Age-Related Macular Degeneration (AMD)
Age-related macular degeneration damages the macula and therefore central vision; suspected late wet active AMD needs urgent macular-service referral, OCT and prompt anti-VEGF treatment, while dry AMD needs risk-factor advice, self-monitoring, low-vision support and clear safety-netting.
Definition
Age-related macular degeneration is an age-associated degenerative disease of the macula causing central visual dysfunction. It includes early disease, late dry disease with atrophy, wet active disease with neovascularisation and fluid/haemorrhage, and wet inactive disease with scar, atrophy or treatment-unresponsive degeneration.
First principles
The macula is central vision, not the whole visual field
The macula supports fine central and colour vision for reading, face recognition and detail. AMD therefore causes central blur, distortion or a scotoma while peripheral vision may remain useful. A new central visual change in an older person should be assessed rather than assumed to be a slow, harmless change.
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