How to Diagnose Macular Degeneration

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How to Diagnose Macular Degeneration

Making the Diagnosis of Macular Degeneration, Retina Eye Doctor

Prevent Blindness America has declared February as “Age-Related Macular Degeneration Awareness Month.”  Making the diagnosis of macular degeneration is usually very straightforward and is based upon your age, your vision and the appearance of your retina.

The “Age-Related” in Macular Degeneration

Age related macular degeneration, or ARMD, certainly increases in prevalence as we get older, that is, the number individuals affected increases as we age.  BUT, this does not mean we are all destined to get the disease.

Overall, I hesitate to diagnose the disease in patients less than 55 years old.  Can a 50 year old have the disease?  Certainly, but not a 20 year old (they must have something different).

So, there is an age requirement:  age > 55.

Your Vision Must be Affected

By definition, the disease is a bilateral (affects both eyes) and causes degeneration of the macula and, thus, decreased central sight.

Remember, the macula is the center of the retina.  It gives us central vision, ability to read fine print and our color vision.

When your vision is tested with the “Snellen” chart (that’s the chart that starts with the big “E” at the top), we are testing only how well your macula functions (as opposed to peripheral sight).

If you your vision is 20/20, it’s hard to say you have any loss of vision caused by a disease.

Your Examination

The examination of your retina is a key to diagnosing macular degeneration.  There are characteristic changes in the appearance of your retina that identify certain patients with macular degeneration.

To diagnose ARMD, I look for pigmentary changes, drusen, loss of pigment, fluid, blood, etc., to make the diagnosis.  Often, I perform a fluorescein angiogram to aid in the diagnosis.

What Does This Mean?

Well, in a nutshell, this means that it is usually pretty easy to diagnose patients with macular degeneration.  Sometimes the diagnosis is difficult, say when the retina appears to have the disease, but the vision is normal.

I get comments all the time about patients who have drusen and wondering if they have, or will have, macular degeneration.

  • Kara February 8, 2011 at 7:20 pm

    Dr. Wong,
    You have a Great website, I stumbled upon it a few weeks ago researching a paper for class. I’m a COA studying at school for COMT, and you had current info on DME. You have many good articles and very readable also, thanks for your email newsletter

    • Randall V. Wong, M.D. February 8, 2011 at 7:34 pm

      Dear Kara,

      Thanks for the compliment. Best of luck with the COMT! It says alot about you!

      Study hard.


  • Razia Iqbal February 10, 2011 at 8:18 am

    Can you please clarify that if one of the eyes gets affected with age related Mucular degeneration, can the other remains unaffected with suitable vitamins etc. Or in any case the disease does travel to the other eye also?

    Can you suggest suitable measures to keep the other eye safe?

  • archie hill March 22, 2011 at 4:39 pm

    Hi Dr.
    my wife who is 49 years of age was diagnosed 2 years ago with m.d because she has soft drusen in both eyes her sight is still good 2 years on .
    ive picked up information from your website (which is great) why hasnt her optomologist insisted on a fluorescein angiogram.

    much obliged.

    • Randall V. Wong, M.D. March 23, 2011 at 8:42 am

      Dear Archie,

      In the U.S. only an ophthalmologist, vs, optometrist (not sure which you meant), can perform a fluorescein angiogram and more usually only a retina specialist would perform such a study.


  • Don W September 3, 2011 at 10:01 pm

    Dr. Wong,

    Just exactly, what are your rules for using the Amsler Grid.


    • Randall V. Wong, M.D. September 4, 2011 at 9:36 pm

      Dear Don W,


      Place the grid on your refrigerator, next to your computer or in your bathroom. Under the same conditions each day (i.e. same distance, same lighting, with glasses/contacts or without) test one eye and then the other. If you haven’t noticed any changes then retest the next day. Placing the Amsler Grid in these locations makes it easy to test. Should take about 2 seconds!!!!

      My guidelines for my patients are that if there is any change that persists for greater than one day….call me, that is, call your doctor!


  • Carma Barker May 7, 2013 at 1:52 pm

    My 14 year old son was diagonosed with Macular Degeneration at Dayton Childrens Medical Center he was just treated with a eye pressure of 38 at ER He is now 23 should they be looking for something else?

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