Macular degeneration is on the rise. Here's how to protect your vision
Explore ways to reduce your risk, detect issues earlier, and proactive steps to protect your vision
Age-related macular degeneration (AMD) is the leading cause of vision loss in Canadians over age 55, affecting an estimated 2.5 million Canadians. And according to Medcan's Clinical Director of Optometry, Dr. Manraj Fervaha, that number is growing.
"Age is the strongest risk factor for AMD and these days people are living longer. Baby Boomers also now make up a larger proportion of the population," explains Dr. Fervaha.
Additionally, more advanced imaging technologies are now available, allowing clinicians to detect retinal changes much earlier than in the past, and often before symptoms develop. As a result, more cases are being diagnosed. Worldwide cases are projected to increase from 196 million to 288 million in the coming decades.
While aging can't be controlled, there are lifestyle and environmental factors that can minimize risk, according to Dr. Fervaha. These are important to know about because even people without a family history of AMD – anyone – can develop it.
"We've seen cases where someone is a non-smoker and eating very healthy, but they're still showing signs of macular degeneration" says Dr. Fervaha. "Research shows that AMD is more common among people of European ancestry, and that Caucasian females also tend to be at a higher risk."
Macular degeneration causes deterioration to central vision, and although it doesn't typically cause complete blindness, it can significantly affect independence and quality of life. Everyday activities such as reading, driving, navigating stairs, or recognizing faces can become increasingly challenging. For some individuals, vision loss may eventually affect their ability to drive, impacting their mobility, and independence.
"We see an increased risk of falls, as well," says Dr. Manraj Fervaha. "When you lose vision or contrast sensitivity, steps and curbs can become more difficult to navigate."
Currently, there is no cure for macular degeneration. However, treatment options can help manage the condition and, in some cases, improve visual function. Historically, management focused on monitoring and nutritional supplementation. However, device-based therapies that enhance visual acuity and contrast sensitivity are now available.
Drawing on insights from Dr. Fervaha, this article explores what you need to know about AMD, including key risk factors, early warning signs, and proactive steps you can take to help protect your vision.
- Age-related macular degeneration (AMD) is a leading cause of vision loss in older adults, affecting an estimated 2.5 million Canadians.
- Early AMD often develops without symptoms, making regular comprehensive eye exams and OCT retinal imaging essential.
- While age and genetics play a role, lifestyle factors such as smoking, poor diet, and UV exposure can increase the risk of AMD.
- Dry AMD is the most common form of the disease and can progress to wet AMD, a more serious condition.
- There is no cure for AMD, early detection. Treatments such as MacuMira and anti-VEGF therapy can help.
What is macular degeneration?
Age-related macular degeneration (AMD) is a progressive condition that affects central vision, making activities such as reading, driving, recognizing faces, or seeing fine details more difficult.
AMD affects the macula, which is the the central part of the retina, As Dr. Fervaha explains, "The retina is the light-sensitive tissue at the back of your eye, which is made up of several layers that work together to help you see."
"As we age, one of those layers starts to become less efficient at clearing waste. Over time, waste materials build up, and form small deposits called drusen."
Age-related macular degeneration (AMD) is an eye disease that affects the macula, the part of the retina responsible for sharp central vision, and can make it harder to read, drive, recognize faces, and see fine details.
Drusen deposits are like particles of debris that gradually accumulate because the eye's natural cleaning system isn't working as well as it once did. They are often one of the earliest signs of age-related macular degeneration.
As these deposits build up, they can damage the macula and overtime they interfere with central vision, making activities such as reading, driving, recognizing faces, or seeing fine details more difficult.
Drusen: small yellow deposits of protein and fat that build up underneath the retina, usually as people age. They are often an early sign of age-related macular degeneration (AMD), although many people with small drusen never develop vision problems.
There are also two categories of AMD: dry and wet.
The two types of macular degeneration
Dry macular degeneration: when a proactive approach can help
Dry AMD is the most common form of macular degeneration. It occurs when drusen begin to accumulate beneath the retina. It develops slowly and may not cause noticeable symptoms in its earliest stages.
The challenge is that these subtle changes aren't always visible during routine eye examinations. "Sometimes they're hard to see with a traditional exam," Dr. Fervaha explains. "This is why, at Medcan, we use Optical Coherence Tomography (OCT) technology, which can scan all the layers of the retina and show us whether drusen are accumulating at earlier stages."
One of the biggest advances in eye health has been the ability to identify AMD before symptoms develop. This is where Optical Coherence Tomography (OCT), which has only become widely available in the last two decades, has become a valuable tool for optometrists.
An OCT scan reveals early drusen deposits, fluid accumulation, and other structural changes that may not be visible during a standard eye exam. "We can see early changes in the back of the eye before a client experiences visual or functional changes," explains Dr. Fervaha.
