Age-Related Macular Degeneration (AMD)

NEI image of how someone with macular degeneration sees: overall blurriness with a blind spot in the center

Are you experiencing blurring or a blind spot in the center of your vision? Are you seeing blurry areas on a printed page? Do some straight lines appear wavy? Are there dark spaces or areas in the center of your vision? It might be age-related macular degeneration.

Age-Related Macular Degeneration (AMD) is a gradual, progressive, painless deterioration of the macula, which is the small area in the center of the retina that gives us our detailed vision. This is why someone with vision loss from macular degeneration may have trouble reading mail or newspapers but have no trouble spotting an object off to the side or while walking around, even in unfamiliar places.

The macula is the retina’s center part, allowing us to see crystal-clear details. When damaged, details—such as the words on this page or a facial expression—become obscured. Your relative or friend with age-related macular degeneration (AMD) may not be able to see your eyes but may still make eye contact because he or she can see at least the outline of your face and know where your eyes are.

Individuals with vision loss from age-related macular degeneration (AMD) appear fine. Their eyes appear just like they always were, and their peripheral (side) vision is preserved. Since their peripheral vision is preserved, they can walk around with little or no difficulty and may even spot a small dark button dropped on a light rug. This ability to see everything around a room but not to see the very thing one is looking at is confusing to others. This is partly because we consider vision a dichotomy of full sight vs. blindness.

Individuals with age-related macular degeneration are “in between.” They may not have full sight, but they are certainly not blind and never will be from AMD. They have low vision, or an even better description is that they are “hard of seeing,” a term coined by the late Dr. Lorraine Marchi, Founding Director of the former National Association for Visually Handicapped. Like the familiar term “hard of hearing,” it sounds more manageable and accurate.

Symptoms of AMD

Your eye care specialist is likely to see signs of macular degeneration before you are aware of any loss of vision. When you do start experiencing vision loss from age-related macular degeneration, symptoms can include:

Blurred or “fuzzy” vision
Straight lines, such as sentences on a page, appear wavy or distorted
Blurry areas on a printed page
Difficulty reading or seeing details in low light levels
Extra sensitivity to glare

Some Simulations of Vision Loss from AMD

Here are some simulations of how individuals with vision loss from age-related macular degeneration would see various scenes. They were created by David J. Marmor, MFA and Michael F. Marmor, MD, and published in Archives of Ophthalmology, 2010; 128:117-125. (Used with permission.) The top image shows the photo a camera would take; the middle image shows what someone with full vision would see (as we see clearly only in the very center of our vision, what we are looking directly at). The bottom image shows how someone with vision loss from age-related macular degeneration would see it.

street scene: top image shows the photo a camera would take (entirely focused); the middle image shows what someone with full vision would see (as we see clearly only in the very center of our vision, what we are looking directly at); and the bottom image shows how someone with vision loss from AMD would see it, with a blurry spot in the middle

To help family members and friends further understand the visual and functional effects of age-related macular degeneration, Macular Degeneration Support has created another online simulation gallery entitled Through Our Eyes: How People with AMD See.

Charles Bonnet Syndrome or Visual Hallucinations

About 20% of individuals who are blind or low vision from any cause, including AMD, see life-like images from time to time that they know are not really there. This phenomenon is named Charles Bonnet syndrome (CBS) after the Swiss naturalist and philosopher who first described it in 1760.

The phantom images of Charles Bonnet syndrome are common, pleasant, everyday things like flowers or animals or people, and the experience is somewhat like looking at a picture or watching a silent movie in color. The images are in full color, and they may move, but there is no sound, smell, or contact. It’s important to know that Charles Bonnet syndrome is related to vision loss, not to loss of mental capacity.

By Lylas G. Mogk, M.D., Edited by Sefy Paulose, M.D.,March, 2022

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Simulation of the effects of macular degeneration, with central visual field loss

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