The most common type of Macular Degeneration affects individuals over the age of 50 and has come to be known as "age related " Macular Degeneration, or late onset Macular Degeneration. There are also a number of earlier onset forms of Macular Degeneration which will be discussed under the heading of Stargardt's and other Juvenile Macular Dystrophies.

The first hint that there may be macular degeneration in a person's retina starts with the appearance of spots on the retina. These spots are called drusen. These drusen are like age spots and themselves do not usually change vision directly, but may be a sign for the doctor to watch for potential danger. These small yellow spots occur beneath the macular retina and with time, these spots may become more numerous. Over a period of time, the retina overlying these drusen may begin to deteriorate, and in a small percentage of patients the eye reacts to this injury by allowing the growth of new blood vessels from an even deeper layer (the choroid) into the space beneath the retina. 

If there is a breakdown of the tissue in the macula which lead to loss of vision that loss will usually start in just one eye. It may affect the other eye, later, or not at all. Sometimes the person is not aware that they have had reduced vision in one eye because the better seeing eye (especially if it is the dominant eye) can see detail and is functioning normally. It is important, however, that in these early stages that the vision should be checked by a doctor as soon as possible. 

A simple way to check your vision daily is by using an Amsler grid like the one pictured here. 

Amsler Grid Instructions

You may notice changes in your vision using this test that you otherwise may have not been able to catch. To use the grid cover one eye, and with your reading glasses on hold the grid approximately 12 to 16 inches away then, look directly at the center with the uncovered eye. Notice whether all the lines of the grid are straight or if any of the areas seem blurred, distorted, or dark. Repeat this process with the other eye. If you notice an abnormality contact your ophthalmologist immediately.

The early stages of Macular Degeneration may sometimes be hardly noticeable. It can also cause different symptoms in different people. Sometimes only one eye loses vision while the other eye continues with good vision for many years. Others may have symptoms in both eyes in a more "milder form" which may not significantly impair vision for many years. For instance, there are estimates of those in the U.S. that are affected by Macular Degeneration in some form totaling 13 million. Those with severe vision impairment from Macular Degeneration range in estimates from 2 to 3 million. 

Other important or frequent symptoms may include distortion where straight lines will look wavy such as lines on the Amsler grid or a door frame or blinds on a window that look bent. Sometimes colors don't look quite right or there may be a purple or gray spot that appears in the center vision. These and other similar symptoms are important and should be attended to by your eye doctor.

Many people with the onset of Macular Degeneration have trouble adjusting quickly between bright sunlight or dim light or shadows. This may be especially dangerous if driving in bright sunlight and then entering the shade of a tree or visa versa. Where the normal retina takes 3 to 5 minutes to adjust from the bright light to a dim light (like entering a movie theater) a person with Macular Degeneration may take 8 to 12 minutes or longer. Many people also begin to show more sensitivity to glare both indoors and outdoors.

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