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Can a regular eye exam detect macular degeneration?

Dr. Manvi P. Maker
Ophthalmologist (Eye Specialist)

Doctors screen for age-related macular degeneration (ARMD) by performing a dilated fundus exam. During this exam, doctors visualize the retina, which is a layer that lines the inside of the eye and is affected by ARMD. Some additional testing may be necessary if there are signs of the ARMD.

Dr. Manvi P. Maker
Ophthalmologist (Eye Specialist)

In the United States, macular degeneration is the leading cause of severe vision loss in people over the age of 50 years.  It affects the central part of the retina (a layer that lines the inside of the eye) which is called the macula.  The macula is responsible for your sharpest "straight-ahead" vision.

A dilated eye exam allows your eye doctor to view the retina and macula and detect signs of macular degeneration.  Some additional testing may be necessary to determine whether it is the dry or wet form, and whether treatment is required.

Dr. Jeffrey S. Heier, MD
Ophthalmologist (Eye Specialist)

A routine eye examination can often detect signs of age-related macular degeneration (AMD)—a serious disease that can steal a person's central vision—before sight is affected and before permanent visual loss occurs. The eye exam includes an acuity test to measure how well you see at different distances (with glasses, if needed). A complete eye exam will rule out or identify coexisting eye diseases, such as cataract or glaucoma.

A doctor may suspect dry AMD if the view through an ophthalmoscope reveals clumps of pigment or clusters of drusen (small yellow deposits that build up under the macula). Although these lesions can indicate early or intermediate stages of AMD, drusen alone are not conclusive evidence.

An Amsler grid test can help to identify the distorted vision typical of AMD. You focus your eyes on a central dot on a grid that resembles graph paper. If the lines near the dot appear wavy or are missing, AMD may be to blame. (You can simulate this test on your own by looking at windowpanes, floor tiles, or ceiling tiles. See if the straight edges look wavy.) Distortion that appears on the grid may be a sign of the wet form of AMD and should be evaluated, especially if it represents a change from previous observations. If you already show evidence of dry AMD, it's a good idea to perform this test regularly to check for signs of disease progression to the wet form of the disease. This is important because the earlier the disease is detected, the greater the likelihood of successful treatment.

If the doctor suspects wet AMD, you will probably also undergo fluorescein angiography. In this test, a special dye is injected into your arm. As the dye travels through the blood vessels in the retina, your doctor takes multiple photographs with a special camera; these images reveal whether the blood vessels in your eyes are leaking and where any abnormalities are located. The procedure helps the ophthalmologist determine the best course of treatment.

When the macula (area of the retina packed with cones, responsible for sharp central vision) is damaged, people may first experience blurred or distorted vision and see straight lines as wavy. As the condition progresses, they may notice a black or dark space at the center of their visual field. An ophthalmologist may ask the patient to focus on a dot on a visual grid (Amsler grid). If the lines near the dot appear wavy, macular degeneration may be responsible.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.