Age-Related Macular Degeneration

When To Call a Doctor

Wet age-related macular degeneration (wet AMD) can damage your vision within days or even hours. This damage can be severe and permanent.

Call your doctor immediately if:

• You have a sudden, rapid loss of vision.
• You suddenly notice a new blank or dark spot in the center of your vision that does not go away.
• Straight lines appear wavy or curved, or objects begin to change size or shape or appear distorted.

Your doctor will refer you to an eye doctor (ophthalmologist) if needed.

Call your doctor immediately if you see either of the following on an Amsler grid :

• Lines that change or appear wavy and curved
• A blank spot that you have not noticed before in the grid

These are signs of the more serious form of the disease, wet AMD. If you have been diagnosed with dry age-related macular degeneration (dry AMD), check your vision in each eye using an Amsler grid every day or as often as your doctor recommends. Dry AMD does not usually develop into wet AMD, but be on the lookout for signs of wet AMD.

The slow vision loss caused by dry AMD does not demand urgent care. The fading of colors or dimming of vision may progress so slowly that it does not bother you, especially if it only affects one eye. But even gradual changes in vision may signal a larger problem.

Call your doctor to discuss whether you need an eye exam if:

• You need more light to read than you used to.
• Colors seem faded or less vivid than they used to.
• Your vision seems to be getting more blurry.

In general, sudden changes in your vision that do not go away need immediate attention. Gradual or slow changes in vision tend to be less serious. If you have noticed gradual changes in your vision, talk to your doctor about whether you need an eye exam.

The American Academy of Ophthalmology recommends that all people between 40 and 54 years of age have a comprehensive eye exam every 2 to 4 years to help detect AMD early. The following table summarizes the recommendations for comprehensive eye exams:³

Age (years)	When to get a comprehensive eye exam
65 or older	Every 1–2 years
55–64	Every 1–3 years
40–54	Every 2–4 years
Younger than 40	5–10 years

Watchful Waiting

Watchful waiting means to take a wait-and-see approach.

Watchful waiting is not appropriate if you have rapid vision loss or sudden changes in your vision. If you have any rapid vision changes, see your doctor as soon as possible. Immediate treatment may be able to slow vision loss caused by wet AMD. Delaying treatment for wet AMD could mean further loss of central vision.

If you have mild, slow vision loss, such as that caused by dry age-related macular degeneration (dry AMD), watchful waiting is appropriate. There is no treatment for dry AMD. And you may never develop vision loss to the point that it disrupts your regular lifestyle.

Who To See

Age-related macular degeneration (AMD) can usually be detected during a routine eye exam by your regular doctor or an eye care professional (optometrist or ophthalmologist).

An ophthalmologist who specializes in problems with the retina and macula can diagnose which type of AMD you have. Also, laser surgery and medicine injections for wet AMD are done by an ophthalmologist.

To prepare for your appointment, see the topic Making the Most of Your Appointment.

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Author:	Jeannette Curtis	Last Updated: August 4, 2009
Medical Review:	Kathleen Romito, MD - Family Medicine Christopher J. Rudnisky, MD, FRCSC - Ophthalmology
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