MACULAR DEGENERATION Hereditary age-related deterioration, which occurs in the central part of the retina (the macula), is responsible for our most detailed vision needed for reading or driving. Very common cause of reduced vision in the elderly. Reduction in central visual acuity is extremely variable, and in fact, most function well with no restrictions in lifestyle. A very small minority progress to the most advanced stage of disease where people cannot read or recognize faces ("legal blindness"). Never results in total blindness; useful peripheral vision is retained and people can still live independently even in the most severe cases. Two general categories—ARMD (Age-related macular degeneration) "Dry" or atrophic; loss of vision is usually very gradual and no treatment is possible; most common type by far. "Wet" or exudative: vision loss can be rapid and severe as abnormal blood vessels leak or hemorrhage. Usually preceded by new distortion in central vision and is often treatable at this stage with the laser. Special photography (flourescein angiogram) is often used to determine if exudative disease is treatable. Newer injectable medications have been found to be Daily monitoring of the central vision with the Amsler Grid (shown below)and multivitamin therapy in accordance with the "AREDS" study in important. (AMSLER GRID)