Macular degeneration is one of the leading causes of vision loss. Almost 20 million U.S. adults have the disease. Globally, it is projected that 288 million people will have the condition by 2040. The image above shows a visualization of how macular degeneration can affect vision. 

In this article, Ability Central answers seven frequently asked questions about macular degeneration, including:

• What is macular degeneration?
• What is central vision loss?
• What causes macular degeneration?
• What are the two types of macular degeneration?
• What are the three stages of macular degeneration?
• Is there a cure for macular degeneration?
• How does macular degeneration affect communication?

What is macular degeneration?

Macular degeneration is a progressive eye disease. It affects the center of the retina, called the macula. Someone with macular degeneration loses central vision while peripheral vision--what you see "out of the corner of your eye"--remains intact. 

Macular degeneration can occur in one or both eyes. It is a leading cause of vision loss in people over 50. The disease is most common in people over age 60, so it is often referred to as age-related macular degeneration (AMD).

What is central vision loss?

Central vision is used to read, drive, and see pictures or faces. With macular degeneration, the center of vision worsens over time. When looking at a clock, for example, a person with macular degeneration may see the numbers without seeing the hands.

People with more serious central vision loss experience difficulty with:

• Reading
• Driving
• Recognizing faces
• Playing sports
• Watching television
• Cooking
• Walking without tripping or falling

What causes macular degeneration?

Specialists do not know the underlying causes of macular degeneration. However, there are certain health conditions that have been linked to the disease. Known risk factors include:

• Diabetes, particularly if it is not closely managed. Untreated diabetes has also been linked to health conditions like glaucoma. 
• Diet. A diet high in fat increases your risk of macular degeneration.
• Genetics. You are more likely to have macular degeneration if someone in your family has had the disease.
• Head injuries.
• High blood pressure.
• Infections.
• Race. People of Caucasian descent are more likely to have macular degeneration than people with African or Latinx ancestry. 
• Sex. Females are more susceptible to macular degeneration than males.
• Smoking. Besides its other harmful side effects, smoking more than doubles your risk of developing macular degeneration. 

What are the two types of macular degeneration?

The two primary types of macular degeneration are wet and dry.

Most people with macular degeneration have the dry (atrophic) type. Dry macular degeneration usually progresses slowly over several years, as cells in the macula slowly break down. This causes blurring and blank spots in the eye's central vision. Symptoms start out subtle, but progress over time.  

Approximately 20% of macular degeneration cases are “wet” (exudative) type. With wet macular degeneration, leaky blood vessels grow to compensate for the functional problems created by dry macular degeneration. The transition to wet macular degeneration can be sudden, accompanied by dramatic central vision loss. It is possible to avoid this if you work closely with your eye care specialist to monitor the progression of your dry macular degeneration and report any changes to your doctor right away.

What are the three stages of macular degeneration?

Dry macular degeneration has three stages.

• Early: Early on, the macula changes, but vision isn’t affected. An eye care provider may see signs during an exam before you notice a problem.
• Intermediate: At this stage, vision may become blurry or wavy. 
• Late (advanced): Central vision is completely gone by this stage.

Wet macular degeneration, which always begins as dry macular degeneration, is only possible in an advanced stage.

Is there a cure for macular degeneration?

There is no cure for macular degeneration, but early intervention can slow the progression of the disease and make symptoms less severe. Treatments may include:

• Nutritional supplements
• Medication
• Photodynamic therapy (PDT)
• Laser therapy

How does macular degeneration affect communication?

Living with macular degeneration can impact your ability to both communicate and receive communication. People with macular degeneration may experience:

• Loss of nonverbal cues. With macular degeneration, the lack of central vision may limit or eliminate the nonverbal communication of facial expressions. It may also eliminate lip reading.
• Reading limitations. The disease may limit your ability to receive information in written form, including books and newspapers.
• Smartphone limitations. With macular degeneration, it may become necessary to use speech technology on your smartphone as the center of the screen may no longer be legible.

If you are having difficulty using your smartphone, consider enabling the accessibility features. Ability Central offers information on a wide variety of mobile devices to meet your changing vision needs.

Where can I get more information about macular degeneration?

Ability Central offers a series of articles to further your knowledge about macular degeneration. See:

• Macular Degeneration: Symptoms and Early Signs
• Macular Degeneration: First Steps After Diagnosis
• Macular Degeneration: Planning for Long-term Care

For more information on conditions related to macular degeneration, see: 

• Top 7 Signs You Might be Losing Your Vision
• Early Signs and Symptoms That Someone May Be Deafblind
• Next Wave of Video-Accessibility Technologies for The Blind