Frequently Asked Questions
Does macular degeneration only affect older people?
Can you get macular degeneration in both eyes?
I love reading. Will I make my macular degeneration worse by continuing to read?
Can 'using' my eyes cause further damage, will resting them 'make them last longer'?
Can 'resting' my good eye save it from developing macular degeneration?
I have dry eyes. Is this the same as dry macular degeneration?
I have watery eyes. Does this mean I have wet macular degeneration?
Can I see for myself if my retina or macula shows any signs of damage before I have symptoms?
Is macular degeneration painful?
Why don't new spectacles help?
Is a macular hole the same as macular degeneration?
Is it 'normal' to experience visual hallucinations?
I have been diagnosed with drusen, does this mean I have macular degeneration?
Is macular degeneration contagious?
Is macular degeneration genetic?
I have geographic atrophy, what does this mean?
I have noticed changes to my vision when using the Amsler grid, what should I do?
Is exercise good for macular degeneration?
Are supplements shown to be preventative?
I have vision loss from macular degeneration and cataracts. Will cataract surgery be of any use?
Does cataract surgery increase the risk of macular disease progression?
Questions and answers
Does macular degeneration only affect older people?
Although the most common form of macular degeneration is age-related, there are many forms of macular degeneration that can affect younger people. These are all quite rare and most are caused by a specific gene defect.
Some of these forms include:
- Best’s Disease or vitelliform macular dystrophy.
- Stargardt's Disease: this is the most common form seen in younger people and may appear from about 10 years of age, although vision loss may not occur until the 20s or 30s.
- Myopic macular degeneration: can occur in people who are severely near-sighted due to extreme elongation of the eyeball. This condition can result in tears in the macula and bleeding beneath the retina.
- Other macular dystrophies: Sorsby's dystrophy, Behr's dystrophy and Doyne's (or honeycomb) dystrophy.
Read Macular Disease Foundation Australia’s fact sheets on other macular diseases here.
Can you get macular degeneration in both eyes?
Yes. You can have early, dry or wet macular degeneration in one eye or both eyes. Some people have early or dry macular degeneration in one eye and the wet type in the other eye. Some people have wet macular degeneration in both eyes.
I love reading. Will I make my macular degeneration worse by continuing to read?
No. You will not make your macular degeneration worse by reading. You may find you become tired more quickly when you are reading because you are having to concentrate more, particularly if you already have some loss of vision. You may need to have a break a bit more often when you are reading.
Can 'using' my eyes cause further damage, will resting them 'make them last longer'?
No, definitely not! You cannot hurt your eyes or wear them out quicker by using them for normal tasks. Please 'use' your eyes as much as you like. By doing so you may learn new ways of seeing things to compensate for your decreased vision.
Can 'resting' my good eye save it from developing macular degeneration?
If only one eye is affected, resting your 'good' eye has no impact on the risk of macular degeneration developing.
I have dry eyes. Is this the same as dry macular degeneration?
No. Dry or itchy eyes (which affects the front of the eye) is a different eye condition to dry macular degeneration which affects the retina at the back of the eye.
I have watery eyes. Does this mean I have wet macular degeneration?
No. Wet macular degeneration means you have some fluid or blood leaking from abnormal blood vessels growing under the retina at the back of the eye. You cannot see this fluid or blood if you look in the mirror. The front of the eye gives us no indication of what is happening at the back of the eye or vice versa. Symptoms such as bloodshot eyes, dry or itchy eyes and watery eyes have no relationship to the retina. Any disease or damage to the retina does not affect the front of the eye in any way. You should speak to your optometrist or ophthalmologist if you have dry or itchy eyes.
Can I see for myself if my retina or macula shows any signs of damage before I have symptoms?
No. It is impossible to examine your own retina, which lines the inside of the eye. You need to have a full eye examination from an eye health professional who will normally dilate (enlarge) the pupil to give a clear view of the retina, including the macula.
Is macular degeneration painful?
