Macular Degeneration Testing at Home and in Aged Care

The condition

What is macular degeneration?

Macular degeneration damages the macula, the small central part of the retina that handles detail. Central vision fades while peripheral vision stays, so it does not cause total blindness.

The macula is what you read with, recognise faces with, and watch television with. One in seven people over the age of 50 have some evidence of macular degeneration.¹

Straight lines suddenly looking bent, or a new dark or empty patch in the centre of vision, needs same day attention. Do not wait for a scheduled visit.²

Symptoms

What are the symptoms?

Straight lines start to look bent or wavy. Door frames, lamp posts and window edges are usually where it is noticed first.

A dark or empty patch appears in the centre of your vision. Faces become harder to recognise across a room, and reading gets harder even with the right glasses.

Distortion is often the first thing a person notices themselves, which is why the Amsler grid is worth using weekly.

Types

Dry and wet

Dry

The slow form, and most cases. It develops over years. Management is monitoring, diet and not smoking.

Wet

Abnormal blood vessels grow beneath the retina and leak. It can take central vision in weeks. It is treated with injections, and treatment started early holds more vision.

Risk

Who is at higher risk?

Age. One in seven people over 50 show some evidence of it, and almost 15 per cent of Australians over 80 have vision loss or blindness from it¹
Smoking. Smokers are three to four times more likely to develop it, and may develop it five to 10 years earlier than non smokers.¹ It is the one risk factor you can change
Family history. A parent or sibling with macular degeneration gives you a 50% chance of developing it¹
Cardiovascular risk, including high blood pressure
Diet. Leafy green vegetables and fish are recommended, along with protecting your eyes from strong sun

Testing

How is macular degeneration tested?

Retinal imaging

Photography of the retina and macula through the slit lamp, kept on file. Change shows as a difference between one year's image and the next.

Macular examination

The macula examined with a diagnostic lens for drusen, pigment change, fluid and haemorrhage.

Amsler grid

Checked at the appointment, and one goes home with you.

Vision and reading

Distance and near acuity measured properly. A drop in reading vision with intact distance vision points at the macula.

Your history

Age, smoking status, family history, cardiovascular history and diet.

Lighting and low vision

Where central vision has already been lost, practical advice on lighting, contrast and magnification, and referral to Vision Australia where it is warranted.

Results

What happens if we find something?

01

No change

Images go on file as a baseline and you are recalled at the interval that matches your risk. You keep the Amsler grid either way.

02

Early or intermediate

Drusen and pigment change documented and photographed, with a shorter review interval, plus advice on smoking, diet and self monitoring.

03

Suspected wet

Referred urgently. Injections for wet macular degeneration hold vision better when started before it has dropped.

04

Established loss

Magnification, lighting and contrast advice, larger print, and referral to Vision Australia where it will help.

Self monitoring

The 30 second check

Cover one eye, look at the centre dot of an Amsler grid, and check whether any lines bend, blur or go missing. Then swap eyes. Check weekly.

Distortion that was not there last week is worth a phone call.

In residential care

Macular degeneration in aged care

A resident who has stopped reading, stopped watching television or stopped recognising faces across a room is describing the macula. Flag them before a clinic day.

Retinal imaging carries the assessment where a resident cannot perform an Amsler grid, and what could not be tested is written into the report.

Where we test

Where does testing happen?

Testing happens in the clinic vehicle at your address, at your workplace, or at your village or aged care home. The instruments are installed and calibrated, and the examination is the same one you would have in a shopfront practice.

If you are already having injections, we work alongside your ophthalmologist, and the report goes to them and to your general practitioner.

Questions

Questions about macular degeneration

How common is macular degeneration?

One in seven people over 50 have some evidence of it, and almost 15% of Australians over 80 have vision loss or blindness from it.

What is the difference between dry and wet?

Dry is the slow form and accounts for most cases. Wet is where abnormal blood vessels grow under the retina and leak, and it can take central vision in weeks rather than years. Wet is the form treated with injections, and treatment started before vision drops holds more of it.

What are the warning signs?

Straight lines that look bent or wavy, a blurred or empty patch in the centre of vision, colours looking washed out, and needing much more light to read than you used to. Any of these appearing suddenly needs same day attention.

What is an Amsler grid?

A printed grid of straight lines with a dot in the middle. You look at the dot with one eye covered and check whether any lines bend, blur or disappear. It takes 30 seconds and it is free. We leave one with you.

Can it be prevented?

Not entirely, because age and family history cannot be changed. Smoking can. Smokers are three to four times more likely to develop macular degeneration and may develop it 5 to 10 years earlier than non smokers. Eating leafy green vegetables and fish, and protecting your eyes from strong sun, are also recommended.

Does it run in families?

Yes, strongly. People with a parent or sibling diagnosed with macular degeneration have a 50% chance of developing it themselves. If that applies to you, say so when you book.

Will I go blind?

Macular degeneration takes central vision, which is what you read and recognise faces with. It does not take peripheral vision, so it does not cause total blindness, and most people keep enough sight to move around independently.

Can you assess this in an aged care home?

Yes. Vision, an Amsler check where the resident can do it, and retinal imaging through the slit lamp are all workable at the bedside. Where a resident cannot perform the Amsler grid, that is recorded, and the retinal images carry the assessment instead.

Written and reviewed by

Ali Selman, Bachelor of Vision Science, Master of Optometry. AHPRA registered optometrist. Last reviewed 23 August 2026.

Sources

Macular Disease Foundation Australia. Risk factors for age-related macular degeneration. "If you smoke, you are three to four times more likely to develop AMD." "Smokers may also develop the disease five to 10 years earlier than non-smokers." "People with a parent or sibling diagnosed with AMD have a 50% chance of developing the condition themselves." "One in seven people over the age of 50 have some evidence of AMD." "Almost 15 per cent of Australians aged over 80 have vision loss or blindness from AMD." mdfoundation.com.au
Royal Victorian Eye and Ear Hospital. Primary Care Referral Guidelines, Ophthalmology, March 2026. Sudden vision loss and acute visual field defects require immediate referral. eyeandear.org.au
Medicare Benefits Schedule, items 10910, 10911 and 10931. mbsonline.gov.au

Macular degeneration testing at your address