Understanding the Stages of Macular Degeneration: Symptoms, Progression, and Management

Learn about the types, stages, symptoms, and treatments for macular degeneration, including guidance on preserving vision and eye health.

By Medha deb

Created on Sep 25, 2025

Learn about the types, stages, symptoms, and treatments for macular degeneration, including guidance on preserving vision and eye health.

What Are the Stages of Macular Degeneration?

Macular degeneration, especially age-related macular degeneration (AMD), is a progressive eye condition affecting the macula—the central portion of the retina responsible for sharp, central vision. As AMD progresses, it can result in irreversible loss of central vision, impacting activities like reading, driving, and recognizing faces. Understanding the stages, symptoms, and types of macular degeneration is crucial for effective management and preserving vision.

Macular Degeneration Overview

Macula: The central part of the retina responsible for detailed vision.
Age-Related Macular Degeneration (AMD): The leading cause of vision loss in older adults.
Occurs primarily in individuals over age 50.

Main Types of Macular Degeneration

Type	Description	Progression
Dry (Atrophic)	Characterized by drusen (tiny yellow or white deposits) buildup under the macula.	Develops slowly in three stages: early, intermediate, and late.
Wet (Neovascular)	Involves abnormal blood vessel growth beneath the macula, which can leak fluid and blood.	Always considered late-stage and can progress rapidly.

The Stages of Dry Macular Degeneration

Dry AMD is the most prevalent form, accounting for about 85–90% of all cases. It develops gradually, typically through three stages:

Early Stage

Symptoms: Usually none; vision remains normal.
Detection: Small drusen detectable only during routine eye exams.
Impact: May not affect vision or daily activities.
Significance: Early detection is vital for monitoring potential progression.

Most people with early stage AMD do not realize they have it until it’s identified during a comprehensive eye exam.

Regular eye checkups are essential for people over 50 to catch early AMD and implement lifestyle changes that may slow its progression.

Intermediate Stage

Symptoms:
- Mild blurriness or distortion in central vision
- Trouble seeing in low lighting conditions
- Vision changes that may come and go
Related: How Macular Degeneration Affects Vision: What You Need to Know
Detection: Larger or numerous drusen, visible on examination by an eye care professional.
Progression: Not everyone with intermediate AMD progresses to late stage.

During the intermediate stage, some individuals may begin to notice symptoms, often triggered by dim light or struggling to discern details.

Late Stage

Types:
- Geographic Atrophy (Dry AMD): Advanced atrophy of the macula, leading to permanent vision loss.
- Wet AMD: Abnormal blood vessels develop, causing rapid central vision deterioration.
Symptoms:
- Significant central vision loss
- Blank or dark spots in the center of vision
- Straight lines appearing wavy or distorted
- Difficulty reading or recognizing faces
- Colors may appear faded or duller
Impact: Loss of central vision may become irreversible. Peripheral vision typically remains unaffected.

Late AMD, whether dry or wet, can severely diminish the ability to perform everyday tasks requiring sharp vision.

Wet Macular Degeneration

Unlike dry AMD, wet AMD can develop at any stage of dry AMD but is always classified as a late-stage condition. Wet AMD is less common but far more damaging and rapidly progressive.

Features: Growth of fragile, abnormal blood vessels under the retina. These can leak fluid or blood, causing the macular tissue to scar.
Consequences: Sudden and severe loss of central vision.

Wet AMD accounts for the majority of severe vision loss cases linked to AMD.

How Does Type Affect Progression?

Dry AMD	Wet AMD
Progresses slowly, symptoms may be absent early on.	Can progress quickly, often leads to substantial vision loss in a short period.
Three stages: early, intermediate, late.	Always considered late stage when present.
Drusen buildup under the retina seen with imaging.	Leaking abnormal blood vessels visualized on scans.

Symptoms and Signs Across Stages

Early Dry AMD: No symptoms, patient unaware without eye exam.
Intermediate Dry AMD:
- Mild blurry vision
- Difficuly adjusting to low light
Late Dry or Wet AMD:
- Blurry or missing center vision
- Wavy or distorted straight lines
- Loss of ability to read, drive, or recognize faces
- Colors appear less vibrant

If you notice symptoms such as central blurriness or distortion, contact your eye doctor immediately.