No. Macular degeneration does not cause any pain. The early stages of macular degeneration can also develop without you being aware of any visual symptoms. That's why you need an optometrist or your ophthalmologists to check your retina. A painful eye can be due to a number of other conditions and should be investigated by an ophthalmologist
Why don't new spectacles help?
Spectacles ‘help’ the lens at the front of the eye to better focus the image onto the retina (at the back of the eye). If the retina is damaged it cannot 'take a good picture' regardless of the strength of the lens or spectacles. An analogy is with an old style film camera. Cleaning the lens at the front of the camera will not help if the film at the back of the camera is damaged.
Does any other eye disease such as cataract, glaucoma or diabetic retinopathy have an impact on macular degeneration?
No. Other eye diseases or complaints have no impact on the incidence, severity or outcome of macular degeneration. Of course many eye complaints may cause vision loss or disturbance to varying degrees and if you have central vision loss due to macular degeneration, other visual symptoms can exacerbate your vision loss, but clinically they do not affect the actual disease process.
Read Macular Disease Foundation Australia’s fact sheets about other macular diseases and other common eye diseases.
Is a macular hole the same as macular degeneration?
No, they are separate and distinct conditions. There is no relationship between the two, although the symptoms can be similar. A macular hole could be described as a 'traumatic' event, when a hole develops in the macula, due to the vitreous gel inside the eye pulling on the retina. This vitreous gel tends to shrink as we get older causing traction. In most cases, macular holes can be surgically repaired, providing they are treated early.
Read more about macular holes.
Is it 'normal' to experience visual hallucinations?
Up to 30% of people who have experienced significant vision loss from macular degeneration or other eye conditions experience a range of visual hallucinations. This is known as Charles Bonnet Syndrome (CBS). These hallucinations can be mildly irritating or quite distressing, especially for those who experience vivid, random images of everyday objects or scenes at the most inappropriate times. People with CBS typically know that the hallucinations are not real, and other senses such as hearing, smell and taste, are not involved. Be assured that these hallucinations are a result of failing eyesight and are not a sign of a mental health issue. Images tend to come and go and will often settle down with time, although in some people, they can last for many years. Please discuss your concerns with your family and your doctor. It is quite possible that your GP will not have heard about CBS.
Read more about Charles Bonnet Syndrome here. The Foundation recommends printing a copy of the factsheet, (or contact the Foundation for a printed copy), to share with your family and GP.
My vision is good but my doctor says I have the early signs of macular degeneration - what does that mean?
Macular degeneration is a progressive disease. It begins in the special layer of cells known as the retinal pigment epithelium (RPE) which lies underneath the retina. The early changes (drusen and pigment loss) normally have no symptoms but can be detected by your optometrist or ophthalmologist when your eyes are examined. In some people, these changes can worsen and the person moves to late stage disease with associated vision loss. It should be stressed that diet and lifestyle modification can reduce the risk of the disease moving to the late stage.
Read more about how macular degeneration progresses and how to reduce the risk of progression.
I have been diagnosed with drusen, does this mean I have macular degeneration?
Almost everyone over the age of 50 has a few very small drusen (also called drupelets). These are considered a normal sign of ageing and are not classified as macular degeneration. If the drusen increase in number and grow beyond a certain size, it may be classified as "early macular degeneration". As the disease progresses, the drusen grow larger and affect the health of the retinal pigment epithelium (RPE) cells. This can then cause atrophy (loss) of the RPE cells called "dry macular degeneration". It may also result in the formation of new, leaky blood vessels under the retina called "wet macular degeneration". Eventually the health of the photoreceptor cells is affected, resulting in vision loss.
Is macular degeneration contagious?
No. It is a degenerative disease and not one that can be passed from person to person.
I have had dry macular degeneration for years. Does this mean I'm going to get wet macular degeneration too?
10 to 15% of people with early or dry macular degeneration will develop wet macular degeneration and this can occur very quickly. For this reason, it is essential to have a regular eye test and macula check, as recommended by your eye health professional. Additionally, use an Amsler grid to check your vision at home every day, especially if you have been diagnosed with macular degeneration. If you notice any sudden change to your vision, contact your eye health professional immediately, as any delay increases the likelihood of losing vision and potential blindness.
