Macular Degeneration — What It Is, What It Does to Your Vision, and What Can Be Done
Macular degeneration is one of the most common causes of central vision loss in older Australians. It affects the macula — the small central region of the retina responsible for the sharp, detailed vision you use for reading, recognising faces and colours.
It comes in two forms — dry and wet — and understanding which form is present is the first and most important step in any assessment. The two forms behave very differently, and the urgency of treatment depends entirely on which one you have.
The patients who do best are the ones who come in early — often because something just felt slightly off in one eye. A small change noticed early is worth far more than a big change noticed late.
What Is Dry Macular Degeneration?
Dry AMD is the more common form. It develops gradually over years as the cells in the macula slowly deteriorate with age. Many people have early changes without knowing it.
In advanced dry AMD, patches of the macula stop functioning entirely — a condition called geographic atrophy. Vision changes are gradual, and because the change is slow, many people adapt without realising how much vision has shifted.
What Is Wet Macular Degeneration — and Why Does Timing Matter?
Wet AMD is less common but more urgent. It occurs when abnormal blood vessels grow beneath the macula and begin leaking fluid or blood into the retinal tissue. Unlike the gradual decline of dry AMD over years and decades, wet AMD can cause significant central vision loss over weeks to months.
The hallmark symptom is distortion — straight lines look bent or wavy, often with a dark blob or grey smudge appearing in the centre of your vision. If you notice this, it needs prompt assessment. This is not a symptom to ignore.
Urgent — Act Promptly
New distortion in central vision of one eye may indicate wet macular degeneration. Prompt assessment significantly improves the chance of maintaining useful vision. Contact the rooms for an urgent appointment, or present to Sydney Eye Hospital emergency if after hours.
With early treatment, wet AMD can often be stabilised and in some patients vision improves. Delayed treatment allows more permanent damage to the macula, which cannot be undone.
What Are the Symptoms of Macular Degeneration?
Symptoms differ between the two forms and it helps to know which pattern you're noticing:
Symptoms more typical of wet AMD — seek prompt review
- Distortion — straight lines (door frames, ruled lines, tiles) appear bent or wavy
- A grey, dark, or blurred patch appearing in the centre of vision
- Central vision that has changed noticeably over days to weeks in one eye
Symptoms more typical of dry AMD — arrange review
- Gradual difficulty reading, particularly in dim light
- Needing significantly more light for close tasks
- Colours appearing less vivid or washed out
- Increasing difficulty recognising faces
- Slower adaptation between bright and dark environments
Symptoms often start in one eye, which can delay detection because the other eye compensates. If you cover each eye separately and notice a difference, that is worth investigating.
Why distorted vision needs urgent assessment →Will Macular Degeneration Make Me Go Blind?
This is the question almost every patient asks, and it deserves a careful answer.
Macular degeneration affects your central vision — the precise, detailed vision you move your eye to look at something with. It very rarely affects peripheral vision. You won't go dark. You won't lose the ability to navigate a room, see people around you, or find your way around.
What does happen — particularly in advanced disease — is that the central vision becomes unreliable or is lost. If you try to look at something and that light falls on a damaged macula it may disappear or be distorted.
The aim of treatment for wet AMD is to prevent that progression — to hold onto the central vision. In many patients with wet AMD who are treated early and consistently, useful central vision is preserved for many years.
How Is Macular Degeneration Treated?
Wet AMD — intravitreal injections
The main treatment for wet AMD is intravitreal injection therapy — anti-VEGF medications injected directly into the eye to suppress the abnormal blood vessel growth and leakage driving the damage. Treatment begins with monthly injections to bring the condition under control, with intervals then adjusted according to how the eye is responding.
This is a long-term treatment. Many patients require ongoing injections for years, though the frequency can often be reduced in eyes that remain stable. Consistency with appointments and retinal imaging at each visit is one of the most important factors in maintaining vision over time.
Treatment is tailored to the individual eye. Dr Hunt adjusts both the choice of agent and the schedule based on OCT imaging and visual assessment at each visit.
What to expect from eye injections →Dry AMD — slowing progression
For most dry AMD, there is currently no treatment that reverses the damage already done. High-dose antioxidant supplements (AREDS2 formulation) are recommended for intermediate dry AMD to reduce the risk of progression to advanced disease.
For advanced dry AMD with geographic atrophy, complement inhibitor therapies have been approved in Australia and can slow the rate of atrophy progression in selected patients. These treatments are not PBS-listed and access is currently limited by cost. Whether they are appropriate is assessed individually, taking into account the rate of progression and extent of involvement.
Research in Macular Degeneration
Through the Fight Retinal Blindness! registry at the Save Sight Institute, Dr Hunt has contributed to research on long-term outcomes of anti-VEGF therapy in AMD — including how treatment intervals, agent choice, and treatment persistence affect vision years into therapy. Registry research reflects how treatments perform in everyday care, not just selected trial populations.
See Dr Hunt's publications →Macular Degeneration Assessment
Dr Hunt sees patients with AMD at Eye Surgeons Miranda for new assessments, second opinions, and ongoing injection treatment. Urgent appointments are prioritised when symptoms suggest wet AMD.
For patients with a strong family history of AMD, or those with early dry AMD wanting a clearer picture of their risk of progression, Dr Hunt can also advise on newly available genetic tests.
Frequently Asked Questions — Macular Degeneration
Will macular degeneration make me go blind?
Macular degeneration affects central vision but very rarely affects peripheral vision. You won't go dark or lose the ability to navigate a room. The aim of treatment for wet AMD is to preserve central vision, and with early, consistent treatment, useful central vision is often preserved for many years.