by Audrey Demmitt, R.N.

How Does Age-Related Macular Degeneration (AMD) Damage the Retina?

AMD affects the center portion of the retina, called the macula. This area helps us see up-close and in detail like when we read, thread a needle, or recognize a friend’s face. The macula is damaged by fatty deposits of drusen and it thins out in the dry form of AMD. In wet AMD, the damage is caused by fluids and blood leaking under the retina, forming blisters. If left untreated, retinal scarring occurs and vision can be lost permanently. These changes in the macula will cause distortions like blurriness, white, gray, or black spots, and wavy or broken lines in the field of vision. The Amsler Grid can help pick up these distortions and monitor changes in your vision. There are treatments that can dry out the fluid and stop the leaking and preserve vision if received in time.

Explanation of the Amsler Grid

Once age-related macular degeneration has been diagnosed, your eye care professional may give you an Amsler Grid to use at home as an early warning system for changes in age-related macular degeneration, particularly a change from dry to wet AMD. The macula is particularly sensitive to horizontal and vertical lines; therefore, waviness, distortion, or missing lines on the grid may be noticed before a change in visual acuity.This black and white grid looks like graph paper with a small black dot at its center. AMD is a progressive disease which causes gradual visual changes that may not be noticed. This simple testing tool can effectively detect visual changes caused by AMD.

The first image below shows an Amsler Grid as seen with normal vision. The next image is how the Amsler Grid may appear to a person with age-related macular degeneration. These images of the grids are much smaller than normal size so that we can show them to you on this website. If you have been diagnosed with age-related macular degeneration, ask your eye care professional for a real Amsler Grid you can use at home. You can also download a free Amsler Grid from the BrightFocus Foundation or request a magnetic version of the Amsler Grid by calling 1-855-345-6637. Note: this screening test does not replace the need for regular eye exams.

Amsler grid as seen with normal vision
Amsler Grid As Seen with Normal Vision
amsler grid as seen with AMD
Amsler Grid as Seen with AMD

How To Use An Amsler Grid

The American Academy of Ophthalmology (AAO) recommends people with AMD use the Grid to check their eyesight once a day, every day. Follow these steps:

  1. Wearing any glasses you normally use to read, hold the grid 12 to 15 inches away from your face in good light.
  2. Cover one eye.
  3. Look directly at the center dot with your uncovered eye and keep your eye focused on it.
  4. While looking directly at the center dot, notice in your side vision if all grid lines look straight or if any lines or areas look blurry, wavy, dark, or blank.
  5. Follow the same steps with the other eye.
  6. The first time you look at an Amsler Grid, take note of any irregularities in the grid and where they appear in the four quadrants. Think of this as your baseline. Now if any changes occur, contact your retinal specialist immediately.

This simple daily routine will take less than a minute and can be sight saving. Remember: Early detection of vision changes means timely treatment that can save your vision. To find out more, Watch this video by the AAO on how to use an Amsler Grid.


Have AMD? Save Your Sight with an Amsler Grid – American Academy of Ophthalmology (