Introduction

Macular degeneration is a common cause of poor eyesight in older people. It usually progresses slowly and almost never leads to total blindness. There's no cure for macular degeneration, but there are treatments that can help some people. There's also plenty you can do to make the most of the eyesight you have.

We've brought together the best research about macular degeneration and weighed up the evidence about how to treat it. You can use our information to talk to your doctor and decide which treatments are best for you.

If you are over 60, and your eyesight is getting patchy and blurred, you could have macular degeneration. People with macular degeneration find it harder to read, recognise people's faces, or make out fine detail.

The full name for macular degeneration in older people is age-related macular degeneration. It's also called AMD for short. Macular degeneration can affect younger people, but this is rare. It can also be caused by injury to the eye, infections, and diabetes (when it's called diabetic retinopathy). Here we deal with the disease that affects older people.

The macula is part of your retina, the lining inside your eye that captures the images you see and sends them to your brain.

The macula is a tiny area in the middle of the retina. It helps you see the fine detail of objects straight in front of you.

But sometimes the cells in the macula get damaged and no longer work properly. When this happens it's called macular degeneration. Eventually things in the middle of your vision may look blurred and distorted.

There are two stages of AMD: early and late.

In early AMD, fluffy white patches form in and around your macula. Doctors call these patches drusen.

The patches don't affect your eyesight, but your doctor or optician can see them during an eye examination.

In late AMD, your eyesight is affected. There are two types of late AMD: dry and wet.

• Dry AMD is more common. It affects more than 8 in 10 people who get AMD.^[1] Dry AMD progresses slowly. The fluffy white patches in your eye can gradually get bigger and join together. And the cells in the macula die. Dry AMD usually affects both your eyes. But the sight in one eye may get worse, while the other eye remains the same. You may get wet AMD.

• Wet AMD affects between 1 in 10 and 2 in 10 people who get AMD. It causes more rapid damage and serious sight problems than dry AMD. In wet AMD, besides the cells in the macula dying, tiny new blood vessels form at the back of your eye.^[2] The blood vessels leak blood and fluid into your eye and damage your sight even more.