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Retina

Macular degeneration

One of the top three blinding diseases —
a major retinal condition easily mistaken for simple presbyopia.

The macula is the central retinal area densely packed with photoreceptors that distinguish colour and shape,
responsible for over 90% of vision.

Macular degeneration damages these photoreceptors as waste accumulates
or abnormal new blood vessels grow.

Missing the right treatment window reduces central vision
and, in severe cases, can lead to blindness.

Types of macular degeneration

Dry (non-exudative)
Waste (drusen) builds up in the retina, atrophying the macula.
Almost no early symptoms; vision declines gradually.
Accounts for the majority of macular degeneration.
Needs follow-up through regular checkups.
Category
Features
Symptoms
Proportion
Management
Wet (exudative)
Abnormal new vessels grow beneath the macula.
Vision declines fast and objects appear bent.
Less common but carries a high risk of blindness.
Early diagnosis and immediate treatment are essential.

Main AMD symptoms

More than vision loss — watch for the signs of macular degeneration.

  • Visual distortion

    Visual distortion

    Centre of objects looks bent,

    straight lines (grids, tiles) appear curved.

  • Central scotoma

    Central scotoma

    A dark spot appears in the centre,

    or part of the view looks empty.

  • Reduced contrast

    Reduced contrast

    Colours and outlines look hazy,

    making light and dark hard to tell apart.

  • Sudden vision loss

    Sudden vision loss

    Central vision drops so sharply that

    detailed tasks like reading or driving become hard.

Causes of macular degeneration

Macular degeneration most commonly arises with aging, and various other factors can also contribute.

  • Aging

    Aging

  • Genetics

    Genetics (e.g. macular dystrophy)

  • High myopia

    High myopia (myopic AMD)

  • Inflammation and trauma

    Inflammation & trauma

  • Smoking and lifestyle

    Smoking & lifestyle

  • Underlying conditions

    Underlying conditions

Self-screening with the Amsler grid

  1. STEP 1Prepare

    Wear your usual glasses or lenses and view the grid in a bright room.

  2. STEP 2Gaze at the centre

    From about 30 cm, cover one eye and gaze at the round dot in the centre of the grid.

  3. STEP 3Check your vision

    Keeping your eyes fixed on the centre dot, check whether the surrounding lines look straight.

  4. STEP 4Test the other eye

    Repeat the same test with the other eye to check for any visual field abnormality.

Amsler grid as seen with normal vision
Normal
Amsler grid distorted by macular degeneration
Macular degeneration
  • The central dot looks blurry or hard to see
  • Lines look bent or broken
  • You cannot see all four corners of the grid
  • The squares do not look uniform in size

Macular degeneration treatment

  • Lifestyle management

    Lifestyle management

  • Medication

    Medication

  • Intravitreal injection

    Intravitreal injection

  • Laser treatment

    Laser treatment

  • Surgical treatment

    Surgical treatment

Macular hole

A hole at the centre of vision — fast action prevents blindness

A macular hole is a small hole that forms in the macula at the centre of the retina.

It mostly occurs in women in their 50s-60s,

and if left untreated, vision declines very rapidly.

Macular hole
  • Idiopathic (age-related)

    Occurs naturally as the vitreous pulls on the retina, with no specific cause.

  • Traumatic

    In younger people, caused by a strong impact to the eye.

  • Other

    Triggered by conditions such as high myopia or epiretinal membrane.