The exam begins by testing your visual acuity or the sharpness of your vision. There are several different tests for visual acuity. The most familiar one has lines of black letters on a white chart. Next, your eyes may be tested with an Amsler grid. This test helps your doctor determine if you are experiencing areas of distorted or reduced vision, both common symptoms of macular degeneration. If you do have macular degeneration, your doctor will use the Amsler grid to determine if your vision has changed.

The Amsler Grid

Your ophthalmologist may provide you with a small version of the Amsler grid such as the Yannuzzi Card to carry with you in your purse or wallet.

After these visual tests, the front part of your eyes will be examined to determine if everything is healthy. Your doctor may put anesthetic drops in your eyes before measuring the pressure in each eye.

Then, drops are administered which cause your pupils to dilate. This will allow your doctor to examine the retina through the enlarged pupil. The drops typically take between 20 and 45 minutes to work, and will wear off in about 4 hours. While the pupils are dilated, it is usually difficult to read, and bright lights may be uncomfortable. Some patients use sunglasses after dilation to reduce light sensitivity.
The slit lamp is a microscope that gives the examiner a magnified view of the retina. Using the slit lamp, your doctor will look for drusen and other areas of the retina that appear suspicious or abnormal.

After the dilating drops are administered and allowed time to work, the eye doctor will seat the patient at a device called a slit lamp. The slit lamp is a special microscope that enables the doctor to examine the different parts of the eye under magnification. When used with handheld lenses or special contact lenses, the slit lamp gives the examiner a highly magnified view of the retina.

The examiner will look for drusen and other areas of the retina that might appear suspicious or abnormal. Since choroidal neovascularization (the new blood vessel growth found in the "wet" form of macular degeneration) occurs beneath the retina, the blood vessels themselves are not usually visible. But the examination can reveal clues, such as elevation of the retina, or fluids behind the retina, that suggest the presence of choroidal neovascularization (CNV). In these cases, further testing may be necessary.

This retinal photograph shows many drusen and fluid under the retina, suggestive of choroidal neovascularization.

Additional testing will be required for complete diagnosis and treatment.