Geographic Atrophy: Signs, Symptoms and Complications – Verywell Health


Dagny Zhu, MD, is an award-winning opthalmologist and Owner and Medical Director of Hyperspeed LASIK. She specializes in laser vision correction and cataract surgery.
A blind spot in your central vision is the hallmark of late geographic atrophy, an advanced form of dry age-related macular degeneration (AMD). Early in the disease, there can be a variety of symptoms linked to the progressive loss of light-sensitive retinal cells.
The symptoms of geographic atrophy range from uncharacteristically slow reading speed to problems with contrast sensitivity, which may make it hard to work in dim lighting.
Your symptoms will correspond with where you are in the geographic atrophy disease process. Late indications are much more pronounced than early ones.
This article will look at symptoms that nearly all people with geographic atrophy have as well as the symptoms that only occur sometimes.

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The symptoms of geographic atrophy that you will have will depend on where a blank spot develops on your retina and how large it is. In most cases, cell loss tends to occur near the center of the vision, leaving the side vision unaffected.

While there might be no symptoms early on, as more cell loss on the light-sensitive retina occurs over time, that changes.
Some common geographic atrophy symptoms include:
Geographic atrophy usually affects the central retina; therefore, your side (peripheral) vision is not affected. However, the lesion can be located more to the periphery. You may notice a dark spot there instead or in the center of your vision. If your detailed central vision is preserved, this may allow you to do things such as read for longer.
Visual hallucinations are an unusual symptom that may occur in very late geographic atrophy when there is a large blind spot. The condition, which is linked to sight loss, is known as Charles Bonet syndrome.
Hallucinations can vary from simple flashes of light to seeing elaborate vistas. Some people may see facial distortions. 
If you're experiencing visual hallucinations from Charles Bonet syndrome, you think they are being caused by a mental health condition, but that's not the case. It's just your brain's reaction to a sudden lack of input. With time, the symptom usually goes away.
See a retina specialist regularly to monitor your eyes for conversion to wet AMD, which requires urgent treatment with specific medications.
A low-vision specialist can help you learn to use visual aids. These tools can help you continue to participate in some fine sight-related activities that are important to you, such as reading. An occupational therapist can show you ways to adjust to low vision.
Having geographic atrophy can also affect your mental health—for example, it can cause or worsen anxiety or depression. You may need more specific support to make sure you are coping with all of these needs effectively.
In addition to talking to your eye health provider and a mental health professional, joining a support group where you can talk to others with geographic atrophy who might be experiencing many of the same things you are can be helpful. Exercising and doing activities that you love can also lift your mood.

Get in touch with an eye health provider at the first sign of geographic atrophy. Since the condition typically occurs during the late stage of (AMD), you may already be monitoring your vision at home with an Amsler grid (a tool that can alert you if there are any blank spots in your visual field).
If you have any symptoms you think might be geographic atrophy, contact an eye health provider right away. They can determine if your symptoms are from geographic atrophy and, if so, how large the affected area currently is.
There is currently no treatment approved by the Food and Drug Administration (FDA), but there are investigational studies underway for potential treatments for dry AMD and geographic atrophy.
If you've been diagnosed with geographic atrophy, it's important to see an eye provider every six months, if not sooner. An eye provider might be able to recommend lifestyle changes that can slow the progression of the condition and may keep it from affecting the other eye for longer.
In geographic atrophy, there might not be symptoms at first. With time, you may notice a small blank area, such as a missing letter or number, when you're reading. You may also find that detailed tasks take longer and require more light to complete. Your contrast sensitivity may also be affected, with colors appearing more washed out.
Eventually, you notice a dark area, usually at the center of your vision. While it's not as common, your side vision can also be affected.
If you have geographic atrophy, it's not uncommon to experience anxiety and depression. It can be helpful to talk to others who are experiencing some of the same things as you.
The symptoms of geographic atrophy can be overwhelming, but keep in mind that the condition is usually slow to progress. There are many strategies that can help you to manage your symptoms and vision effectively for some time.

Bright Focus Foundation. What is geographic atrophy?.
Prevent Blindness. Eye diseases and conditions geographic atrophy.
Macular Society. Charles Bonnet syndrome.
Review of Optometry. Sizing up geographic atrophy.
By Maxine Lipner
Maxine Lipner is a long-time health and medical writer with over 30 years of experience covering ophthalmology, oncology, and general health and wellness.

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