What Is Macular Degeneration (Age-Related Macular Degeneration)?

Macular degeneration — medically, age-related macular degeneration (AMD) — is the gradual deterioration of the macula, the part of the retina responsible for sharp, detailed central vision. It typically develops later in life and affects tasks that need fine detail, such as reading or recognising faces. Central vision is affected, but peripheral vision is usually preserved, and regular eye examinations can catch it at an early stage.

Macular degeneration is most common in people over 50, and becomes more frequent with age. It has two main forms — dry and wet (neovascular); wet can progress faster but often responds better to treatment. Ophthalmologists manage the condition, and regular follow-up matters a great deal. Diagnosis and monitoring happen through a standard eye examination and, where needed, a dedicated retina exam, so anyone at higher risk is advised to have regular eye check-ups.

The macula is a small but functionally critical part of the retina, at its centre, giving the eye its sharpest vision — reading, recognising faces and driving all depend on it working well. In age-related macular degeneration, cells here are damaged over time, and the disease usually progresses through early, intermediate and late stages. In the dry form, small yellow-white deposits called drusen build up in the macula and the tissue gradually thins (geographic atrophy), usually over years. In the wet form, abnormal, fragile new blood vessels grow beneath the macula (choroidal neovascularisation); leaking fluid or blood can damage the macula quickly, and without treatment, vision loss can become noticeable within weeks to months. Progression speed varies widely, which is why regularly reassessing the stage and form shapes treatment decisions directly. Macular degeneration doesn't lead to total blindness; even though central vision is significantly affected, peripheral vision usually keeps everyday orientation intact.

The most typical symptom is seeing straight lines as wavy or bent. Blurring or a dark patch in central vision, missing words while reading, and faded colours are also common complaints, and some patients notice floaters too. In the dry form, symptoms tend to progress slowly and quietly; in the wet form, vision loss can develop quickly enough to notice within days or weeks, sometimes alongside difficulty reading in low light. Symptoms often start in one eye, which is why checking each eye separately — for example, by covering the other — can help catch changes early.

Several factors combine to cause macular degeneration, and how much each matters varies from person to person. Age is the single most decisive risk factor, and the condition becomes markedly more common with age. Smoking is a modifiable risk factor, harming blood flow and oxygenation in the retinal tissue and contributing to both onset and progression. A family history can point to a genetic predisposition, making regular eye examinations even more important. High blood pressure, obesity and some poorly controlled chronic conditions are also counted among the additional factors that can affect how the disease progresses. The diagram below summarises these factors by frequency; the order shown is not a percentage or proportion.

If straight lines start to look bent or wavy, part of the text disappears while reading, or central vision suddenly blurs, see an ophthalmologist without delay — early treatment is especially decisive in the wet form. Checking each eye separately at home with a simple grid pattern, similar to an Amsler grid, can also help you notice distortion early; if you spot a change like this, book a retina exam without waiting.

Macular degeneration is diagnosed by combining a detailed eye examination with imaging. The examination starts with a review of symptoms and a visual acuity test; the pupil is then dilated with eye drops for a fundus examination that looks closely at the macula. OCT (optical coherence tomography) imaging shows cross-sectional changes in macular thickness and any fluid build-up, and is decisive in telling the dry form apart from the wet form. If the wet form is suspected, or treatment is being planned, further tests such as fluorescein angiography or OCT angiography may map the location and extent of any abnormal blood vessels. The diagram below summarises the order this assessment generally follows.

In the dry form, the focus is usually on regular monitoring and lifestyle measures — stopping smoking, eating a balanced diet — rather than active treatment. In the wet form, vision loss can progress quickly without treatment, so starting early matters a great deal, though fully recovering lost vision isn't possible for every patient; the aim is to preserve existing vision and slow progression. The decision to start treatment in the wet form is usually made alongside imaging findings, and the condition can become active again if treatment is paused, so keeping to the follow-up schedule matters as much as treatment itself. Follow-up in the dry form is scheduled more closely as the stage advances.

In wet macular degeneration, the most common treatment is intravitreal injection therapy (anti-VEGF), aiming to reduce leakage from abnormal blood vessels and protect the macula. Treatment usually starts with a loading series every few weeks, then maintenance injections at intervals extended according to the patient's response, which varies from person to person. In advanced dry disease (geographic atrophy), options are more limited, and regular monitoring alongside measures that support remaining vision takes priority. In some less common situations — an off-centre lesion or significant bleeding, for example — retinal laser treatment and surgery may also be considered, though injection therapy remains first-line for wet disease today. Which approach suits a patient depends on the disease's type, stage, and OCT/angiography findings together.

Diabetic retinopathy and retinal tear/detachment are other retinal conditions that, like macular degeneration, can cause floaters, and are worth considering within this same ecosystem. Our retinal diseases page covers other conditions and treatment options in general; many retinal findings, including suspected macular degeneration, can be picked up during a fundus examination.

If you're noticing straight lines looking bent, or you're in a higher-risk group, you can book an appointment for a retina exam.