Even if you have age-related macular degeneration (AMD), you may not have heard of geographic atrophy (GA), a form of late-stage AMD. It affects about one million people in the United States, with around 160,000 new cases occurring each year.
Because GA can cause permanent vision loss, it’s worth learning as much as you can about the condition. “This is an irreversible, progressive, and potentially disabling disease,” says Nora Lad, MD, PhD, an ophthalmologist and retinal specialist with Duke Health in Morrisville, North Carolina.
As it slowly — and often quietly — steals your sight, you lose your visual acuity and may start to see blank or blurry spots. Eventually, this vision loss can interfere with your ability to do everyday tasks and participate in social activities. Here are some ways geographic atrophy can affect your life.
1. It Limits Your Ability to Be Independent
One of the major ways geographic atrophy can have an impact on your life is by hindering your ability to drive. Even if your AMD hasn’t progressed to this late-stage version of the disease, you may still have trouble seeing the road, street signs, lane markers, and other vehicles, according to the National Highway Traffic Safety Administration (NHTSA).
AMD also makes it more difficult to see in dim light or transition from bright to dim lighting. In one study, drivers with early or intermediate-stage AMD were rated less safe compared with a control group of people the same age. The greatest effect was during complex driving situations, such as navigating tricky intersections.
If you are still driving, you may find it more comfortable to drive during the day, in familiar areas, says Dr. Lad. While that means you can still drive, it does limit going to new places or heading out in the late afternoon or at night. The NHTSA recommends asking family members and friends for rides, finding public transportation options, or taking safe walking routes. Rideshares may also be an option in your area. For more information on transportation services, go to www.eldercare.acl.gov.
2. It Increases the Risk of Mental Health Problems
The changes that come with visual impairment can have a serious impact on your mental health, including your emotional health. For example, a study found that people with geographic atrophy had some of the lowest ratings for mental health, while people with milder forms of AMD fared better.
One reason for the poor mental health scores, according to the study authors? At the time the research was published, there was no available treatment for geographic atrophy, which left the study participants feeling frustrated and stuck.
Thankfully, that has changed. Two injectable drugs — pegcetacoplan injection (Syfovre) and avacincaptad pegol intravitreal solution (Izervay) — were approved by the U.S Food and Drug Administration in 2023 for slowing the progression of GA. Several other promising treatments, including cell therapy, gene therapy, and microcurrent stimulation, are also in the pipeline, according to a review.
If you have GA, you can also follow certain lifestyle habits — such as quitting smoking, eating a healthy diet, and taking certain supplements — to reduce the risk of further eye damage.
3. It Can Cause a Social Faux Pas
Because geographic atrophy can lead to blurry or blind spots, you may have difficulty recognizing faces, especially from farther distances or in crowded situations. According to a review, 63 percent of patients with GA reported having difficulty recognizing faces. That can make it incredibly hard to socialize.
In addition, people with geographic atrophy may experience other socially embarrassing moments. In one example Lad gives, the person accidentally put their hand into a bowl of dip, thinking they were going for the potato chips. These moments can be tough to laugh off, especially when you know there’s an underlying problem that caused the flub. Eventually, some people choose to withdraw from social situations altogether.
4. It Makes Falling More Likely
Older adults are about 3.5 times more likely to experience a fall if they have vision loss, according to research. (This includes people with geographic atrophy, another review indicates.)
Falls are particularly dangerous for older adults. Every year, one in four people over age 65 fall, and 20 percent of those falls lead to a serious injury, such as broken bones or a head injury, according to the Centers for Disease Control and Prevention. Deaths from falls have also been on the rise over the past decade.
Making low-vision modifications to your home, such as removing clutter, cords, and throw rugs and arranging furniture in a way that makes it easy to get around, can help you live safely, according to BrightFocus Foundation.
5. It Makes Daily Tasks Tough
You might have to make some serious changes to how you operate on a day-to-day basis. According to a review, people with geographic atrophy tend to have trouble performing routine tasks such as:
Cooking
Doing household chores
Paying bills
Reading
Recognizing faces
Watching TV or movies
This could be why many people with geographic atrophy rely on a caregiver for support. Other research indicates that this reliance on others leaves people with GA feeling isolated and dependent on others.
Not everyone has a support system, but seeing an occupational therapist who is skilled in treating people with low vision can help you implement strategies to cope with vision changes. This can include identifying people based on voice and using voice function technology to read text aloud.
The Takeaway
Geographic atrophy is a type of late-stage AMD that can stealthily steal your eyesight.
Eventually, vision loss can affect your ability to engage in routine tasks and interfere with your social activities.
With the right treatment and changes in lifestyle habits, you can preserve your vision as much as possible and maintain your quality of life.
Michael W. Stewart, MD, is professor and chairman of ophthalmology at Mayo Clinic in Jacksonville, Florida, and the Knights Templar Eye Foundation Professor of Ophthalmology Research. He graduated with honors in chemistry from Harvard College in Cambridge, Massachusetts, and from the McGill University Faculty of Medicine in Montreal. He completed an internship in internal medicine at Jackson Memorial Hospital in Miami and an ophthalmology residency at Emory University in Atlanta. Dr. Stewart completed vitreoretinal fellowships at Touro Infirmary in New Orleans and at the University of California Davis.
His research interests include diabetic retinopathy, macular degeneration, retinal vein occlusions, and infectious retinitis. He has a particular interest in retinal pharmacology, pharmacokinetics, and the mathematical modeling of ocular diseases and treatments.
Jessica Migala is a freelance writer with over 15 years of experience, specializing in health, nutrition, fitness, and beauty. She has written extensively about vision care, diabetes, dermatology, gastrointestinal health, cardiovascular health, cancer, pregnancy, and gynecology. She was previously an assistant editor at Prevention where she wrote monthly science-based beauty news items and feature stories.
She has contributed to more than 40 print and digital publications, including Cosmopolitan, O:The Oprah Magazine, Real Simple, Woman’s Day, Women’s Health, Fitness, Family Circle, Health, Prevention, Self, VICE, and more. Migala lives in the Chicago suburbs with her husband, two young boys, rescue beagle, and 15 fish. When not reporting, she likes running, bike rides, and a glass of wine (in moderation, of course).
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