Macular Degeneration

Age-related macular degeneration is a leading cause of vision loss. It affects the macula at the back part of your retina. The macula controls your central vision — or the things directly in front of you.

AMD has three stages — early (macula changes without vision loss), intermediate (things might seem blurry or wavy) and late (you lose your central vision). Often, your routine eye care provider may find signs of this retinal disease during your annual eye examination.

There are two different types of macular degeneration, which can develop in one or both eyes.

• Dry macular degeneration: In dry (atrophic) AMD, the macula becomes thinner, causing gradual vision loss. This is the most common type of AMD.
• Wet macular degeneration: In wet (exudative) AMD, blood vessels at the back of your eye grow in ways they shouldn’t. They damage the macula, quickly causing vision loss.

Our healthcare providers are familiar with all stages and types of macular degeneration and will work with you to pinpoint what’s causing your vision issues. Then, they’ll craft the most personalized treatment plan for your needs and goals.

What to expect at your first visit

At Cleveland Clinic, you’ll work with our experienced ophthalmologists. They’ll lead a care team of other skilled healthcare providers — like surgeons, nurse practitioners and physician assistants — to make sure you get expert, personalized care.

At your first visit, your providers will sit down and get to know you. They’ll ask what kind of symptoms you’ve been having and how long they’ve been happening. They’ll also ask you about your medical history and do a thorough eye examination to check for changes to your retina or macula.

During this exam, we’ll have you do a test where you look at a grid of straight lines and ask you if you see any sections of the grid that look blurry, wavy or broken. This is called an Amsler grid test. We’ll also use eye drops to widen (dilate) your pupils so we can use a special lens to look deeper into your eyes and check your retina.

Diagnostic testing

After your eye exam, you’ll likely have a number of specialized tests so we can make a solid diagnosis. These tests could include:

• Fluorescein angiogram (FA): We inject a yellow dye (fluorescein) into your arm to make your blood vessels more visible. We use a special camera to see if abnormal vessels have formed and if dye leaks from them into the macula.
• Optical coherence tomography (OCT): We use this high-resolution optical coherence tomography to take pictures of the back of your eye, including your retina and macula.
• Optical coherence tomography angiography (OCTA): In this test, we use laser light reflection instead of dye to get 3D images of how blood flows through your eye.

If we learn you do have macular degeneration, we’ll create a personalized treatment plan to help you manage your condition and slow vision loss. Your treatment options will depend on the type and stage of AMD you have.

Treating dry AMD

If you have dry AMD, your provider may recommend nutritional supplements, like the AREDS 2 vitamins — which include vitamins C and E, copper, zinc and lutein — to help slow your vision loss. Regular exercise and quitting smoking can also help your eyes stay healthier.

Treating wet AMD

Our ophthalmologists can help slow vision loss associated with wet AMD using:

• Anti-vascular endothelial growth factor (anti-VEGF) injections: Specialists inject medication to prevent the growth of abnormal blood vessels in your eye.
• Photodynamic therapy: In photodynamic therapy (PDT), experts inject you with a drug that interacts with light. They use lasers to cause a chemical reaction and destroy the blood vessels that cause wet AMD.

Taking the Next Step

When you’re diagnosed with macular degeneration, you’ll face changes as your central vision decreases. You may not be able to easily recognize faces, read as well as you used to or even drive. We know how frustrating this can be. That’s why we offer more than medical treatment. When you come to Cleveland Clinic, you have an instant support team of caring providers to help you and your family understand and manage the changes that come hand-in-hand with macular degeneration. We’re here for you, every step of the way.