Macular Degeneration


Macular degeneration comprises a group of degenerative diseases of the retina that cause progressive, painless loss of central vision, affecting the ability to see fine detail, drive, read and even recognise faces.

Macular degeneration usually affects people over the age of 50 and becomes more common with increasing age. About 1 in every 10 Australians over the age of 50 have MD and up to 30% of people more than 80 are affected.

Symptoms of Macular Degeneration

Distortion of objects e.g. lines appear wavy or bend
Black patches or missing/blurry patches in the centre of your vision
Faces become hard to recognise
Difficulty with reading as lines are mildly distorted/wavy
Slow adaptation to dim conditions – such as coming inside to a dark room after being in strong sunlight
The symptoms of macular degeneration may  present slowly over a period of many years, with vision only becoming affected later in the course of the disease.

The most worrying change is the sudden onset of decreased vision, a blur or dim patch in the central vision and distorted vision.

Distortion & Loss of Central Vision (Scotoma)

Distortion & Loss of Central Vision (Scotoma)

If you have any of these symptoms, contact the Clinic immediately on 9411 5000 and mention these symptoms so you can be seen urgently.

These symptoms usually mean that an abnormal blood vessel (known as a choroidal neovascular membrane or ‘CNVM’) has formed under the retina. This is commonly called “wet” macular denegeration. Wet macular degeneration only develops in a minority of patients with AMD, but causes the greatest amount of vision loss. Effective treatment to stabilise and even improve vision is available, but the best results are achieved when treatment is begun as soon as possible

What happens to the eye?

Macular degeneration develops because the supportive layer under the retina, the RPE, degenerates. It is akin to the underlay under your carpet wearing out, so that the carpet itself is affected. Degeneration is due to the accumulation of waste products from the retina in the RPE, disrupting its function.

Normal OCT showing RPE

Normal OCT showing RPE

The main early change is the appearance of drusen (white deposits of debris under the retina) and some clumps of pigment. Gradually the RPE and the retina (the ‘underlay and the carpet’) wear out (this is called ‘atrophy’).



Atrophic change around the central macula

Atrophic change around the central macula

In some people, the damaged RPE lets an abnormal blood vessel grow under the retina (a CNVM). This is called wet AMD because the abnormal vessel leaks fluid and blood. Untreated, it leads to scar formation that destroys the central part of the macula, causing severe visual loss.

Choroidal Neovascular Membrane (CNVM or Wet MD)

Choroidal Neovascular Membrane (CNVM or Wet MD)

What treatments are available for Wet AMD?

Treatment of CNVM (Choroidal Neovascular Membrane), or wet Macular Degeneration , is very effective.
A long course of injections of Lucentis, Eylea or Avastin directly into the eye is effective at controlling the growth of the abnormal blood vessel. These medicines are antibodies that block the action of chemicals within the eye that cause abnormal blood vessels to grow.

Vision stabilises in most patients and improves significantly in about one third of people who are treated. A major determinant of final vision is the amount of damage done to the macula by the abnormal blood vessel, which is why early detection of the CNVM is so important.

Assessment and ongoing management of patients with CNVM is very specialised. retina consultants uses the most advanced imaging to detect and monitor wet AMD, and our staff are highly trained and experienced in the care of patients with this problem, with the aim of maximising the vision of our patients with macular degeneration and minimising the risks of treatment.

Can I prevent macular degeneration?

While there are no specific treatments for early AMD, there are some important measures that can be taken to minimise the risk of developing AMD and, perhaps, slow its progression.

The risk factors for developing AMD include age, family history, dietary factors and smoking.

If a close relative is affected, or you are a smoker, you are four times more likely to develop AMD than someone who does not have these risk factors.

To reduce your risk of developing AMD and to slow the progress of the disease:

Don’t smoke.
Eat a diet rich in vegetables, fruits, fish and low in both vegetable and animal fats. Even one fish meal per week has been shown to decrease the risk of vision loss by half in some studies.
Wear a hat and sunglasses when outside.
Have your eyes regularly examined by an ophthalmologist ( a medically trained eye doctor).
If examination of the retina shows changes of early AMD (i.e. drusen are present):The use of high dose antioxidant vitamins has been shown to decrease the risk of vision loss and to slow the progression of the disease.
There are a number of preparations available, but all include a combination of Vitamins C and E and zinc. Some include additional antioxidants such as Lutein and zeaxanthin and fish oil, although the benefit of these additional products hasn’t yet been proven.
Check your vision at home regularly. Check the vision in each eye separately, to check for the development of wet macular degeneration.  The use of a simple grid (known as an Amsler grid) helps in this test: look for the onset of blurred vision, a central dark patch or central distortion.

The Amsler Grid

The Amsler Grid is a way of checking for the major symptoms of AMD both at home and when you are seen by the Ophthalmologist.

To perform the Amsler Grid test:

Wear any glasses that you would normal use when reading
Cover one eye using the palm of your hand
Look at the centre spot on the Amsler grid from approximately 33cm away
Whilst looking at the centre dot, take note if there is any distortion, broken lines, black patches or missing areas.
Repeat by covering the alternate eye with the palm of your hand
If you notice any changes, please contact the Rooms immediately on 9411 5000

Amsler Grid

Amsler Grid

Please contact us to arrange an appointment

The Chatswood Eye Specialists Clinic has been servicing the community of Chatswood for over 35 years.  In 2016 we moved to our brand new clinic in the Chatswood Private Hospital building on Albert Avenue.  This new and exciting consulting suite features the latest ophthalmology equipment and technology.  Our Eye Specialists are leaders in their field and our highly trained Orthoptists are on hand to take you through any tests that may be required during your visit.  Please feel free to call one of the friendly reception staff if you would like to enquire about any of our services.

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