What Are the Symptoms of Age-Related Macular Degeneration and How Is It Diagnosed?

Lylas G. Mogk, MD, a renowned expert on age-related macular degeneration (AMD), founding director of the Visual Rehabilitation and Research Center of Michigan, part of the Henry Ford Health System Eye Care Services, and co-author of Macular Degeneration: The Complete Guide to Saving and Maximizing Your Sight [1], explains:

Symptoms of age-related macular degeneration can include the following:

• Blurred or "fuzzy" vision
• A blank, blurred, gray, or "blind" spot in the center of vision
• Straight lines, such as sentences on a page, appearing wavy or distorted
• Blurry areas on a printed page
• Dark areas or spaces in the center of your vision
• Difficulty reading or seeing details in low light levels

To diagnose AMD effectively, most macular specialists recommend the following procedures:

• Distance and near vision acuity tests [2]
• A dilated eye (or fundus) examination [3], which includes the use of an ophthalmoscope. In a dilated eye examination, it is the pupil that is dilated — not the entire eye. This allows the examiner to see through the pupil to the macula at the inside back wall of the eye. Acuity tests alone may not be sufficient to detect AMD in its early stages.
• A fluorescein angiography [4] test, if wet AMD is suspected.
• The newer technique of optical coherence tomography [5] (OCT) may be used to gain a clearer picture of the macula and its supporting layers.

[6]In addition, an Amsler Grid test can be used to monitor changes in AMD. The macula is particularly sensitive to horizontal and vertical lines; therefore, waviness, distortion, or missing lines on the grid may be noticed before a change in visual acuity. Online Amsler Grid tests are available from Macular Degeneration Support [7]. Wavy, distorted, missing, or broken lines, or holes or black spots in the grid, as shown here, can indicate the presence of AMD.

The first image below is an image of an Amsler Grid as seen with normal vision. The next image is how the Amsler Grid may appear to a person with AMD. These images of the grids are much smaller than normal size so that we can show them to you on this web site. Ask your eye care professional for a real Amsler Grid you can use at home.

As seen with normal vision (above)

As seen with AMD (above)

Individuals who are over 50 should have a dilated eye examination from an ophthalmologist or optometrist at least every two years. The National Eye Institute [8] and Macular Degeneration Support [9] list and explain additional risk factors, health considerations, and lifestyle recommendations related to AMD.