Early Signs of Macular Degeneration and How They Progress

Macular degeneration affects the macula, the small part of the retina responsible for sharp, central vision. When this area deteriorates, it becomes harder to see clearly straight ahead—even though your peripheral (side) vision may remain unaffected.

There are two main types:

• Dry macular degeneration: The most common form. It develops gradually as the macula thins with age.
• Wet macular degeneration: Less common but more serious. It happens when abnormal blood vessels grow under the retina, leaking fluid and causing sudden vision changes.

Macular degeneration often starts slowly and without pain. You may not notice the symptoms right away, but small vision changes can signal the beginning of the condition. Common early signs include:

• Blurriness when reading or looking at fine details
• Needing more light to see clearly, especially in dim rooms
• Colors appearing faded or less vibrant
• Trouble adjusting between bright and dark settings

Because the early signs can be subtle, regular eye exams are key to catching changes before they become serious.

As macular degeneration progresses, the most noticeable symptom is blurring or distortion in your central field of vision. Straight lines might appear wavy. Text may seem jumbled. You might also notice a dark or empty area in the center of your sight.

Faces can become harder to recognize. Fine print may disappear altogether, even with glasses. A common tool for spotting these changes is the Amsler grid—a simple chart with a grid of lines and a central dot. If the lines look warped or parts are missing, it may be a sign of macular damage.

As the condition worsens, macular degeneration can interfere with common tasks. You may struggle with:

• Reading books, newspapers, or menus
• Driving safely, especially at night or in unfamiliar areas
• Recognizing people’s faces or expressions
• Using phones, tablets, or TVs comfortably

Over time, many people start relying more on their peripheral vision. This adjustment can be frustrating but manageable with the right tools and support.

Dry AMD usually progresses slowly. Vision may become gradually fuzzier, but many people retain useful vision for years. Wet AMD, on the other hand, can develop quickly and cause more rapid central vision loss.

If you suddenly notice a large blind spot or distortion in your central vision, seek medical care immediately. Early treatment for wet AMD can help prevent permanent damage.

Some people with macular degeneration report seeing things that aren’t really there, such as patterns, shapes, or even people or animals. This is called Charles Bonnet Syndrome. It happens when the brain fills in missing visual information due to poor input from the eyes.

These hallucinations are not a sign of mental illness. They’re surprisingly common and usually harmless—but can be unsettling if you don’t know what they are. Talking to your doctor can help you understand and manage them.

In dry AMD, vision loss tends to happen slowly. Blurriness increases over months or years. Some people with dry AMD eventually develop wet AMD, which causes faster vision loss. That’s why regular monitoring is important—so any sudden changes can be addressed early.

Routine eye exams with dilation allow your doctor to track changes in the retina and recommend treatments or lifestyle adjustments as needed.

Macular degeneration isn’t the only cause of age-related vision loss. It helps to understand how it compares to other common conditions:

• Cataracts: Cause overall cloudiness and glare, not central distortion. Surgery can usually restore vision.
• Glaucoma: Damages peripheral vision first, not central vision. Often progresses without symptoms.

Because these conditions affect different parts of the eye, they require different treatments. Seeing an eye specialist is the only way to get a clear diagnosis.

If you notice any of the symptoms mentioned—especially new blurriness, distortion, or a dark spot in your central vision—schedule an appointment with an ophthalmologist or optometrist. Seniors over 60 should have annual eye exams even without symptoms.

Early diagnosis can help slow the progression of AMD. New treatments, especially for wet AMD, can preserve vision when caught in time.

There’s no cure for macular degeneration, but there are many ways to manage its effects. Some helpful tools include:

• Magnifying glasses and handheld readers
• High-contrast or large-print books and devices
• Voice-controlled assistants and screen readers
• Bright task lighting and anti-glare filters

Low vision specialists can help you adapt your home or work environment. Support groups, both in person and online, can also make a difference by connecting you with others going through similar experiences.