Macular degeneration is diagnosed with a comprehensive eye exam. This involves dilating your eyes and undergoing various tests to assess your vision and eye health.
Macular degeneration is the breakdown of the central part of your retina, the special layer of cells at the back of your eye that allows you to see. Macular degeneration may be caused by age-related changes in your eye, genetic diseases, or complications of other medical conditions.
People with macular degeneration may notice changes to their central vision, such as distortion or blurriness. It’s essential to see an eye doctor whenever you experience changes in your vision.
The first step to your diagnosis will likely be a comprehensive eye exam performed by an ophthalmologist or optometrist.
This article reviews how macular degeneration is diagnosed and what tests you may receive.
A comprehensive eye exam is a thorough evaluation of your eyes and vision. It’s called a “comprehensive” exam because it’s an all-over examination of your eye.
Eye doctors use a comprehensive eye exam to help diagnose a particular condition if you develop symptoms. It may include some or all of the following tests.
Eye dilation
You’ll likely receive eye drops during your exam to dilate your eyes and allow doctors to see the structures at the back of your eye.
Ophthalmoscopy (Fundoscopy)
Fundoscopy is the main test doctors use to look at your retina during a comprehensive eye exam. After your eyes are dilated with drops, your doctor will examine the back of your eye through a special tool called a fundoscope.
Most optometrists and ophthalmologists use direct and indirect ophthalmoscopes to view the retina. Primary care physicians and neurologists usually use the fundoscope.
Visual acuity test
A visual acuity test measures the ability of each of your eyes to distinguish shapes at a certain distance. It’s usually performed by having you read characters on an eye exam chart from a set distance.
Visual refraction eye test (vision test)
A refraction assessment, more commonly called a vision test, helps your eye doctor determine if you need corrective lenses. An optimum result is 20/20, which means you’re able to read letters that are 3/8ths of an inch tall 20 feet away.
Your eye doctor will first assess how light bends as it moves through your cornea and the lens of your eyes. This test helps your doctor determine whether you need corrective lenses.
If you need corrective lenses, your doctor will have you sit in front of a Phoropter, which is a piece of equipment that resembles a large mask with holes for viewing.
Your doctor will test one eye at a time by asking you to read letters on a chart while looking through the lens of the Phoropter.
Your doctor will change the lenses on the Phoropter, asking you each time which lens is the clearest. When your doctor is finished, they will have a prescription that comes closest to giving you 20/20 vision.
Visual field test
A visual field test helps your eye doctor determine your central vision and peripheral vision range. There are many different types of visual field tests.
Slit-lamp exam
During a slit lamp exam, your doctor uses a special microscope called a slit lamp to look at the front parts of your eye, such as your:
- cornea
- macula (the part of the retina at the back of your eye)
- lens
- iris
- anterior chamber
Intraocular pressure test
An intraocular pressure test helps screen for glaucoma. Either a burst of air will be applied to your eye, or a handheld instrument will be gently pressed against your eye to measure the pressure inside your eye.
Color vision test
A color vision test measures your ability to distinguish colors. It often involves looking at pictures made up of two colors, such as red and green. People with color blindness will have trouble seeing the contrast between these colors.
Corneal topography
Corneal topography is a test to examine the shape of your cornea. During the test, you’ll look into a large bowl with lighted circles while your eye doctor takes pictures.
It’s worth noting that doctors typically do not check color vision or corneal topography if they suspect macular degeneration.
Several types of imaging are used to help diagnose macular degeneration, including the following:
Optical coherence tomography (OCT)
OCT is a type of imaging that takes about 5 to 10 minutes to complete and should be painless.
OCT is the most common type of imaging for macular degeneration. It allows doctors to visualize the macula and surrounding structures.
Visible light OCT
Visible light OCT is an emerging imaging technique that uses visible light instead of near-infrared light. This change may increase the contrast of the image in certain situations.
OCT angiography (OCTA)
Doctors may decide to use
Fluorescein angiography
Fluorescein angiography is often used to assess active blood vessel leaking during wet macular degeneration. It involves injecting a fluorescent dye into your bloodstream and then taking photographs of your eye.
Indocyanine green angiography
Fundus autofluorescence imaging
Some forms of macular degeneration are caused by genes inherited from one or both parents. Your doctor may send you for a genetic test if they suspect you may have a genetic condition such as Best disease or Stargardt’s disease.
Genetic tests are typically performed using a small blood sample.
After your doctor has completed their diagnosis, it’s important to follow their treatment recommendations. The particular treatment you need depends on your underlying condition.
For mild cases of dry ARMD, a doctor may recommend that you come in for a checkup every year or every 6 months. A doctor may also have you self-monitor your eyes with an Amsler grid every week, looking for vision changes such as wavy lines.
Those with advanced wet ARMD may require monthly injections. The monthly injections may become more spaced out as the treatment goes on.
Here are some frequently asked questions people have about macular degeneration.
An optometrist may be able to diagnose early signs of macular degeneration with a comprehensive eye exam. They’ll likely send you to a specialist for treatment.
The first sign of macular degeneration is often blurriness or distortion in your central vision. It’s important to visit your eye doctor if you notice either of these symptoms.
Macular degeneration can be mistaken for some other conditions, such as retinal detachment or epiretinal syndrome. It’s important to seek medical attention if you develop potential signs of macular degeneration so your eye doctor can make a proper diagnosis.
A comprehensive eye exam is the most common way macular degeneration is diagnosed. This collection of tests provides a thorough evaluation of your eyes and vision.
If you notice changes to your vision, it’s important to seek medical attention as soon as possible. Getting a diagnosis as soon as possible often improves the outcomes of macular disease.