To diagnose macular degeneration, doctors can use the Amsler grid and other diagnostic tools to check the macula, the part of the retina at the back of the eye. Doctors may spot early symptoms, such as distorted vision and blind spots.

Macular degeneration affects a part of the eye known as the macula. It is a condition that can cause severe loss of vision over time. Macular degeneration is a common condition, accounting for roughly 8.7% of worldwide cases of blindness.

This article will discuss the diagnostic use of the Amsler grid, its limitations, and other methods for diagnosing macular degeneration. It also gives a brief overview of macular degeneration.

An example of the Amsler gridShare on Pinterest
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The Amsler grid is a square grid of 10 centimeters (cm) by 10 cm, which allows users to detect eye dysfunction symptoms such as distorted vision and blind spots.

Healthcare professionals typically ask people to use the Amsler grid at home to self-monitor symptoms. Professionals can then use more sophisticated diagnostic methods in a clinical setting if necessary.

An early diagnosis can make a large difference to the outlook of those with macular degeneration, as it can help prevent significant vision loss.

Read more about the diagnosis using the Amsler grid.

How doctors use it

In the first instance, the medical professionals must illuminate the grid and place it 33 cm away from the person’s eyes. They may wear corrective lenses if necessary. The medical professionals will then ask them to close one eye and look at the central dot on the Amsler grid.

At this point, it is up to the individual to notice and report any visual problems. Distorted lines on the Amsler grid indicate visual distortions, while missing or blurring squares may indicate blind spots.

The medical team will then ask the individual to mark these visual abnormalities on the grid so that doctors can compare their results for any:

  • improvement
  • stabilization
  • deterioration

Doctors encourage people to use the Amsler grid at least once a week to check their eyesight. People can obtain a grid from their eye doctor or can save or download the version in this article.

If a person cannot see the corners, doctors will also test for other eye diseases, such as glaucoma and retinitis pigmentosa.

Is the Amsler grid effective?

An increasing number of eye doctors, or ophthalmologists, claim that the Amsler grid is an unreliable tool for diagnosing macular degeneration.

The Amsler grid is not always effective for monitoring vision. In some instances, people’s brains may complete missing details or distorted lines on the grid, which could cause slight visual abnormalities to go without detection.

Therefore, Amsler grids may not always provide a precise measure of how the disease progresses, as the results may vary from one screening to the next.

For this reason, doctors may also use other diagnostic tests to determine whether someone has macular degeneration.

A 2020 review provided information about the main diagnostic tests for macular degeneration. These tests can often be safe, though some can be more invasive. Diagnostic methods for macular degeneration include:

  • Funduscopic evaluation with dilated pupils: This test involves using a medicated eye drop to dilate a person’s pupils. This allows doctors to look more closely at the fundus of the eye.
  • Macular layer imaging with optical coherence tomography (OCT): OCT is an accurate method for diagnosing retinal diseases. Using OCT, healthcare professionals can differentiate different macular degeneration types such as geographic atrophy and wet age-related macular degeneration.
  • Fluorescein angiography (FA): FA allows eye doctors to acquire images of the choroidal, which is the layer beneath the retina, and retinal circulation. This technique also provides detailed information about the presence of pathological vessels and the integrity of the blood-retinal barrier.

The macula is a major component of the retina and is responsible for central vision. For this reason, people with macular degeneration experience vision problems that can worsen over time.

In the initial stages of the condition, people with macular degeneration may experience vague or mild visual problems.

There are two types of macular degeneration: dry and wet.

Dry macular degeneration

This type of macular degeneration develops gradually over time and is the more common form.

Wet macular degeneration

This type is less common but can be more serious, as blood vessels develop under the macula, leading to blood and fluid buildup and leaks.

Without treatment, many people can experience vision loss. Treatments, such as anti-vascular endothelial growth factor injections, may help reduce this loss, but they cannot cure macular degeneration.

Symptoms

Macular degeneration symptoms may develop over time but can gradually worsen, such as:

  • blurred vision and less defined
  • slow recovery of visual function after exposure to bright light
  • blind spots that usually occur with wet macular degeneration and affect central vision
  • objects looking smaller
  • not recognizing people’s faces

If eye doctors, known as ophthalmologists, do not treat macular degeneration, the condition can worsen and cause vision loss.

People experiencing any of the above symptoms must speak with a doctor as soon as possible.

Risk factors

Some people may be at an increased risk of developing macular degeneration. Risk factors for this condition may be demographic factors — it tends to be common in women and in people more than 60 years old. Other risk factors can include lifestyle factors such as smoking and having high blood pressure.

Although macular degeneration can lead to serious vision problems, early diagnoses can greatly improve the outlook of people who have it.

The outlook for those with macular degeneration depends upon when and how soon they receive a diagnosis and treatment. Without treatment, macular degeneration can likely cause vision loss. However, treatment can help preserve a person’s vision.

People with macular degeneration may experience psychological distress and lose some independence due to their vision. Individuals can seek support from their relatives, family, and medical professionals to ensure their vision does not affect other aspects of their lives.

The Amsler grid may help some people notice certain macular degeneration symptoms. However, doctors must run further tests to diagnose this condition safely.