Macular degeneration

Also called AMD, Age-related macular degeneration

Central vision failing while the edges stay. The leading cause of sight loss in the UK, and the wet type is an emergency.

What it is

The macula is the small central part of the retina that does detail: faces, reading, the difference between a five and a six. Age-related macular degeneration damages it, so the middle of the picture fades while peripheral vision remains.

Around 700,000 people in the UK have late-stage AMD. There are two forms and the distinction is urgent.

Dry AMD develops slowly over years and currently has no treatment. Wet AMD develops over days to weeks, caused by abnormal blood vessels leaking under the retina, and it does have treatment: injections that can preserve sight if started quickly. Delay of a few weeks can cost vision permanently.

Signs you might notice

Straight lines looking bent or wavy. This is the classic early sign, and an Amsler grid on the fridge is how people catch it.

A blurred or dark patch in the centre of vision.

Needing much more light to read. Faces harder to recognise while walking is still fine.

Sudden distortion or a rapid change means possible wet AMD. That is a same-week, ideally same-day, referral.

How it can affect day-to-day life

Losing central vision takes reading, driving and faces, which is a very specific kind of isolation: the person can still walk around perfectly well, so others assume they can see.

Charles Bonnet syndrome frightens people badly and almost nobody warns them about it. Vivid visual hallucinations occur in people losing sight, because the brain fills in missing input. It is not a mental illness and it is not dementia, and saying so plainly is enormously reassuring.

Depression after sight loss is common and under-treated.

Supporting someone well

Get an Amsler grid, put it somewhere used daily, and check one eye at a time. This is the cheapest early warning available.

Treat sudden distortion as urgent. Wet AMD treated early keeps sight; treated late does not.

Maximise contrast and light rather than magnification alone. A dark plate for pale food, a light switch that stands out, a task lamp over the chair.

Ask about certification as sight impaired, which unlocks real practical support.

Warn about Charles Bonnet syndrome before it happens, so it is not experienced as losing one's mind.

Register with a low vision service, and use talking books, screen readers and large print without treating them as a last resort.

Where to get help

Any optometrist can assess and refer urgently. Say the words sudden distortion.

The Macular Society run a helpline on 0300 3030 111 and local groups.

RNIB provide practical support with technology, benefits and daily living.