Age-related macular degeneration (Guidelines)


Age- related macular degeneration symptoms

  • Central loss of vision with central scotoma/distortion

Exudative or wet ARMD

Wet ARMD usually presents with central visual loss or distortion which develops over a few days or weeks. Fundal examination may show retinal thickening, sub-retinal fluid, haemorrhage and exudates at the macula. With time a fibrovascular or disciform scar develops. If detected early, wet ARMD may be amenable to treatment which may stabilise or improve the vision.

Atrophic or dry ARMD (also known as geographic atrophy)

Dry ARMD causes much slower disability, usually over months or years. Pigmentary changes and/or atrophy develop at or just around fixation resulting in juxtafixation scotomas which may cause difficulty in reading,  With time, both near and distant vision slowly deteriorates. No treatment is currently available. 


  • If wet ARMD is suspected then advise the patient to attend their own optometrist for assessment.
  • Optometrists can refer directly to the ophthalmology department via the rapid access pathway.
  • Patients should be seen within 2 weeks if wet ARMD is suspected

Support and advice

  • Practical and emotional support is available for visually impaired patients and relatives from the eye
    clinic liason officers (ECLO).
  • Inverness area:
  • Caithness, Sutherland, Lochaber, Skye:
  • The Macular Society website is a useful source of information for patients relatives and professionals
  • The QR code below is a link to an information leaflet on ARM

Last reviewed: 21/06/2023

Next review date: 30/06/2026

Author(s): Ophthalmology Review Group.

Version: 2

Approved By: TAM Subgroup of ADTC

Reviewer name(s): Dr T Leslie, Consultant Ophthalmologist.

Document Id: TAM188

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