This allows for earlier monitoring, lifestyle recommendations, and treatment planning.
Once symptoms occur, you may experience:
- Blurred or fuzzy central vision that makes reading or seeing details more difficult
- Straight lines may appear wavy, bent, or distorted (for example, door frames or lines on a page)
- Difficulty recognizing faces
- A dark, blurry, or blank spot in the centre of your vision
- Needing brighter light for reading or close-up tasks
- Colours appearing less vivid or vibrant
- Difficulty adapting to changes in lighting, such as moving from bright sunlight into a dim room
"This is why early detection is critical because intervention can be focused around reducing risk factors and slowing progression through lifestyle changes, nutritional support, and monitoring," says Dr. Fervaha.
Early detection is critical because intervention can be focused around reducing risk factors and slowing progression through lifestyle changes.- Medcan Clinical Director of Optometry, Dr. Manraj Fervaha.
Wet macular degeneration: when disease progresses
In some cases, dry AMD can progress to wet AMD, a more serious form of the disease. This occurs when abnormal blood vessels develop beneath the retina and begin leaking fluid, which causes more rapid vision loss.
"The accumulation of drusen can eventually stress the retina causing new leaky blood vessels to form, causing fluid to leak into the eye," explains Dr. Fervaha.
Patients with wet AMD are typically referred by Medcan to an ophthalmologist for treatment, which may include anti-VEGF injections (medications injected into the eye) that help control the leaking blood vessels and preserve vision.
Common symptoms of wet AMD include:
- Straight lines appearing wavy or bent
- Blurry central vision
- Difficulty reading or recognizing faces
- A dark or blank spot in the centre of vision
- Colours appearing less bright
Typically, wet macular degeneration develops from dry macular degeneration. However, a person may not realize they ever had the dry form before wet AMD appears.
Risks and prevention
Research shows that both genetic predisposition and lifestyle factors play an important role in a person's risk of developing AMD. Variations in several genes have been linked to risk, while modifiable factors – risks inside a person's control - such as smoking, physical inactivity, obesity, cardiovascular disease, and diet can also influence the development and progression of the condition.
According to the most recent research here are the top non-modifiable and modifiable risks:
Non-modifiable risk factors
- Age
- Family history of AMD
- Genetics, including variants in genes such as CFH, ARMS2/HTRA1, and others associated with AMD risk
- European/Caucasian ancestry, which has been associated with higher AMD prevalence in several studies
- Female sex, with studies showing a higher overall disease burden among women
Modifiable risk factors
- Smoking (one of the most consistently identified risk factors)
- Physical inactivity
- Obesity
- Poor diet, particularly diets low in fruits, vegetables, lutein, zeaxanthin, and omega-3-rich foods
- High blood pressure (hypertension)
- Cardiovascular disease
- Diabetes
- Excessive sunlight/UV exposure
According to Dr. Fervaha, "Age is the strongest risk factor for macular degeneration."
The condition becomes more common after age 55, and the risk continues to increase with each decade of life.
Smoking is considered one of the most significant modifiable risk factors. According to Dr. Fervaha, "The reason for this is that the cells beneath the retina that help keep the light-sensing cells of the eye healthy (the retinal pigmented epithelium) are always working. Over time, smoking can deplete some of the antioxidants – which support the body's defense system – in that area resulting in increased stress to the retinal pigment epithelium.”
UV protection is a major factor too. "UV light over time can cause damage and changes to the retina," explains Dr. Fervaha.
Additionally, diet is a factor. It's as important for your eyes as it is from the rest of your body to whole foods. When it comes to protecting against visual conditions like AMD, Dr. Fervaha recommends, green, leafy vegetable and foods with carotenoids that have that pigmentation for the macula.
He also suggests increasing omega-3. "Foods like salmon and other fish with omega-3s provide more nutrients for the eye."
Family history is one of the strongest risk factors for macular degeneration. According to the American Academy of Ophthalmology, people with a first-degree relative who has AMD are up to 12 times more likely to develop the condition themselves. However, having a genetic predisposition to AMD means your risk is higher, but it does not guarantee that you will develop the condition. Research shows that both genes and lifestyle influence AMD risk and progression.
In fact, a 2026 study found that even among people at high genetic risk, those who adopted healthier lifestyle habits had substantially lower rates of progression to advanced AMD than those with less healthy habits.
Dr. Fervaha says, "One of the most important preventative steps you can take is to make sure to get routine eye exams, every 2 years prior to 65 and yearly after 65."
"Additionally, a dilated exam with OCT scan is ideal because we can see if drusen are developing and we can monitor for changes."
