By Renova Hospitals
January 06, 2026
Macular Degeneration: Causes, Types, Symptoms, Diagnosis, and Treatment
Macular degeneration is a chronic retinal disease that affects central vision. It occurs when the macula, the most sensitive part of the retina, begins to deteriorate. This condition is a leading cause of irreversible vision impairment in older adults.
Patients with macular degeneration often struggle with tasks that require fine visual detail. Reading, driving, and facial recognition become progressively difficult. Peripheral vision usually remains intact, allowing basic mobility.
Understanding about macular degeneration helps patients recognise early warning signs. Early diagnosis allows timely intervention. Proper management can significantly slow disease progression.
Overview
Both dry and wet forms of macular degeneration affect the macula of the retina. The macula is responsible for sharp, central, and detailed vision. Damage to this region directly impacts daily functional vision.
Macular degeneration does not result in complete blindness. Most patients retain side vision throughout life. However, central vision loss can severely affect independence.
The speed of progression varies widely. Some patients experience a slow decline over the years. Others may lose vision rapidly without treatment.
What is macular degeneration?
Macular degeneration is a degenerative disease of the central retina. It interferes with the eye’s ability to focus on fine details. The condition develops due to age-related and pathological retinal changes.
The macula converts light into sharp visual signals. Damage disrupts signal transmission between the eye and brain. This results in blurred, distorted, or missing central images.
Macular degeneration most commonly affects people over 50. Ageing retinal cells become vulnerable to oxidative stress. Genetics and lifestyle factors influence severity.
Does macular degeneration affect both eyes?
Macular degeneration may initially affect one eye. Over time, both eyes are commonly involved. The degree of damage may differ between eyes.
One eye may compensate for the other early on. This often delays symptom recognition. Regular eye exams help identify early bilateral involvement.
Patients are advised to monitor each eye separately. Covering one eye can reveal subtle changes. Sudden distortion requires urgent evaluation.
How common is macular degeneration?
Macular degeneration is one of the most common causes of vision loss worldwide. Millions of adults are affected globally. Prevalence increases sharply after age 60.
In India, rising life expectancy has increased disease burden. Urban lifestyles contribute to higher risk exposure. Awareness and screening remain limited.
Global prevalence is expected to rise steadily. Early detection reduces long-term disability. Public education plays a critical role.
Who might get macular degeneration?
Age is the strongest risk factor for macular degeneration. Family history significantly increases susceptibility. Genetic predisposition affects retinal resilience.
Lifestyle and medical factors also influence risk:
- Smoking and tobacco exposure
- Obesity and sedentary habits
- High blood pressure and cholesterol
- Poor antioxidant intake
Younger individuals may develop myopic macular degeneration. High myopia stretches the retinal tissue. This leads to early macular damage.
What Are the Types of Macular Degeneration?
Macular degeneration exists in multiple clinical forms. Each type differs in cause, progression speed, and treatment approach. Accurate classification guides management decisions.
Some forms progress slowly over the years. Others cause rapid and permanent vision loss. Early identification is critical.
Dry (Atrophic) Macular Degeneration
Dry macular degeneration is the most common form. It accounts for nearly 90% of all cases. Vision loss is gradual and progressive.
Drusen deposits accumulate beneath the retina. These deposits interfere with nutrient and oxygen exchange. Macular thinning follows over time.
Key characteristics include:
- Slow progression
- Gradual central vision decline
- Often asymptomatic early
Patients may remain stable for years. Vision decline is usually mild initially. Supplements can delay progression.
Wet (Exudative) Macular Degeneration
Wet macular degeneration is less common but more severe. It develops due to abnormal blood vessel growth under the retina. Vision loss can occur rapidly.
This condition is also called exudative age related macular degeneration. Fragile vessels leak blood and fluid. This causes sudden macular damage.
Key features include:
- Rapid vision deterioration
- Distorted or dark central vision
- High risk of permanent loss
Untreated wet AMD leads to irreversible damage. Early treatment is critical. Anti-VEGF therapy is highly effective.
Other Important Variants
Neovascular age related macular degeneration represents an advanced wet form. Aggressive new vessel growth occurs beneath the macula. Vision can decline within weeks.
Myopic macular degeneration affects people with high myopia. Excessive eye elongation weakens the retina. Vision loss may begin at a younger age.
Acute macular degeneration presents suddenly. It may result from inflammation, infection, or vascular events. Immediate treatment is essential.
What Are the Stages of Macular Degeneration?
Macular degeneration progresses through defined stages. Staging helps predict visual outcomes. Treatment urgency depends on disease stage.
Dry Macular Degeneration Stages
Dry macular degeneration progresses gradually through three stages. In the early stage, small drusen deposits form beneath the retina, but most people do not notice any change in vision.
During the intermediate stage, the drusen becomes larger, and individuals may begin to experience mild visual distortion or difficulty with fine details. In the advanced stage, significant macular atrophy occurs, leading to severe loss of central vision, which can greatly affect daily activities such as reading and recognizing faces.
Symptoms often appear late in the disease. Early stages may go unnoticed. Regular screening detects early changes.
Wet macular degeneration is considered advanced at diagnosis. It requires immediate treatment. Delay leads to permanent damage.
