Macular Degeneration (AMD)

Macular Degeneration (AMD)

Macular Degeneration (AMD)

Macular Degeneration (AMD)

Macular Degeneration (AMD)

Macular degeneration, commonly referred to as age-related macular degeneration (AMD), is the single largest cause of sight loss in the developed world and affects more than 10 million Americans. It usually affects people over the age of 60, but has been known to affect those who are younger. It is a painless condition that usually affects both eyes with the loss being experienced in the central vision. It does not affect the peripheral vision, meaning that it does not cause total blindness.

What is the macula?

The macula is the most sensitive part of the retina and is responsible for our central vision and what allows us to see fine details with clarity.



  • The dry form is usually less severe.
  • The progression of the disease is slower (years).
  • The first sign may be the formation of small yellow flecks called drusen (SEE PICTURE).
  • Unfortunately, there is no actual treatment. Over-the-counter eye vitamins containing Lutein & Zeaxanthin have been shown to slow progression.
  • Stop smoking (the number one risk factor besides genetics)
  • Eating dark greens and fish (particularly salmon) is very good at staving off AMD.
  • To prevent it from developing into a wet form, both office and home monitoring are used.
  • GEOGRAPHIC ATROPHY: A more serious, less common sub type of dry AMD, which can lead to more severe visual loss. As of 2023 there is a treatment available that can slow the progression.


  • The wet form is considered more severe than the dry form due to bleeding.
  • The progression is faster.
  • TREATMENT is usually monthly eye injections of Anti-VEGF medications such as Avastin, Lucentis, or Eylea.
  • The patient needs to be closely monitored both in the office and at home (with a special Amsler Grid chart).
  • Special magnifiers to help enlarge the print can also be prescribed for both wet and dry AMD​​​​​​

OPTOS (Wide Field Retinal Imaging)

We are pleased to be able to provide the latest cutting-edge technology in retinal imaging. Optos is an ultra-widefield imaging system that allows us to photograph a 200-degree view of the back of your eye (retina) without dilation. It is crucial in obtaining these photographs in diagnosing and monitoring macular degeneration. The software included provides special filters that enable the smallest changes to be identified.

  • The test is completely painless
  • Takes only seconds to perform
  • Can be submitted to insurance
  • Reduces the need for dilation

Macula is darker due to a duel of blood supply

Early AMD: note the yellow drusen deposits

Advanced DRY AMD

End Stage AMD (Geographic Atrophy

OCT (Optical Coherence Tomography)

Zeiss 6000 OCT is the newest technology that takes 100,000 scans per second of the structures beneath the surface of the macula. further enhancing our ability to diagnose and monitor AMD. By evaluating the underlying layers of the macula, it gives us the ability for a very early diagnosis tha could otherwise go undetected. This instrument has the unique ability to assess if the macular degeneration is converting from DRY AMD to the more severe forms of either Geographic Atrophy or WET AMD. Early identification and treatment of these more severe forms are essential in obtaining a better outcome.

Normal OCT of the macula and its layers

Early AMD: note the bumps in the Retinal Pigmented Epithelium layer (red line)


This is the only technology that can diagnose macular degeneration (AMD) up to 3 years BEFORE it shows up in a regular eye exam. The cells in your eye that help you see in the dark (called rods), are the first part of the eye that is affected by Macular degeneration. This test has the concept of walking into a dark theater from the outside. Your eyes take a minute or so to adjust, and then you can begin to see in the dark.

With macular degeneration, the ability of the eye to adjust quickly from light to dark is impaired. The Adapt Dx test measures the number of minutes it takes your vision to adjust to the darkness and compares it to the normative database.

The end result is known as the Rod Intercept (RI). If the RI measures greater than 6.5, then that is indicative of underlying macular degeneration. If that occurs, then it is recommended to return for an extended version of the test to get a baseline reading so as to be able to monitor any future progression,

If it is determined that you have early signs of macular degeneration, lifestyle changes are recommended as follows.

  • STOP SMOKING: #1 risk factor that can slow up AMD progression

  • Increase intake of dark greens and fish such as spinach, kale, broccoli, and salmon

  • Exercise; cardio

  • Maintain good cholesterol and blood pressure readings

  • Quality sunglasses with Ultraviolet A and B protection

  • Addition of specific eye vitamins containing Lutein and Zeaxanthin

​​​​​​​This test should be performed if:

  • You have noticed a harder time with night vision

  • Over 50 and family history of AMD (There are easy genetic tests that can determine if you have the AMD gene)

  • Been told macular changes were noted in your exam

Vision with AMD


  • Blurred vision
  • Distorted or "wavy" vision
  • Noticeable blind spot in one's vision, usually central
  • Poorer night vision
  • Problems reading


  • Stop smoking. Number one risk factor that can prevent / slowdown the disease
  • If outdoors a lot, wear sunglasses with UV protection and a hat with a brim to avoid direct sunlight.
  • Eat a balanced diet rich in fruits and vegetables.
  • Patients 55 and older should be examined for signs of advanced macular degeneration (AMD) yearly.
  • Obtain baseline testing: Optos, OCT, and Dark Adaptation (Adapt Dx).
  • If there is a positive family history, take a simple (oral swab) genetic test, specifically for the AMD gene
  • If signs of AMD are present, take a special eye vitamin with AREDS formula. Ask us which products would be best for you, as some, that contain zinc, can cause stomach upset. Others, that contain beta-carotene, should not be used by smokers as it can increase the risk of lung cancer. Thus we would recommend the AREDS2 vs. AREDS (AREDS2 does not contain beta-carotene).
  • Patients are often given an "Amsler Grid" for self-monitoring at home.​​​​​​​


Patients are given an Amsler Grid to self check at home. Any distortion or blank areas of the grid indicate progression of the disease and should be promptly relayed to the doctor.

Normal vision.

AMD: Causes distorted viisionand blind spots

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