Seeing Through the Fog: Understanding Macular Degeneration

Helping with reading, driving and daily tasks, caregivers often serve as the ‘eyes’ for their loved ones

Paul Wynn,

AARP

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Published September 24, 2025

glasses with one lense being blurry while the other is clear

Marco Baccioli

In her early 40s, Jan* began noticing subtle but troubling vision changes. Driving at night felt risky, and road signs blurred into the dark. Like many people, she chalked it up to needing stronger eyeglasses. But under the care of her longtime eye doctor, she eventually learned the true cause: age-related macular degeneration, or AMD.

As Jan’s vision declined, once enjoyable activities like reading recipes and cooking favorite meals grew increasingly difficult. At their home in Cincinnati, her 82-year-old mom, Carolyn, reads recipes aloud, measures ingredients and keeps her daughter connected to the kitchen rituals she cherishes.

Three years ago, Jan, now 57, developed geographic atrophy (GA), an advanced form of dry AMD. She is legally blind in her left eye. Her doctor recommended a prescription eye injection given monthly to help slow progression of geographic atrophy in her right eye. Jan’s goal is to preserve her vision for as long as possible.

Still working as an administrative assistant, Jan relies on her mom not only to help her navigate daily life but also to keep her spirits up. “I call my mom ‘Eyes’ because she’s always there to help me see what I can’t, and to help me find the silver lining every day.”

What is age-related macular degeneration?

For nearly 20 million Americans, AMD is more than a medical term; it’s a daily challenge that can affect independence, mobility and quality of life. AMD damages the macula, a small part of the retina located at the back of the eye. The macula is responsible for sharp, central vision, which we rely on for activities such as reading, recognizing faces, driving and even seeing fine details on a smartphone or tablet.

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“Although significant advances have been made in treating AMD, it remains the leading cause of severe vision loss for adults over 50, affecting far more people than glaucoma,” says Dr. Jeffry Gerson, an optometrist in private practice in Olathe, Kansas.

There are two main types of AMD.

Dry AMD: This is the most common form of AMD, affecting about 85 to 90 percent of people with the condition. It develops slowly and is marked by thinning of the macula and the buildup of yellowish fatty deposits. As these deposits grow in size and number, the risk of developing wet AMD increases. Symptoms can include blurry or distorted vision, trouble seeing in low lighting and difficulty seeing fine details up close or at a distance. However, many people with dry AMD notice few or no changes in their vision for years. GA is an advanced form of dry AMD in which patches of retinal cells die (atrophy), causing blind spots and gradual central vision loss. Unlike wet AMD, GA does not involve abnormal blood vessel growth but can still lead to significant vision impairment over time. It affects more than 1 million people in the U.S.

Wet AMD: This less common but more severe form of AMD occurs when abnormal blood vessels grow under the delicate retinal tissue and leak fluid or blood, rapidly damaging the macula. About 10 to 15 percent of people with dry AMD convert to this form, which can quickly destroy the sharp central vision needed for activities like reading, driving and using a computer. Symptoms may include blurred or distorted vision, straight lines appearing wavy and dark spots in the center of vision, though some people notice no changes until significant vision loss has occurred.

Impact on daily life

For people like Jan, the effects of GA extend far beyond blurred vision. Tasks that were once routine — managing medications, paying bills, watching TV — can become frustrating. Loss of independence around driving is a major factor for patients. Several years ago, Jan had to give up driving and now relies on her mom to drive her everywhere. Even hobbies such as gardening, watching movies or reading can feel inaccessible.

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“The loss of central vision isn’t just physical,” explains Gerson. “It affects confidence, independence and mental health. People often experience anxiety, frustration or depression as they adjust to these changes.”

This is where caregivers step in, providing practical support and emotional encouragement while helping their loved ones adapt to a new way of seeing the world. Caregivers often become their loved one’s vision for everyday tasks and needs.

“Caring for a loved one with macular degeneration is a constant balancing act,” says Donna Auger, executive director of the Macular Degeneration Association in Sarasota, Florida. “Patients may feel frustrated or isolated, or feel like a burden as they lose their independence, while caregivers face the emotional strain of finding the best way to support them.”

Navigating AMD at home

The diagnosis of AMD significantly hindered the ability of Frances Owens, 79, to care for her terminally ill husband. Her declining vision made complex tasks, like administering IV medications, managing feeding schedules and monitoring his condition, far more challenging and stressful.

