Table of ContentsView AllTable of ContentsAge It StartsSymptomsAMD in Young AdulthoodAMD and Vision LossCauses of SymptomsAfter Diagnosis
Table of ContentsView All
View All
Table of Contents
Age It Starts
Symptoms
AMD in Young Adulthood
AMD and Vision Loss
Causes of Symptoms
After Diagnosis
Macular degenerationis an eye disease that causes problems with yourcentral vision, what you see straight ahead of you. It is also calledage-related macular degeneration (AMD)because it occurs as a result of changes linked with aging.
AMD ranks as the leading cause of vision loss and blindness among people age 65 and over in the United States.While rare, it can also affect much younger people. Other forms of the disease can strike between childhood and early adulthood.
Age is the main risk factor for AMD. Other factors such as smoking, poor diet, lack of movement, and a family history of AMD can increase your risk of developing it.
This article describes the most common ages when AMD occurs. It explains when symptoms can present and reasons they may not be recognized. It also describes risk factors and treatments.
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Age at Which Macular Degeneration Could Start
Macular degeneration occurs as a result of changes to yourmacula. It is often called age-related macular degeneration because it is most commonly found in people over 60 years old. While it is a rare diagnosis before age 55, it can occur at any age. The majority of people who experience macular degeneration are age 75 and older.
The prevalence of macular degeneration increases with age, ranging from 2% for people aged 40 to 44 vs. 44 % to 46.6% for people aged 85 and older.
Determining the age of onset can be challenging because dry AMD often exists without symptoms. Wet AMD only occurs after dry AMD. The age at which macular degeneration could start includes the following ranges:
From Symptom Onset to Diagnosis
Age-related macular degeneration occurs differently in everyone. This can be problematic because early detection is critical for effective disease management and reducing vision loss.
In a cross-sectional study, researchers reported that 25% of the eyes examined using a dilated eye exam and then diagnosed as normal had characteristics of AMD. A total of 30% of those undiagnosed eyes had symptoms of intermediate AMD that could have been treated if an earlier diagnosis had been made.
Other research indicates that people with AMD had a delay in diagnosis due to a wide range of reasons that included the following:
Early-stage dry AMD usually occurs without symptoms. Vision impairment may include slight problems adjusting from bright to dark environments, though changes are usually undetectable or very subtle. As a result, many people don’t realize they have the condition until it is diagnosed during a routine dilated eye exam.
Understanding how AMD progresses can improve your chances of getting an early diagnosis. The rate at which dry AMD progresses to the intermediate stage varies. The impact on visual ability can be minimal or more noticeable. At this stage, one or more of the following symptoms may occur:
In advanced or late-stage dry AMD, also calledgeographic atrophy, irreversible vision loss can occur. This disease stage can involve the following symptoms:
Advanced-stage wet AMD occurs in about 10% to 15% of people with dry AMD. By the time of diagnosis, it is typically a serious condition that requires prompt treatment. Symptoms are similar to those that occur with the advanced stage of dry AMD but also include the following:
Stages of Macular Degeneration
Age-Related MD in Young Adulthood
Researchers have reported finding evidence of early AMD in people under age 30. In one large-scale population study, evidence showed early AMD features in 3.8% of participants aged 35 to 44.
A diagnosis of early age-related MD may be related to the following types of changes in a person’s retina:
Due to the asymptomatic nature of early AMD, people at any age can remain unaware of its existence as it progresses. However, regular eye examinations that check your macula can help identify AMD in its earliest stages.
Unlike AMD, which occurs with the natural aging process, juvenile macular degeneration is linked to genetic causes. This type of macular degeneration typically causes a slow loss of central vision that can begin in childhood or early adulthood.
Causes and Risk Factors of Macular Degeneration
How Old Are AMD Patients With Blindness?
Being age 50 or older increases your risk of AMD.Once the disease begins, factors such as your disease severity, lifestyle, genetics, and general health can impact how quickly the disease progresses and the type of vision loss it will cause.
While AMD is one of the leading causes of blindness among people 60 and older, not everyone with AMD develops the advanced form of the disease.Even among people with advanced AMD, blindness is not inevitable since the disease affects everyone differently.
Macular Degeneration: Timeline of Vision Loss Progression
Reasons Macular Degeneration Symptoms Start
Macular degeneration occurs due to the natural aging process of your macula. The macula is the part of your eye that controls central vision and your ability to perceive color. It is located near the center of your retina (the tissue in the back of your eye that sends visual signals to your brain).
Dry Macular Degeneration
Dry macular degeneration results when parts of your macula thin with age and dysfunction. The deterioration of macular tissue allows for the accumulation of waste deposits in the form of fatty proteins called drusen. Drusen usually don’t cause symptoms in the early stages of AMD.
As they accumulate, drusen begin to interfere with the flow of oxygen to the photoreceptor cells that send visual messages to your brain. The affected cells eventually die, causing vision to become blurry. Dry AMD progresses slowly and worsens as the drusen grow and accumulate.
Wet Macular Degeneration
Wet macular degeneration occurs when dry AMD changes to wet AMD. Wet AMD is a more serious type of AMD in which new, abnormal blood vessels form under your retina and macula. These abnormal vessels leak blood and other fluids, damaging the macula. Symptoms of vision loss can occur dramatically and rapidly.
While the specific cause of AMD is not known, certain risk factors increase your chances of having this disease. People with the following characteristics have a higher risk of developing AMD:
The likelihood of having AMD increases further if you have any of the following lifestyle risk factors:
Macular Degeneration: Foods to Avoid Disease Progression
After Diagnosis: Supporting Eye Health With AMD
The treatment plan your ophthalmologist recommends after a diagnosis of AMD will depend on the severity and stage of your disease. While macular degeneration is incurable, appropriateAMD treatmentsmay help slow disease progression. In some cases, treatments may help you regain vision loss.
