Understanding the Stages of Macular Degeneration

A comprehensive guide to the stages, symptoms, types, and treatments for macular degeneration.

By Sneha Tete, Integrated MA, Certified Relationship Coach

Created on Sep 25, 2025

A comprehensive guide to the stages, symptoms, types, and treatments for macular degeneration.

Macular degeneration is a leading cause of vision loss for older adults. Its gradual effect on central vision, vital for reading, driving, and recognizing faces, can majorly impact daily life. This guide explains what macular degeneration is, its progression through key stages, differences that can occur in each eye, and what current treatments can offer to help preserve vision.

What Is Macular Degeneration?

Macular degeneration is an age-related eye disease affecting the macula—the central part of the retina responsible for sharp central vision. The condition is most common in adults over 50 years old and is also referred to as age-related macular degeneration (AMD). Damage to the macula gradually impairs the ability to see fine details, making everyday activities increasingly challenging. While AMD rarely leads to complete blindness, it can cause significant central vision loss.

Most prevalent in adults over 50
Impacts central vision, crucial for activities like reading and driving
Does not typically result in total blindness, but greatly impairs visual detail
Two main types: Dry (atrophic) and Wet (neovascular) AMD

How Macular Degeneration Progresses

Macular degeneration is often a progressive disease. The pace and severity of vision loss can vary based on the AMD type and individual health factors. While most people experience a gradual decline, some might maintain stable symptoms for years, or have one eye progress more quickly than the other. Regular eye exams are essential for early detection and management, even when symptoms are not apparent.

The progression is generally slow, particularly in dry AMD
Symptoms are often absent in early stages, making regular screening vital
Some individuals have asymmetrical progression (one eye advances faster)
Wet AMD can cause sudden, severe loss of vision compared to dry AMD

The Three Stages of Macular Degeneration

Macular degeneration is typically characterized by three main stages: early, intermediate, and late. Each stage is marked by changes in the retina and worsening symptoms. Understanding these stages is critical for recognizing the threats to central vision and taking appropriate action.

Early Stage

The early stage of dry macular degeneration is usually asymptomatic. Individuals do not notice any change in their vision, and the disease is most often discovered during routine eye exams. The key sign is the presence of small to medium-sized yellow deposits called drusen beneath the retina. Eye care professionals recommend periodic eye examinations in at-risk populations to catch this stage as early as possible.

No noticeable symptoms for most people
Detected during comprehensive eye exams with the identification of drusen
Guidelines often advise annual or biennial eye exams for adults over 50 or with risk factors

Intermediate Stage

The intermediate stage may still be silent for some, but for others, mild symptoms start to emerge. The drusen become larger, and the retinal pigment epithelium—the layer that nourishes the retina—may show distinct thinning and damage. Vision changes can include mild central blurriness, reduced contrast sensitivity, or more significant issues seeing in low-light or at night.

Possible symptoms include slight central vision blurriness or trouble with night vision
Difficulty seeing in dim light or picking up fine details
Onset of mild visual distortion (e.g., straight lines appearing wavy)
Changes may be more pronounced when reading or recognizing faces

Late Stage

Late-stage macular degeneration involves significant functional vision loss. Known as geographic atrophy (GA) in the dry form or as the onset of wet AMD, this stage is when central vision becomes noticeably and often irreversibly degraded. Wet AMD, characterized by the growth of abnormal blood vessels under the retina, can emerge during any stage but always signals an advanced disease state. Sudden or severe vision changes in one or both eyes may occur.

Pronounced central vision loss, including blind spots (scotomas)
Straight lines may appear distorted, crooked, or warped
Increasing trouble with color contrast and adaptation to light
Possible rapid decline if wet AMD develops due to bleeding or fluid leakage
Late-stage dry AMD is termed “geographic atrophy” due to atrophic (wasted) areas in the retina

Types of Macular Degeneration: Dry vs. Wet

Feature	Dry (Atrophic) AMD	Wet (Neovascular) AMD
Prevalence	90% of AMD cases	10% of AMD cases
Progression	Slower, gradual	Faster, sometimes sudden
Main Pathology	Accumulation of drusen, thinning of retina	Abnormal blood vessels, bleeding, fluid leakage
Symptoms	Mild to moderate central vision loss	Rapid, severe central vision loss
Stage Structure	Early, intermediate, late	Always represents late/advanced stage

All cases of AMD begin as the dry form, which may progress slowly through early and intermediate stages. About 10% of cases transform into the wet form, which can cause much more rapid and extensive vision loss.

