Age-Related Macular Degeneration: Blurred Center Vision and Wavy Lines

What it involves

The MedlinePlus encyclopedia explains that macular degeneration is an eye disorder that slowly destroys sharp, central vision, making it hard to see fine details and read. It is most common in people over age 55, which is why it is often called age-related macular degeneration, or AMD.

Who this is for

• Adults over 55 who notice blurred, dim or distorted center vision.
• Patients who see straight lines, such as a door frame, as wavy.
• People with a family history of macular degeneration or who smoke or used to smoke.
• Anyone who has trouble reading print or recognizing faces that is getting worse.

What to expect

• Questions about what you see, how fast it changed, which eye and your smoking and family history
• A review of your general health, blood pressure and medicines
• Advice that central vision changes need an eye doctor, ideally a retina specialist
• A referral for the dilated eye exam and imaging that diagnose and track the condition

Fast changes need an eye doctor right away

The MedlinePlus encyclopedia says that with both types of AMD, central vision loss can occur quickly, and if it does you need to be seen right away by an ophthalmologist, preferably a retina specialist. Early detection leads to earlier treatment and often a better outcome. Do not wait for a routine primary care appointment if lines suddenly look wavy or a dark spot appears. Sudden vision loss with severe eye pain, or with weakness or trouble speaking, is a 911 or ER situation.

Dry and wet forms

The encyclopedia says there are two types. In dry AMD the blood vessels under the macula become thin and brittle and small yellow deposits called drusen form, and almost everyone starts with this form. Wet AMD occurs in about 10 percent of people, when new fragile blood vessels leak blood and fluid under the macula, and it causes most of the vision loss. AMD does not affect side vision, so complete blindness does not occur from AMD alone, but loss of the ability to read, drive and recognize faces can.

Who is more likely to get it

MedlinePlus lists a family history of AMD, being White, cigarette smoking, a high-fat diet and being female as risk factors. It is rare before age 55 and occurs mostly in people 75 and older. Smoking is the risk factor a primary care visit can change, and the quitting smoking guide explains how. Blood pressure and cholesterol matter for the eyes too, and the hypertension visit guide and the high cholesterol numbers guide cover those checks.

How it is checked

The encyclopedia says an eye doctor dilates your pupils and uses special lenses to view the retina, blood vessels and optic nerve, and looks for changes in the macula and for drusen. You may be asked to look at an Amsler grid, a pattern of lines that appear wavy if there is AMD, and further tests include a fluorescein angiogram, fundus photography and optical coherence tomography. These are eye specialist tests, so a primary care visit leads to a referral rather than a retina exam.

Treatment is specialist care

MedlinePlus says no proven treatment restores vision in advanced dry AMD. For early AMD in someone who does not smoke, a specific combination of vitamins, antioxidants and zinc, called the AREDS formula, may keep it from getting worse, and it should be taken only if an eye doctor recommends it. For wet AMD, an eye doctor may recommend laser treatment, photodynamic therapy or medicines injected into the eye. Low-vision aids can help you use the vision you have. Ask your provider before adding any supplement.

Follow-up and how primary care helps

The encyclopedia says dry AMD calls for a complete eye exam once a year, while wet AMD may need frequent, perhaps monthly, follow-up with the eye doctor. Primary care supports the rest of your health, including blood pressure, blood sugar, smoking and falls risk as vision changes, and the balance problems guide covers fall prevention. Other eye topics are in the blurry vision guide and the eye floaters and flashes guide.

Sources

• MedlinePlus Medical Encyclopedia: Age-related macular degeneration
• MedlinePlus: Macular Degeneration