Visual impairment in old age: understanding and treating age-related macular degeneration
November 28, 2025
5 min
Good vision contributes significantly to quality of life. Changes in visual acuity can therefore be unsettling - especially if they occur suddenly or for no apparent reason. Age-related macular degeneration is one of the most common causes of impaired central vision. It often develops gradually and is not always noticed immediately. In this article, we give you a clear overview of the disease, typical signs, risk factors and modern treatment options. Our aim is to provide guidance and show how those affected can lead as self-determined and good a life as possible despite visual impairments.
When the centre of vision deteriorates
Macular degeneration is a disease of the retina that mainly occurs in old age. It affects the macula, the central area of the retina that is responsible for sharp and colour vision. If this area is damaged, central vision becomes blurred or distorted - it becomes more difficult to recognise faces or read. However, the outer field of vision usually remains intact so that you can still orientate yourself well in space.
Two forms of macular degeneration
Dry macular degeneration
This is the more common form. It develops slowly over years. Tiny metabolic residues (so-called drusen) are deposited in the retina. Gradually, sensory cells die off, which initially only slightly impairs vision.
Wet macular degeneration
This form occurs less frequently, but often progresses more quickly. Fine, unstable blood vessels grow under the retina. They can leak fluid or blood and thus damage the tissue. Vision usually deteriorates rapidly, sometimes suddenly and significantly.
Typical signs
- Straight lines suddenly appear wavy or distorted ("metamorphopsia")
- Letters or words are missing when reading
- Faces appear blurred
- A dark or grey spot appears in the centre of the field of vision
If you notice such changes, you should consult an ophthalmologist as soon as possible. Early clarification is crucial.
Causes and risk factors
Macular degeneration is usually caused by a combination of several factors.
Important risk factors are
- Age
- smoking
- familial predisposition
Unproven risk factors that presumably also play a role are
- High blood pressure or cardiovascular disease
- unbalanced diet
- Exposure to strong sunlight without eye protection
A healthy lifestyle, not smoking and a vitamin-rich diet with plenty of vegetables, fruit and fish can help to reduce the risk. We recommend eating fish, sweetcorn, tomatoes and broccoli in particular and wearing sunglasses if you are significantly exposed to the sun, as well as stopping smoking.
Treatment options
Dry form
There is currently no effective treatment. Certain nutrient supplements (e.g. vitamins, zinc, lutein and zeaxanthin) may be able to slow down the progression, but there is no strong evidence for this.
Wet form
Drugs are available that inhibit the growth of diseased blood vessels. They are injected directly into the eye at certain intervals (anti-VEGF therapy). This treatment can stabilise or even improve vision.
Living well despite macular degeneration
Even if visual acuity decreases, there are many ways to actively organise everyday life.
Aids such as magnifying glasses, reading devices, enlarged text on the screen or good lighting make everyday life easier.
Low-vision counsellors can help those affected to make the best possible use of their existing vision. We work together with Zürcher Sehhilfe in this regard.
Sharing experiences with other sufferers and expert support can help make it easier to deal with the condition.
Conclusion
Macular degeneration is a common and partially treatable eye disease in old age.
If you pay attention to changes in your vision and seek medical advice early on, you can do a lot to preserve your eyesight for as long as possible.
A healthy lifestyle and annual eye examinations after the age of 65 are the best way to protect your eyesight.
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