Her daughters, Jennifer and Andrea Owens, moved in to help care for their dad, while also supporting their mom as her vision worsened. “Mom was always the caregiver,” recalls Jennifer. “Then the roles reversed, and it became our turn to be there for her.”

Frances was diagnosed with AMD seven years ago; her central vision slowly eroded in both eyes, making daily activities, from reading bills to cooking and navigating her home, daunting challenges. Both daughters stepped in to assist their mom, helping with everything from managing medications to adapting her environment with large-print labels and specialized lighting. “You feel helpless at first,” says Frances. “But having my daughters by my side makes all the difference.”

Jennifer found a low-vision occupational therapist to assist her mom and help her reclaim some independence at home. “Occupational therapy helps people with low vision regain some quality of life by teaching them to maximize their remaining sight, safely navigate their homes and continue the activities that matter most to them,” says Vanessa Carmody, an occupational therapist specializing in low-vision care in Sarasota, Florida. “Caregivers play a critical role in supporting this process, reinforcing exercises at home and helping create environments that are safe, accessible and tailored to the individual’s vision.”

How caregivers can help

Many caregivers feel overwhelmed, alone and unsure where to turn for help, highlighting the need for better support systems and resources for both patients and their families. Here are some practical ways caregivers can support loved ones with AMD.

Facilitating safe mobility

Even with peripheral vision intact, navigating a familiar home can become tricky when central vision is compromised. Caregivers can help by keeping walkways clear, labeling furniture edges and ensuring adequate lighting in hallways and staircases. “Simple tools like contrast tape on steps or brightly colored markers on appliance controls can make a big difference,” says Carmody.

Assisting with daily activities

Tasks such as reading labels, measuring ingredients or managing medications can become difficult. Large-print materials, magnifiers and smartphone apps that read text aloud can help, but some tasks may still require hands-on support like Jan’s mom provides. Caregivers can help by prepping meals, labeling household items in large print or with tactile markers, and using black cutting boards that provide more contrast.

Jan's mom helps her continue cooking by reading directions aloud and measuring ingredients.

Courtesy Snow Companies

Finding low-vision specialists

A low-vision specialist is typically an optometrist with advanced training in helping people who have permanent vision loss that can’t be corrected with standard glasses, contacts, surgery or medication. Instead of treating the disease itself, they focus on maximizing the sight a person still has. They evaluate how someone’s vision loss affects daily tasks and match them with tools, strategies and training to stay independent. “This can include prescribing special high-powered glasses, magnifiers, telescopic lenses, electronic reading devices and improved lighting,” says Gerson. Occupational and physical therapists can also specialize in low-vision care.

Tapping into technology

Low-vision aids have advanced dramatically in recent years. Screen-reading software, voice-activated assistants and devices that enlarge or project text can help people maintain independence. Caregivers can help research, set up and teach these tools, making daily tasks more manageable and boosting confidence, adds Carmody.

Providing emotional support

Losing the ability to see clearly is emotionally challenging. “Caregivers play a crucial role in offering reassurance, empathy and encouragement,” says Jennifer Owens. Simply being present, listening and validating feelings can reduce anxiety and frustration. Support groups, either in-person or online, can also provide a community for both people with AMD and their caregivers.

Preparing for the future

AMD is a progressive disease, so planning ahead is crucial. Caregivers can help loved ones explore home modifications, access low-vision specialists and plan for transportation alternatives.

Jennifer has worked with Carmody to make a series of changes around their house to reduce fall risks and make daily life safer for her mom. Bright, cool-white task lights were installed in key areas such as Frances’s reading and writing space and the kitchen, after experimenting to find a specific color of light that provides the best contrast. In the kitchen, they swapped out traditional appliances for safer alternatives, including an electric teakettle with an automatic shutoff so she can make coffee.

They also added raised, colored tactile markers to the microwave’s 30-second start button so she can operate it by touch rather than sight. Because the white knobs on the oven are hard for her to see, Frances now avoids using it entirely, relying on family members for stovetop or oven cooking. “Together, these small but strategic changes have helped her remain more independent while reducing the risk of accidents,” says Jennifer.

*Last name has been withheld for privacy

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Paul Wynn, a veteran health care writer, has spent over a decade immersed in the caregiving community, both as a family caregiver and as a journalist covering caregiving issues for national publications.