Is macular degeneration genetic?
Yes, there can be a genetic component in many cases of macular degeneration and it is one of the three risk factors. Up to 70% of people with macular degeneration have a genetic link and if you have a direct family member with the disease there is a 50% chance of getting the disease. A direct family member can be a parent or sibling. At least 35 gene variations can influence one's risk of getting the disease. Other risk factors are age and smoking.
I have geographic atrophy, what does this mean?
This is the name given to the late stages of dry macular degeneration. It is so named because the patches of atrophied retina appear like islands on a geographical map.
An Amsler grid, available free from Macular Disease Foundation Australia, is a quick and convenient way to check your vision every day. The Amsler grid will help you detect any changes to your vision in between visits to your eye health professional. It does not replace an eye test or macula check by a qualified eye health professional.
Order a free macular degeneration information kit (which includes an Amsler grid) here.
I have noticed changes to my vision when using the Amsler grid, what should I do?
If you notice any sudden changes to your vision when using an Amsler grid it is critical that you advise your health care professional (optometrist or ophthalmologist) immediately and make an appointment to have your eyes tested and your macula checked. When making the appointment, state that you have had a sudden change in vision. If you are given an appointment which is more than a week away, ask for it to be sooner. Dry macular degeneration can turn into wet macular degeneration very quickly and delays in seeking treatment can lead to loss of sight.
Find an eye health professional in your area here.
Is exercise good for macular degeneration?
The Foundation advises that regular exercise is good not only for your general health and wellbeing but there is also evidence that people who exercise regularly are less likely to progress to late-stage disease. In addition, exercise is important for your emotional wellbeing.
Are supplements shown to be preventative?
The original AREDS study showed that a supplement based on a specific formula of zinc and antioxidants slowed the progression of age-related macular degeneration for people in the intermediate stage in one or both eyes, or in the late stage in one eye. The AREDS formula reduced the risk of progression of the disease by 20 to 25% and delayed vision loss.
The AREDS study showed that the formula had no effect on people with no age-related macular degeneration, or only very early signs of the disease (eg a few small drusen), or people with advanced disease in both eyes. An optimal eye health diet is more appropriate for these people.
Any decision to take a supplement should be made in consultation with your optometrist, ophthalmologist or GP.
Read more about AREDS and other supplements here.
I have vision loss from macular degeneration and cataracts. Will cataract surgery be of any use?
In people with severe macular degeneration, most central vision is lost and the person is very dependent on their peripheral vision. If these people also have significant cataracts, cataract surgery can significantly improve the quality of peripheral vision. Several studies have shown that in people who have significant cataracts and severe macular degeneration, cataract surgery can produce major improvements in overall quality of life, even if central vision is not improved. In contrast, people with severe macular degeneration and mild cataracts do not usually benefit greatly from cataract surgery
Does cataract surgery increase the risk of macular disease progression?
Cataracts and macular degeneration are common eye conditions that can affect older people at the same time. Some studies and anecdotal reports suggest that cataract surgery may accelerate the progression of macular degeneration. Other studies have shown no link. On balance, cataract surgery does not appear to contribute to worsening of macular degeneration.
In some people, dense cataracts can mask the symptoms of macular degeneration. When a dense cataract is removed and replaced with a new intraocular lens, vision is usually much clearer meaning that the symptoms of macular degeneration such as distortion can become more obvious. Some people have mistakenly concluded that the surgery made the macular degeneration worse.
People with conditions such as 'wet' macular degeneration may be receiving regular injections of an anti-VEGF drug to reduce the formation of unwanted new blood vessels and leakage under or within the retina. If these people also have significant cataracts, it is generally considered appropriate to delay cataract surgery until the new blood vessel formation and leakage has stabilized. Delaying cataract surgery will not have any negative impact on the outcome of the surgery.