If you or someone you love has recently been told they have macular degeneration — or if you’re noticing changes in your central vision — you’re not alone. Macular degeneration is the leading cause of vision loss in Americans over 50, affecting more than 11 million people in the United States. In Oregon, where our population includes a large and growing number of adults over 60, it’s one of the most common conditions we treat at Retina Care.
The good news is that early detection and modern treatment have transformed what this diagnosis means. Understanding your condition is the first step toward protecting your vision. This guide covers everything Oregon patients need to know — from what the macula actually does, to the difference between wet and dry forms, to the latest treatment options available today.
What Is the Macula — and Why Does It Matter?
Your retina is the thin layer of light-sensitive tissue at the back of your eye — think of it as the film in an old camera. The macula is a small, specialized area at the center of the retina, roughly the size of a sesame seed. Despite its size, it’s responsible for nearly all of your sharp, detailed central vision: reading, recognizing faces, driving, watching television, and seeing fine detail.
When the macula is healthy, central vision is crisp and clear. When it deteriorates, the center of what you see becomes blurry, distorted, or — in advanced cases — dark and blank, while peripheral (side) vision typically remains intact.
What Is Macular Degeneration?
Age-related macular degeneration (AMD) is a disease in which the macula progressively breaks down over time. The exact cause involves a combination of aging, genetics, and lifestyle factors. The result is a gradual — or sometimes sudden — loss of central vision.
AMD does not cause total blindness. Peripheral vision is preserved. But the loss of central vision is life-altering: it can make reading impossible, make faces unrecognizable, and make driving unsafe.
Dry vs. Wet Macular Degeneration: What’s the Difference?
There are two forms of AMD, and understanding the difference matters enormously for treatment.
Dry Macular Degeneration (Atrophic AMD)
Dry AMD is by far the most common form, accounting for roughly 85–90% of all AMD cases. It occurs when tiny yellow protein deposits called drusen accumulate under the macula, causing the retinal tissue to thin and slowly break down over time.
Dry AMD typically progresses slowly — over years or decades — and is divided into early, intermediate, and advanced stages. The advanced stage of dry AMD is called geographic atrophy (GA), in which patches of the retinal cells die off entirely, creating permanent central vision loss.
Key facts about dry AMD:
- Progresses slowly in most patients
- Both eyes are often affected
- Symptoms include gradual blurring of central vision, difficulty reading in low light, and needing brighter light for close-up tasks
- Until recently, there was no approved treatment — but that has now changed (more on this below)
Wet Macular Degeneration (Neovascular AMD)
Wet AMD is less common (10–15% of cases) but far more aggressive. It occurs when abnormal, fragile blood vessels grow underneath the macula and leak blood or fluid — hence the term “wet.” This leakage rapidly damages macular cells and can cause severe central vision loss in a matter of days or weeks.
New Wet AMD needs to be treated promptly. If you notice sudden changes in your central vision — a new dark spot, sudden distortion, or wavy lines where there should be straight ones — contact a retina specialist immediately.
Key facts about wet AMD:
- Can progress rapidly — vision loss can occur within days
- Highly treatable with modern injections if caught early
- Symptoms include sudden blurring, distortion (straight lines appearing wavy), and a dark or blank spot in central vision
- The Amsler grid (a simple checkerboard pattern) is a useful daily monitoring tool
Symptoms to Watch For
AMD often develops without pain and with subtle early symptoms. Many Oregon patients are unaware they have it until a routine eye exam catches early signs. Warning signs to take seriously include:
- Blurred or fuzzy central vision
- Difficulty reading fine print, even with glasses
- Colors appearing less vivid or washed out
- A dark, blurry, or empty area in the center of your vision
- Straight lines appearing wavy, bent, or distorted
- One eye seeming noticeably worse than the other
- Needing significantly more light to read or do close work
If you notice sudden changes in your vision — especially distortion or a new dark spot — do not wait for a scheduled appointment. Call Retina Care at (541)-873-8462 to get an urgent macular degeneration exam and consultation.
