If you’re over the age of 60, you may have noticed changes in your vision as you’ve gotten older. You might wonder which vision problems are normal, though, and which ones signify that you’re developing a serious medical issue.
Having trouble seeing in low light, reading close text, and telling apart colors are all normal, age-related eye changes. Seeing blurry areas or spots in your vision — or experiencing sudden vision loss — is not normal and should be evaluated by a qualified ophthalmologist as soon as possible. These symptoms could be signs of a late-stage macular condition called geographic atrophy.
What Is Age-Related Macular Degeneration, and How Is It Related to Geographic Atrophy?
Perhaps you’ve just been diagnosed with age-related macular degeneration (AMD) and you’re confused by your ophthalmologist's concerns about geographic atrophy. Are these two different names for the same condition? Not quite.
Read on to learn about retinal atrophy in humans and understand how geographic atrophy is related to age-related macular degeneration.
Age-related macular degeneration. AMD affects the part of the eye called the macula, which is an area in the retina (the back of the eye) that helps you focus on small visual details like printed text, small movements, and facial features. The most common form of AMD — with up to 90% of patients being diagnosed with this subtype — is called “dry” AMD. The other subtype is “wet” AMD.
- Dry AMD: Retinal waste products known as drusen appear in the macula. They look like small yellow spots, and they can make a big difference to the quality of your vision. A patient with dry AMD might progress from having only one spot or a few of these tiny drusen to having many. Dry AMD tends to develop slowly, though, which makes it easier to monitor over time. A patient might first notice blurry vision and trouble with small details (rather than sudden vision loss).
- Wet AMD: This vision loss is not caused by drusen. Instead, small blood vessels grow into the retinal space and break. This causes bleeding, which is why it’s called “wet” AMD. A buildup of both blood and fluids pools in the back of the eye. Unlike dry AMD, wet AMD can cause sudden vision loss that can’t be prevented.
Geographic atrophy. The last stage of dry AMD is called geographic atrophy. In this stage, the drusen damage is so extensive that it causes blind spots in the patient’s central vision. Up to 20% of people with AMD develop geographic atrophy.
Geographic atrophy is more commonly associated with the dry subtype. It’s possible for a patient to have both wet and dry AMD at the same time, though, and to develop geographic atrophy independently of having wet AMD. In other words, having wet AMD does not mean that a patient is safe from geographic atrophy.
What Are Common Geographic Atrophy Symptoms?
Younger people may be able to skip a yearly eye exam or two if they have no vision problems and are otherwise healthy. If you’re over 50, though, you should make an appointment for an eye exam on a yearly basis to make sure you’re seeing clearly — and to make sure that you are not developing an eye condition like AMD.
People who notice the following symptoms, regardless of whether they’re over 50, should make an appointment with a qualified eye doctor:
- Central vision loss: Vision loss in the middle of your field of view. You use this part of your eyesight for nearly every task.
- Difficulty in low-light conditions: If you’re unable to read, cook, sew, or see another person clearly when the lights aren’t bright, you should be evaluated. You might notice yourself turning on extra lights to see better, or someone in your family might comment on how many lights you need to perform an everyday task.
- Trouble seeing colors clearly: This symptom might be harder to notice if you’re not someone who pays attention to colors. If your vision seems dull, faded, or obscured in any way, though, you might be developing geographic atrophy due to AMD.
What Are Risk Factors for Geographic Atrophy?
Being over the age of 60 puts you at risk for age-related macular degeneration and geographic atrophy of the retina. Other risk factors include the following:
- Being a smoker
- Having one or more close relatives with AMD
- Having high blood pressure, high cholesterol, or both
- Being overweight or obese
- Eating a low-quality diet
- Quitting hormonal replacement therapy (HRT) or not using HRT at all in menopause
- Experiencing a lot of direct sun exposure throughout your life
- Having chronic medical conditions like heart disease or diabetes
What Is the Best Geographic Atrophy Treatment?
Many patients don’t know they have AMD, and others don’t attribute symptoms like faded colors or needing more light to read to geographic atrophy. Symptoms of dry AMD are difficult to recognize if the patient doesn’t lose all of their central vision at once. Similarly, a patient who develops symptoms of geographic atrophy in one eye might not immediately make an appointment. Unfortunately, delaying treatment could mean permanent loss of vision.
Dry AMD — the type that most often leads to geographic atrophy of the retina — is usually treated with high-quality dietary supplements. Right now, there aren’t any FDA-approved medications or treatments for this condition, but there are clinical trials available to some patients who qualify. Your doctor may ask you to take zeaxanthin, lutein, and zinc to slow the progression of geographic atrophy. You might also take vitamins that contribute to eye health such as vitamin C and vitamin E.
It's important to keep up with your treatment and make appointments with your ophthalmologist to monitor your condition. If your dry AMD is progressing, you might still be able to slow down the disease and preserve your vision before you reach the geographic atrophy stage.
Remember, patients with wet AMD can also develop dry AMD at any time as well. Don’t assume that you can’t have one if you have the other.
What Can a Patient Do If They’ve Already Lost Some Vision to AMD?
If you’ve already lost some of your vision to this condition, you might qualify for special aids and devices that can help you. There are many lifestyle changes you can make to help yourself at home and at work as well. Consider writing with bolder pens and markers, setting your devices to display large print, and using motion-sensor lights around your home so that you don’t fall while searching for the light switch.
It’s possible to have a good quality of life even when you’re living with low vision or vision loss due to AMD and geographic atrophy. If you’ve just been diagnosed with this condition, or if your treatment isn’t working as well as you hoped, reach out to your ophthalmologist for help navigating your options.