Early-Stage Dry AMD
A diagnosis of early-stage dry AMD means that you caught the disease as early as possible. While AMD is often asymptomatic at this stage, it can still cause damage, leading to vision loss.
Recommendations at this stage often involve lifestyle changes that can help slow disease progression. These changes include the following:
Intermediate-Stage Dry AMD
A diagnosis of intermediate-stage dry AMD means you have a higher risk of the disease progressing to late-stage AMD and some vision impairment. The same lifestyle modifications used in early-stage AMD are advised at this more advanced stage.
Treatment at this stage of AMD involves a daily regimen of supplements called AREDS 2 to help slow the progression to late-stage AMD. These vitamins, minerals, and antioxidants are based on evidence from research in the second Age-Related Eye Disease Study (AREDS 2).
AREDS2 supplements are packaged in a single over-the-counter formulation. They include the following ingredients:
Advanced, or Late-Stage, Dry AMD
Treatments for late-stage dry AMD, or geographic atrophy, are relatively new. In 2023, the Food and Drug Administration (FDA) approved the following medications for administration viaintravitreal injection. This is an injection in the vitreous cavity (the space at the back of your eye behind the lens):
Advanced, or Late-Stage, Wet AMD
Late-stage wet AMD is the most severe type of AMD. Treatments work to reduce the growth of abnormal blood vessels and slow leaking from existing ones. Treatments include the following:
Anti-VEGF (Anti–Vascular Endothelial Growth Factor) Treatment
Anti-VEGF treatments are regarded as the first-line treatments for this stage of AMD. These medications reduce vascular endothelial growth factor, which promotes the growth of abnormal blood vessels and their leaking in your retina.
Drugs used in anti-VEGF treatments include the following:
Photodynamic Therapy
When used with anti-VEGF treatments, photodynamic therapy may help a small portion of wet AMD cases. It involves the injection in the arm of verteporfin, a photosensitizing agent (a substance sensitive to the influence of radiant energy, namely light). When it reaches your eye, a laser beam is directed toward the back of your eye. This activates the drug so it can attack the abnormal blood vessels.
Laser Photocoagulation
Laser photocoagulationis a type of minimally invasive laser surgery. It uses thermal laser treatments to shrink and destroy faulty blood vessels. However, it is only appropriate for certain types of wet AMD that involve abnormal blood vessels not beneath the center of your macula. This is because there is a risk of laser damage to overlying vision cells in the treated area.
Coping With Macular Degeneration
Summary
Age-related macular degeneration is an eye disease that most often affects people over age 60. However, research shows the disease may also affect a small group of people at a much younger age.
Getting yearly eye exams can help you identify vision problems at any age. Knowing AMD’s risk factors and symptoms can help you identify the need for care as early as possible. This can help you begin treatments proven to reduce vision loss and slow disease progression.
Medical experts advise not ignoring any changes in your vision, especially those that affect how you see objects in your central vision. Prompt treatment may make a difference in preventing vision loss from AMD.
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Centers for Disease Control and Prevention.Age-related macular degeneration.
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Xu K, Huang S, Yang Z, et. al.Automatic detection and differential diagnosis of age-related macular degeneration from color fundus photographs using deep learning with hierarchical vision transformer.Computers in Biology and Medicine. 2023;167:107616. doi:10.1016/j.compbiomed.2023.107616
Neely DC, Bray KJ, Huisingh CE, Clark ME, McGwin G, Owsley C.Prevalence of undiagnosed age-related macular degeneration in primary eye care.JAMA Ophthalmol. 2017;135(6):570-575. doi:10.1001/jamaophthalmol.2017.0830
Parfitt A, Boxell E, Amoaku WM, Bradley C.Patient-reported reasons for delay in diagnosis of age-related macular degeneration: a national survey.BMJ Open Ophthalmol. 2019;4(1):e000276. doi:10.1136/bmjophth-2019-000276
American Academy of Ophthalmology.What are drusen?
American Macular Degeneration Foundation.Macular degeneration symptoms.
BrightFocus Foundation.View how macular degeneration may affect vision.
University of Wisconsin Department of Ophthalmology and Visual Sciences.Macular degeneration.
National Eye Institute.Age-related macular degeneration (AMD).
Macular Society.Early age-related macular degeneration (AMD).
American Academy of Ophthalmology.What is juvenile macular dystrophy?
BrightFocus Foundation.Age-related macular degeneration: facts and figures.
Heesterbeek TJ, Lorés-Motta L, Hoyng CB, Lechanteur YTE, den Hollander AI.Risk factors for progression of age-related macular degeneration.Ophthalmic Physiol Opt. 2020;40(2):140-170. doi:10.1111/opo.12675
American Academy of Ophthalmology.Surprising facts about age-related macular degeneration.
Casey Eye Institute.The ABC’s of drusen.
American Macular Degeneration Foundation.Wet macular degeneration.
BrightFocus Foundation.Macular degeneration: prevention and risk factors.
García-Layana A, Cabrera-López F, García-Arumí J, Arias-Barquet L, Ruiz-Moreno JM.Early and intermediate age-related macular degeneration: update and clinical review.CIA. 2017;12:1579-1587. doi:10.2147/CIA.S142685
Danese C, Lanzetta, P.Treating AMD at the intermediate level.Retinal Physician. 2022;19(April):30, 32, 34.
National Eye Institute.Story of discovery: NEI-funded research paves way for new dry AMD drugs.
American Academy of Ophthalmology.Anti-VEGF treatments.
Wills Eye Hospital.Wet AMD.
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