The American Macular Degeneration Foundation recognizes three phases of macular degeneration: early, intermediate, and late. Those phases are determined by the symptoms doctors can see as well as the symptoms you might report to a doctor. What you should do at each stage of the disorder varies.
In the early stage, you may have no vision issues, but your doctor might advise you to make some lifestyle changes to keep the disorder from progressing. In the intermediate stage, you may begin to experience difficulty with central vision, and your doctor may ask you to use vitamins to slow progression. In the late stages, you may have difficulty seeing clearly. Your doctor may advise surgery, or you may consider working with an occupational therapist.
On average, it takes about 10 years to move from diagnosis to legal blindness, but there are some forms of macular degeneration that can cause sight loss in just days.
Early AMD: What It Is and What to Do
Age-related macular degeneration (AMD) is caused by changes beneath the sensitive tissues that communicate with your optic nerve and allow you to see. In the dry form of the disease, which is the most common form, the damage begins with accumulations of yellow deposits below the retina, known as drusen.
Your doctor may spot drusen in a routine eye exam, and drusen may be visible long before you have symptoms of AMD. If your doctor spots drusen, according to the Bright Focus Foundation, your doctor may request that you visit for eye exams frequently. That can allow your doctor to look for changes that indicate that the disease is progressing. It's vital to keep those appointments even if you feel fine. You will not be able to see drusen on your own. You will need a doctor's help.
Your doctor may also encourage you to take care of your overall health by:
- Eating a plant-based diet.
- Exercising regularly.
- Quitting smoking.
- Losing weight if you are overweight.
Your eyes rely on a healthy cardiovascular system, and that means paying attention to the choices that can harm your heart could be a key part of keeping AMD from progressing. You might start that work now and keep it up throughout the course of your AMD journey. Your doctor can help you make these changes, and your doctor can refer you to other specialists, such as dietitians, if you need extra help.
Intermediate AMD: What It Is and What to Do
The organization Prevent Blindness suggests that people in the intermediate stage of AMD have many drusen, and while some may not have symptoms, others may begin to see holes or black spots in the center of the visual field. In addition, people in intermediate stages may struggle to move from a bright location to a dim location, such as walking into a darkened movie theater on a sunny day, due to changes within their eyes. These changes may be subtle.
These signs indicate that the disease is progressing, and your doctor may begin to add therapies to help you gain control and ensure that you do not lose much more sight. Vitamin therapy may be one of the solutions your doctor offers.
According to the American Academy of Ophthalmology, there are specific vitamin formulations that have been proven to slow the course of AMD, but they work best in people with intermediate or advanced cases of the disorder. Your doctor may provide you with a specific brand and product name to buy, or your doctor may have those vitamins in the office for you to take.
Your doctor may encourage you to continue with healthy lifestyle habits, including keeping weight under control and exercising regularly. You may also be encouraged to visit the doctor even more frequently, so your AMD can be monitored and your doctor can look for signs of progression of the disease. Again, it's vital for you to keep your appointments.
Late AMD: What It Is and What to Do
In the late stages of AMD, you may have many drusen and your vision may be significantly impaired. Straight lines may look wavy, and you may have a large spot of fuzziness in the center of your visual field. You may be unable to read expressions on the faces of those you are talking to, and you may struggle to read or work on a computer.
Your doctor may discuss surgery with you. An implanted lens that enlarges images as they enter the eye may allow the healthy parts of your eye to take over from the damaged portions. This type of surgery is not right for everyone, but it might be a good option for some people.
Your doctor may also encourage you to work with an occupational therapist if surgery is not a good option for you. There are techniques you can use to help you cope with life with low vision, and a therapist can help you discover which techniques are right for you.
Your doctor may also ask you to work with a mental health professional. According to research published in the journal Clinical Ophthalmology, it is not uncommon for people with AMD to develop depression and/or anxiety due to the condition. There are many therapies that can help with these mental health challenges, and taking advantage of them could help you feel better.
How Long Does It Take?
The American Optometric Association reports that most people move through the process of diagnosis to legal blindness in about 10 years, but this is very much an estimate. Taking care of your health, using vitamins, and following the advice of your doctor may all be vital in helping you to slow this progression.
Your vision may change in fits and starts rather than shifting gradually. As the Foundation Fighting Blindness puts it, your vision may be stable between visits with your doctor, but that does not mean that the condition is reversing. That is not part of the condition, but it can mean that you are doing a good job of keeping rapid deterioration from taking hold.
There are some forms of macular degeneration that can cause a rapid deterioration of vision, unfortunately. These wet forms of macular degeneration involve the growth of blood vessels deep within the eye, and when those vessels leak or burst, they cause rapid loss of vision. According to The American Journal of Managed Care, some people lose their sight within days of experiencing symptoms.
This is why it's so vital for you to work with a doctor you can trust and explain your symptoms as soon as they appear. Sudden changes in what you can see could indicate that your eye health is changing, and there are therapies available for the unusual blood vessels growing within your eyes. As soon as you tell your doctor this is happening, that treatment can begin.
According to the Macular Disease Foundation of Australia, about 15 percent of people with dry macular degeneration progress to wet macular degeneration in time, so it is important to be in touch with your doctor as much as possible.
There Is Room for Hope
Contemplating a life without clear central vision can be scary, but there is reason to be hopeful. Doctors continue to look for ways to help people who have this condition, and they are coming up with novel therapies that could serve as a cure one day. For example, experiments with stem cells are ongoing now, and they could suggest a therapy in the future.
Until those new therapies come to fruition, it is vital to work with an experienced doctor who can provide you with current therapies that work for the type of macular degeneration you have now. We have doctors who are ready to work with you, and our doctors can perform advanced therapies to help you keep your eyes as healthy as they can possibly be.
We'd like to introduce you to our doctors and help you preserve your vision. Contact us to find out more.
The Patient Experience
What Is Macular Degeneration? American Macular Degeneration Foundation.
Symptoms and Progression of Age-Related Macular Degeneration. (July 2015). Bright Focus Foundation.
Dry Age-Related Macular Degeneration (AMD). Prevent Blindness.
Age-Related Macular Degeneration PPP. (October 2019). American Academy of Ophthalmology.
Anxiety and Depression in Patients With Advanced Macular Degeneration: Current Perspectives. (December 2015). Clinical Ophthalmology.
Macular Degeneration. Foundation Fighting Blindness.
Stages of Progression in Age-Related Macular Degeneration. (May 2017). The American Journal of Managed Care.
Macular Degeneration: Frequently Asked Questions. Macular Disease Foundation Australia.