Risk Factors for AMD

While age is the primary risk factor, certain genetic and lifestyle factors can increase the likelihood of developing AMD:

Age over 50
Family history of macular degeneration
Smoking
Obesity
High blood pressure
Poor diet low in antioxidants
Prolonged exposure to sunlight

Diagnosis

Diagnosing AMD typically requires a thorough eye examination by an optometrist or ophthalmologist. Techniques include:

Dilated eye exam
OCT (Optical Coherence Tomography) imaging
Retinal photographs
Amsler grid testing (for distortion detection)

Routine eye exams are essential for early detection, particularly since early stages often lack symptoms.

Treatment Options by Stage

Early-Stage Dry AMD

No formal treatment is currently available.
Lifestyle modifications are recommended:
- Balanced, nutrient-rich diet (leafy greens, fish, nuts)
- Regular exercise
- Smoking cessation
- Managing chronic diseases (hypertension, diabetes)
Ongoing monitoring by a specialist is important.

Intermediate-Stage Dry AMD

Dietary supplements (AREDS2 formulation: vitamins C, E, zinc, copper, lutein, zeaxanthin) may help slow progression.
Healthy lifestyle and disease management critical.
Regular follow-up with an ophthalmologist.

Late-Stage Dry AMD (Geographic Atrophy)

No treatment can reverse vision loss.
Low vision aids and rehabilitation can help maximize remaining vision for daily activities.

Wet AMD

Intravitreal injections of anti-VEGF medications reduce abnormal blood vessel growth and leakage.
Laser therapy or photodynamic therapy may be options in select cases.
Early detection and treatment can preserve central vision in many patients.

Living with Macular Degeneration

Adapting to changes in vision can be challenging, but various resources are available:

Low vision aids (magnifiers, special lighting, electronic devices)
Orientation and mobility training
Support groups and counseling services
Smartphone and tablet accessibility features

Preventive Strategies

Maintain a healthy diet rich in antioxidants and omega-3 fatty acids
Avoid smoking and exposure to secondhand smoke
Regular physical activity
Routine eye examinations, especially after age 50
Protect eyes from excessive sunlight

Frequently Asked Questions (FAQs)

Is macular degeneration hereditary?

Yes, genetics play a role. Having a first-degree relative with AMD increases your own risk of developing the condition.

Can macular degeneration be reversed?

No, current treatments cannot reverse existing vision loss. Some interventions can slow progression and help retain remaining vision, especially with wet AMD.

How common is AMD?

Globally, it’s estimated that 200 million people have AMD, with numbers expected to rise to 300 million by 2040.

Should both eyes be monitored if only one is affected?

Yes. Having AMD in one eye increases your risk for the other eye, and up to 35% of people may have different stages in each eye.

What symptoms should prompt a visit to the eye doctor?

If you experience blurred central vision, straight lines appearing wavy, difficulty in low light, or blank spots in vision, consult your eye care provider immediately.

Images: What Do the Stages Look Like?

Early Dry AMD: Small yellowish-white drusen deposits visible on retina imaging.
Intermediate Dry AMD: Larger and more numerous drusen present.
Wet AMD: Drusen visible with accompanying abnormal blood vessels that may leak or bleed.

Summary

The stages of macular degeneration—early, intermediate, and late—are defined primarily for dry AMD, while wet AMD is always considered late stage due to the rapid emergence of abnormal blood vessels and bleeding. Early detection through routine eye exams and lifestyle modifications can help manage risk and slow progression. Treatment options exist to protect vision at intermediate and late stages, particularly for wet AMD. People with macular degeneration benefit greatly from vision support resources and ongoing medical monitoring.

References

Author

medha deb

Medha Deb is an editor with a master's degree in Applied Linguistics from the University of Hyderabad. She believes that her qualification has helped her develop a deep understanding of language and its application in various contexts.

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