Symptoms and Causes
What causes macular degeneration?
Macular degeneration develops due to cumulative retinal damage. Oxidative stress damages photoreceptor cells. Ageing reduces the retina’s repair capacity.
Genetic predisposition plays a major role. Certain genes affect retinal metabolism and inflammation. Environmental factors accelerate degeneration.
Non-age causes include:
- Diabetes and metabolic disease
- Head or eye trauma
- Chronic inflammation
- Nutritional deficiencies
What are the symptoms of macular degeneration?
Symptoms vary based on disease type and stage. Early disease may be completely silent. Changes often progress gradually.
Common symptoms include:
- Blurred or faded central vision
- Straight lines appear wavy
- Difficulty reading or recognising faces
- Dark or blank central spots
Sudden distortion suggests acute macular degeneration. Immediate evaluation is required. Delay worsens outcomes.
Diagnosis and Tests
How is macular degeneration diagnosed?
Early diagnosis preserves vision. Many patients are diagnosed during routine eye exams. Advanced imaging confirms disease type.
A comprehensive macular degeneration test includes clinical examination and imaging. Structural scans detect early damage. Vascular imaging identifies leakage.
Common Diagnostic Tests
Common diagnostic tests help evaluate macular health and identify vision-threatening changes. A dilated retinal examination allows the doctor to directly detect macular damage and drusen deposits. The Amsler grid is a simple tool used to identify visual distortion or missing areas in central vision.
An OCT scan (Optical Coherence Tomography) provides detailed images of the retinal layers, helping assess thinning or structural damage. Fluorescein angiography is used to detect leaking or abnormal blood vessels, while OCT angiography maps retinal blood flow without dye, offering detailed insight into vascular changes.
Home monitoring is encouraged. Patients should test their vision weekly. Any change requires prompt review.
Management and Treatment
How is macular degeneration managed or treated?
There is no permanent cure. However, macular degeneration treatment can slow progression and preserve vision. Early care improves outcomes.
Treatment depends on disease type and severity. Dry forms focus on slowing damage. Wet forms require active intervention.
Long-term follow-up is essential. Disease activity can recur. Ongoing monitoring protects vision.
Nutritional Supplements for Dry AMD
AREDS-2 supplements slow disease progression. They reduce oxidative stress. Supplements do not restore lost vision.
Common components include:
- Vitamin C and Vitamin E
- Zinc and copper
- Lutein and zeaxanthin
Smokers should avoid beta-carotene. Safer alternatives are available. Supplements should be taken under medical advice.
Medications for Wet AMD
Anti-VEGF injections are the standard of care. They block abnormal vessel growth. Vision stabilisation is common.
These are used in neovascular age related macular degeneration and exudative age related macular degeneration. Injections are repeated at regular intervals. Response varies between patients.
Treatment is outpatient-based. Local anaesthesia is used. Most patients tolerate therapy well.
Is Surgery Needed?
True macular degeneration surgery is uncommon. Surgery is not a first-line treatment. Injections remain the gold standard.
Surgery may be required for complications. Retinal detachment is one example. These cases are rare.
Complications of Macular Degeneration
Central vision loss affects daily independence. Many tasks become challenging. Emotional health may suffer.
Common difficulties include:
- Reading and writing problems
- Difficulty recognizing faces
- Driving restrictions
- Loss of work productivity
Advanced disease may cause legal blindness. Supportive care improves quality of life. Counselling and rehabilitation help adaptation.
Outlook / Prognosis
What is the prognosis for macular degeneration?
Prognosis depends on disease type and treatment timing. Dry AMD progresses slowly. Wet AMD progresses rapidly without treatment.
Early diagnosis improves long-term outcomes. Many patients retain functional vision. Regular care is essential.
Vision aids can help significantly. Magnifiers and adaptive lighting improve daily function. Vision rehabilitation supports independence.
Prevention
How can macular degeneration be prevented?
Complete prevention is not always possible. Risk reduction is achievable. Lifestyle choices play a major role.
Protective steps include:
- Quit smoking completely
- Control blood pressure and cholesterol
- Maintain a healthy weight
- Eat leafy greens and omega-3-rich foods
Annual eye exams are essential. Early retinal changes are detectable. Prevention delays progression.
When should I call my healthcare provider?
Seek medical care for sudden vision changes. Distortion or dark spots require urgent evaluation. Pain or flashes should not be ignored.
Do not dismiss subtle symptoms. Early action prevents permanent damage. Regular follow-ups are critical.
What questions should I ask my healthcare provider?
Patients should ask clear, specific questions. Understanding the disease improves adherence. Informed patients achieve better outcomes.
Common questions include:
- What type of macular degeneration do I have?
- What treatment is best for me?
- How often should I return for follow-up?
Expert Retinal Care at Renova Hospitals
At Renova Hospitals, retinal care focuses on early diagnosis and precision treatment. Advanced imaging and evidence-based protocols guide every decision. Our specialists manage all forms of macular degeneration with expertise and compassion.
If you notice any vision changes, do not delay evaluation. Early treatment preserves independence and quality of life. Your vision deserves expert attention.
