VisionAware

By Lylas G. Mogk, M.D., Edited by Sefy Paulose, M.D.,March 2022

As you may not notice any signs of age-related macular degeneration, the best way to protect your sight from AMD is to have regularly scheduled annual eye examinations. During this examination, an ophthalmologist or optometrist will be able to assess how healthy your retina is and if you have any signs of AMD by doing a comprehensive medical eye examination. A condition called Late-Onset Retinal Degeneration (L-ORD) is often mistaken for regular macular degeneration, but in its severest state, affects both central and peripheral vision.

A Health and Medication History

• Your overall heath
• Questions about any other risk factors such as smoking, high blood pressure, obesity etc

Visual Acuity Testing

• Distance and near vision acuity tests to determine the sharpness or clarity of your reading and distance vision
• Testing your vision with different lenses (sometimes contained in a machine called a phoropter) to determine if your vision can be improved or corrected with regular glasses or contact lenses

 An Eye Health Evaluation

• Confrontation to visual fields
• Amsler Grid – this is a black and white grid with a small black dot at its center. Your doctor will have you wear your glasses as you normally would to read then hold the gride about one foot away from your face. They will ask you to cover one eye and look directly at the center of the dot. While looking directly at the center of the dot and using only your peripheral vision, your doctor will ask you if all the grid lines look straight or if any lines look blurry, wavy or dark. The same will be done for your other eye. Find out how to use an Amsler Grid to detect changes in your vision related to AMD.
• A special microscope, called a slit lamp, is used to examine the anterior segment of the eye (front third of the eyeball), including the cornea, pupil, iris, lens, and aqueous drainage structures.
• A dilated eye (or fundus) examination that can be achieved with the use of special lenses will allow your doctor to see inside your eye and examine the retina. Your doctor might choose to use eye drops to see the retina and optic nerve more clearly. During this exam, the doctor will examine your macula, or the center part of your vision, to see if there are any signs of AMD. You will then be asked to look in different directions so that your doctor can examine every section of your retina to assess for other signs of retinopathy.

OCT

• As discussed, your doctor is able to subjectively look at your macula to assess for any signs of AMD. However, your doctor may want to assess this objectively with a machine that takes a cross-sectional photo of your macula. This test is done through a non-invasive imaging test called an Optical Coherence Tomography, or OCT.
• The technician or ocular photographer will have you rest your head on a chinrest and look straight at a target. The machine will then focus on your macula and scan the area in order to see all the layers of the macula and assess for any changes. Your doctor will be able to view these results and assess progression of AMD by comparing these results with any past or future test results.