Symptoms of Macular Degeneration by Stage

Early Stage: Typically no symptoms. Detected via drusen in eye exams.
Intermediate Stage:
- Mild blurriness in central vision
- Difficulty seeing at night
- Reduced ability to discern colors or contrast
Late Stage:
- Significant central vision loss and blind spots
- Distorted or wavy vision (straight lines appear warped)
- Difficulty with reading, driving, or recognizing faces
- Trouble adapting between light and dark environments
- Colors appear faded or less vibrant
Wet AMD: Symptoms can progress rapidly and may include perceiving straight lines as blurred or wavy, sudden central vision loss, or seeing dark patches in the center of vision.

Can Macular Degeneration Progress Differently in Each Eye?

Macular degeneration commonly affects both eyes, but it does not necessarily do so at the same pace. About 64.5% of people have AMD at the same stage in both eyes, while approximately 35.5% may experience different stages between their eyes. Early AMD in one eye is a strong risk factor for the progression to AMD in the other.

One eye may remain stable while the other progresses
Vision loss in one eye can be masked by compensatory visual ability in the other eye
Both eyes usually progress with age, but at variable rates
Regular, comprehensive monitoring of both eyes is advised

Treatment Options at Each Stage of Macular Degeneration

While there is no cure to restore lost vision from macular degeneration, there are preventive steps, lifestyle adjustments, and, at advanced stages, medical interventions to help manage the disease and slow its progression:

Early Stage

Routine monitoring—no specific medical treatment
Lifestyle changes: Healthy diet (leafy greens, fish, nuts), smoking cessation, blood pressure control, and UV protection
Scheduled eye exams to detect progression or emergence of symptoms

Intermediate Stage

Nutritional supplements, specifically the AREDS2 formula (vitamins C & E, copper, zinc, lutein, zeaxanthin), may slow progression
Continuation of healthy lifestyle habits
Close follow-up with an ophthalmologist

Late Stage: Geographic Atrophy and Wet AMD

Dry (Geographic Atrophy): Supportive care, magnifying devices, low-vision therapy, and continued monitoring
Wet AMD: Anti-VEGF injections to stop abnormal blood vessel growth and reduce fluid leakage
Options may also include laser therapy in select cases

Assistive technologies like magnifiers, electronic reading devices, and vision rehabilitation programs can further improve quality of life for those with significant visual impairment.

Risk Factors for Developing Macular Degeneration

Age (most important risk factor, especially over 50)
Family history and genetics
Smoking (increases AMD risk two- to four-fold)
Cardiovascular disease and high blood pressure
Poor diet or obesity
Excessive sunlight exposure without eye protection
Presence of drusen as detected on eye examination

Prevention Tips for Macular Degeneration

Do not smoke, or quit if you do
Eat a balanced diet high in dark leafy greens, fruits, and fish
Maintain a healthy body weight and exercise regularly
Manage chronic conditions such as hypertension and cholesterol
Wear sunglasses to limit UV exposure
Get regular, comprehensive dilated eye exams after age 50 or earlier if at increased risk

How Quickly Does Macular Degeneration Progress?

The timeline for progression varies depending on several factors, including the type and individual risk factors. Dry AMD progression from initial diagnosis to significant vision loss typically spans several years—often up to a decade. Wet AMD, by contrast, can develop rapidly, with vision changes sometimes occurring within days or weeks. Prompt recognition and treatment of wet AMD are critical for preserving as much sight as possible.

Frequently Asked Questions (FAQs)

Can macular degeneration cause complete blindness?

No, macular degeneration does not usually lead to total blindness. Peripheral vision generally remains, but central vision loss can have a substantial impact on daily living.

Is macular degeneration hereditary?

Yes, genetics play a significant role. Having a parent or sibling with AMD increases your risk, though lifestyle factors also influence its development.

Can both eyes be affected differently?

Yes, it is common for one eye to progress faster than the other, and stages can differ. Regular exams are important to monitor both eyes.

What can I do to prevent or slow progression?

Adopt a healthy lifestyle, don’t smoke, protect your eyes from UV, manage chronic medical issues, and follow your ophthalmologist’s recommendations for supplements or monitoring.

How is AMD diagnosed?

An ophthalmologist will conduct a comprehensive eye exam, often using dilation, visual acuity tests, retinal imaging, and an Amsler grid to detect visual distortion.

Is there a cure for macular degeneration?

Currently, there is no cure, but advancements in drug therapy and low-vision aids provide improving options for managing vision loss and maintaining independence.

Conclusion

Awareness of the stages and progression of macular degeneration empowers individuals to seek early care, monitor changes, and adopt lifestyle habits that may help preserve vision. If you are at risk, schedule regular comprehensive eye exams and consult your ophthalmologist about the best preventive and therapeutic measures for you.

References

Author

Sneha TeteBeauty & Lifestyle Writer

Sneha is a relationships and lifestyle writer with a strong foundation in applied linguistics and certified training in relationship coaching. She brings over five years of writing experience to thebridalbox, crafting thoughtful, research-driven content that empowers readers to build healthier relationships, boost emotional well-being, and embrace holistic living.

Read full bio of Sneha Tete