Risk Factors for AMD
Anyone can develop macular degeneration, but certain factors increase the risk:
- Age — Risk rises significantly after 60, and increases further with each decade
- Family history — AMD has a strong genetic component; if a parent or sibling has it, your risk is substantially higher
- Smoking — The single most modifiable risk factor; smokers are 2–4x more likely to develop AMD
- Race — AMD is more common in Caucasians than in other populations
- Cardiovascular disease — Heart disease, high blood pressure, and high cholesterol are associated with higher AMD risk
- UV exposure — Prolonged sun exposure without UV-protective eyewear may contribute
- Obesity and diet — A diet low in leafy greens and high in processed foods is associated with increased risk
How Is Macular Degeneration Diagnosed?
Diagnosis requires a dilated eye exam by a retina specialist. At Retina Care, Dr. Peter Karth uses several tools to evaluate the macula in detail:
- Dilated fundus exam — Direct examination of the retina after dilating drops widen the pupil
- Optical coherence tomography (OCT) — A non-invasive imaging scan that produces detailed cross-sectional images of the retinal layers, detecting even subtle fluid or structural changes
For patients with a family history of AMD, early baseline imaging is strongly recommended — catching the disease in its early stages dramatically improves outcomes.
Treatment Options for Macular Degeneration
Treatment depends on the type and stage of AMD.
Treating Dry AMD
For early and intermediate dry AMD, there is currently no approved medication to stop progression, but lifestyle changes and nutritional supplementation can slow it meaningfully. The AREDS2 formula — a specific combination of vitamins C, E, zinc, copper, lutein, and zeaxanthin — has been shown in large clinical trials to reduce the risk of progression to advanced AMD by about 25%.
For advanced dry AMD (geographic atrophy), two FDA-approved treatments now exist for the first time: Syfovre (pegcetacoplan) and Izervay (avacincaptad pegol), both approved in 2023. These are administered as eye injections and work by slowing the rate of retinal cell loss. While they do not restore lost vision, they represent a major step forward for patients who previously had no treatment options. Dr. Peter Karth offers both treatments at Retina Care.
Treating Wet AMD
Wet AMD is treated with anti-VEGF injections — medications injected into the eye to block the abnormal blood vessel growth that causes leakage and vision loss. When started promptly, these treatments can not only halt vision loss but in many cases improve vision significantly.
Currently available anti-VEGF medications include:
- Vabysmo (faricimab) — A top level medication
- Eylea HD — A safe and well-established, highly effective option, that is the best or one of the best
- Eylea (aflibercept)
- Lucentis (ranibizumab)
- Avastin (bevacizumab) — Used off-label but widely effective and more affordable
The thought of an injection in the eye understandably concerns many patients. In practice, the procedure takes only a few minutes, is performed with numbing drops, and is well-tolerated by the vast majority of patients. Many people say it is far easier than they expected.
Living With Macular Degeneration
A diagnosis of AMD does not mean you’ll lose your independence. Many patients live full, active lives with AMD, especially when the condition is caught early and managed carefully. Practical strategies include:
- Using bright, focused task lighting for reading and close work
- Magnifying readers or electronic readers with adjustable font sizes
- High-contrast settings on smartphones and computers
- Large-print books and audiobooks
- Low-vision rehabilitation services, which teach adaptive techniques
Why See a Retina Specialist?
Macular degeneration is a disease of the retina, and managing it well requires retina-specific expertise. A retina specialist has completed four years of medical school, a four-year ophthalmology residency, and an additional two year fellowship dedicated exclusively to diseases of the retina and vitreous.
At Retina Care, retina care is all we do. Dr. Peter Karth is a Stanford-trained, fellowship-trained retina specialist — a Fellow of the American Society of Retina Specialists (FASRS) and a Fellow of the American College of Surgeons (FACS). Every exam, every treatment, and every surgical procedure is performed by Dr. Peter Karth personally. Patients across Oregon — from Eugene/Springfield and Roseburg and Salem to the Oregon Coast communities of Bandon, Brookings, and Coquille — come to Retina Care because they want to see a specialist, not a generalist.
Protecting Your Vision Starts Now
Macular degeneration is a serious condition, but it is no longer one that patients face without options. Modern imaging, proven nutritional strategies, anti-VEGF injections for wet AMD, and now the first-ever treatments for geographic atrophy have changed the outlook dramatically. The most important thing you can do is not wait — early detection gives you the best possible chance of preserving your vision for the years ahead.
At Retina Care, retinal specialist Peter Karth, MD, MBA, FASRS, FACS is happy to help you with your retina concerns. Please call 541-873-8462 to schedule an appointment at a location near you.