One of the most important preventative steps you can take is to make sure to get routine eye exams, every 2 years prior to 65 and yearly after 65.- Medcan Clinical Director of Optometry, Dr. Manraj Fervaha.
Treating macular degeneration
For patients with early to moderate dry macular degeneration, Medcan now offers MacuMira, a non-invasive therapy designed to help improve visual function.
This treatment uses a device that delivers low-dose electrical stimulation to the eye. Treatment consists of four 32-minute sessions over a 10-day period, followed by maintenance sessions every three months. It is administered by the Medcan Optometry team, and we offer a pre-test consultation to help determine if it’s right for you.
MacuMira works by stimulating cells in the retinal pigment epithelium (RPE), which help support energy production (mitochondrial function) within the retina. "It can assist cells to manage metabolic waste products associated with macular degeneration, including drusen," explains Dr. Fervaha.
MacuMira is not intended to reverse or stop AMD. However, studies suggest it may help improve visual function in some people who have already experienced vision loss.
"The treatment works well for those who are starting to show early signs and symptoms of dry macular degeneration, but not those with advanced macular degeneration or wet AMD.”
According to Dr. Feveraha, "Clients often report improvements in contrast sensitivity, colours and images appearing brighter and more distinct. Some also notice better depth perception and sharper vision."
Research from a randomized controlled trial found that participants receiving microcurrent electrical stimulation with MacuMira experienced significant improvements in visual acuity compared with those in the sham-control group. On average, participants gained approximately eight letters on a standard ETDRS eye chart, representing a meaningful improvement in visual clarity for some individuals. The study also demonstrated improvements in contrast sensitivity, which is the ability to distinguish an object from its background when differences in brightness, colour, or shading.
For those with more moderate to advanced macular degeneration a common treatment is, AREDS2 supplements, which are special vitamin and mineral formulations that can help slow progression in people with intermediate or advanced dry age-related macular degeneration.
The AREDS2 formulation includes:
- Vitamin C
- Vitamin E
- Zinc
- Copper
- Lutein
- Zeaxanthin
There have been landmark clinical trials conducted by the U.S. National Eye Institute to show that these nutrients help combat oxidative stress, which is believed to contribute to retinal damage in AMD. The study found that this specific combination of antioxidants and nutrients can help reduce the risk of progression from intermediate AMD to advanced AMD in certain patients.
With no way to reverse the condition, Dr. Fervaha emphasizes, the main objective is to control the risk factors.
Among our five senses, according to research, vision is the one people rank as the one their most fearful losing. Sight plays a central role in our quality of life.- Medcan Clinical Director of Optometry, Dr. Manraj Fervaha.
Protecting your vision starts early
As AMD becomes more common with age, Dr. Fervaha emphasizes being proactive when it comes to vision care.
“Having regular comprehensive eye exams, including retinal imaging when appropriate, is one of the most important steps you can take to protect your vision.”
“Prevention also matters. Avoiding smoking, protecting your eyes from UV exposure, maintaining good cardiovascular health, and following a nutrient-rich diet such as the Mediterranean diet can all help support long-term eye health and may reduce the risk of AMD progression.”
Medcan recommends regular comprehensive eye exams to help detect changes in vision and identify eye conditions early. Screening recommendations include:
- Under age 19: Every year
- Under age 40: Every 2 years
- Ages 40 to 64: Every 2 years
- Age 65 and older: Every year
However, individuals with a family history of age-related macular degeneration, diabetes, existing eye conditions, or changes in vision may require more frequent monitoring.
As AMD becomes increasingly common in an aging population, early detection may be one of the most powerful tools available. Dr. Fervaha emphasizes the importance of regular checks to keep your vision health.
"Among our five senses, according to research, vision is the one people rank as the one their most fearful losing. Sight plays a central role in our independence and quality of life, affecting everything from reading and driving to recognizing loved ones and navigating the world around us."
And so, when it comes to preserving vision, what you can't see today may be exactly what your optometrists need to find.
Take action
Regular vision assessments are crucial for reducing the risk of ocular disease and prolonging the health of your eyes. Medcan offers an Enhanced Vision and Eye Exam, including thorough evaluation of your vision, and the structure of your eye. This can be done as a standalone service or completed on the same day as your Annual Health Assessment at the 150 York location.
For those diagnosed with dry AMD, Medcan is now proud to be an official provider of MacuMira, the first and only non-invasive microcurrent treatment approved by Health Canada to improve visual function in patients with dry AMD.
When you choose Medcan as your MacuMira provider, you receive the support of an expert optometry team to administer the treatments and guide you through the process, starting with a complimentary consultation to ensure MacuMira is right for you. You do not need to be a Medcan member to receive this treatment. Explore MacuMira here.
