave. Also, you may see a dark gray spot similar to the after-effect caused by a flashbulb.
There may be other changes in vision. For example, an object may appear to have a different color or different size when viewed with your left eye vs. your right eye. These are important symptoms to report to your doctor.
Regular eye care visits can help monitor for signs of macular degeneration. For those patients who already have dry macular degeneration, regular eye care visits can help monitor for progression to wet macular degeneration.
Our doctors can detect macular degeneration during a dilated eye examination where they will view your macula with an ophthalmoscope. If abnormalities or drusen are found, treatment options and follow-up examinations will be discussed.