Managing Age-Related Macular Degeneration: Essential Steps to Safeguard Your Vision

Even though age-related macular degeneration (AMD) doesn’t yet have a cure, timely treatment can slow it down and prevent vision loss. The earlier you address your condition, the better. But no matter when you begin, it’s crucial you stay proactive to best manage your disease.

Monitor Your Condition at Home

AMD changes your vision over time. These changes happen slowly, making it harder to notice them as they’re happening. That’s why it’s important to have tools to keep track of your sight day to day so you can catch any new symptoms quickly. Early treatment can slow or stop vision loss.

Amsler grid

An Amsler grid is a simple tool you can use at home to test your vision every day. It’s a square with a grid pattern and a dot in the middle printed onto a piece of paper. To use the Amsler grid, follow these steps once a day:

• Make sure you’re in good lighting and wear the glasses you use for reading.
• Hold the grid 12 to 15 inches from your face.
• Cover one eye, and with the other eye, focus on the center dot.
• While you’re looking at the dot, take note of any disturbances in the grid, especially any lines that look blurry, wavy, dark, or blank.
• Repeat the test with the other eye.

If you notice any changes, tell your eye doctor right away.

Home monitoring device

In May 2024, the FDA authorized the first at-home AMD monitoring device, called ForeseeHome. The device looks like some of the tools your eye doctor uses in the office – it sits on a tabletop, and you look into it the way you would a microscope.

You use it once a day. After you turn it on, you look into the viewfinder. During the test, a series of dotted lines flash on the screen and disappear. Using a computer mouse, you’ll click where you saw a distortion (a bump or wave) on the dotted line.

It takes a couple of minutes per eye. The device sends the results of your test to a vision monitoring center. If the device detects changes, your doctor gets a notification.

In a large clinical trial, 87%-94% of people with dry AMD who used the device were able to keep 20/40 vision or better from the time it detected wet AMD, compared to 62% of people who used an Amsler grid only. This early detection and earlier treatment for wet AMD means more sight can be preserved for longer.

See Your Eye Doctor Regularly

Your doctor will tell you how often you should be getting regular vision screenings to monitor your AMD. This could be anywhere from monthly to once a year, depending on how severe your disease is and how much it’s progressed.

You should be seeing a retinal specialist for your AMD. These are specialized ophthalmologists with training in diseases of the retina and vitreous (the clear gel-like substance in the eye between the lens and retina). If you haven’t yet seen a retinal specialist, your optometrist or ophthalmologist can refer you to one.

These visits are especially important because on top of your home monitoring, your doctor can give you more detailed tests that check for changes that may not be causing symptoms.

Some of the tests you may have include:

Ophthalmoscopy (fundoscopy). Your doctor uses a handheld ophthalmoscope to look closely inside your eye. They’ll look for drusen, which are yellowish white spots under your retina. Drusen are a normal part of aging eyes, but a large or growing number of them can be a sign of worsening AMD.

Fluorescein angiography. In this test, your doctor uses a special camera to take pictures of your retina. They’ll look for new or leaking blood vessels, which can be signs of wet AMD.

Optical coherence tomography (OCT). A machine uses light waves to take cross-section pictures of your retina during this test. An OCT tells your doctor if there are changes in the structure of your eye.

Set Your Treatment Expectations

The treatment you’ll need for your AMD will depend on the stage you’re in and the type of AMD you have. If you have early AMD, your doctor will likely recommend regular eye exams and healthy eye practices.

If your AMD has progressed to the intermediate stage, your doctor may recommend special vitamins you take at home to help stop it from turning into late AMD. AMD can progress differently in different eyes, so even if one eye has progressed to late AMD, you’ll still need to take the vitamins to help prevent it from progressing in the other eye.

When you have wet AMD, your treatment options may include:

• Medicines called anti-VEGF drugs that a doctor injects into your eye
• Photodynamic therapy (PDT), a combination of shots and laser treatment

If the thought of a needle near your eye worries you, you’re not alone. Your doctor will use numbing medicine for your eye first, and the needle is very thin and small. Don’t let your fear keep you from going to your treatments. These medicines help stop bleeding and leaking from blood vessels in the back of your eye and can help save your sight.

Questions to Ask Your Doctor

As you see your eye doctor, come prepared with your questions so you take an active part in your AMD treatment. You can ask:

What is the best treatment for my AMD? The treatment you need will depend on the type of your AMD and how severe it is.

Do I need cataract surgery? Sometimes cataracts can cloud your vision alongside your AMD. Your doctor can help determine if surgery to remove cataracts could help improve the vision you have now.

What is my risk of losing my vision? This is a common concern for people with AMD. Your doctor may be able to reassure you, and they can tell you the steps you can take to help preserve your sight for as long as possible.

Should I see a low vision specialist? Your doctor may recommend a vision rehabilitation specialist or other specialist who can make the most of the vision you have so you can be as independent as possible.

What clinical trials are available for AMD? If you qualify, you could take part in some of the latest research and treatments for AMD.

When should I call you? Make sure you’re clear on what symptoms your doctor will want to know about.

Boost Your Overall Eye Health

As you’re seeing your doctor and following treatment protocol, you can also adopt healthy habits that help protect vision. These practices may also delay the start of your symptoms or make the symptoms you have less severe.

Don’t smoke. Smoking speeds up the damage AMD does to your eyes. If you’re a smoker, talk to your doctor about programs and tools that can help you quit.

Protect your eyes from the sun. Experts think there may be a link between exposure to sunlight and the risk of AMD. Wear sunglasses and a hat with a wide brim when you’re outside.

Eat your fruits and veggies. Research shows certain nutrients in fresh fruits and vegetables may help prevent AMD, and may continue to protect your eyesight when you do have it. Leafy greens are especially helpful since they’re high in lutein and zeaxanthin, which are antioxidants that play an important role in eye health.

Try omega-3s. Fish and other foods high in omega-3 fatty acids may help preserve vision and promote overall good health.