Famed British actor Dame Judi Dench has opened up her loss of vision, which has had serious consequences for her career.

Dench, 88, was diagnosed with age-related macular degeneration (AMD) in 2012, and recently told The Mirror’s Notebook Magazine the disease has progressed to the point she can’t read scripts.

She gave up driving a few years ago as her eyesight worsened, and now finds herself increasingly dependent on others – something she described as “ghastly” and “the most terrible shock to the system”.

But despite her troubles, Dench has no plans to disappear from screens, as she still aims to work as much as she can with the help of friends and her “photographic” memory.

“I mean I can’t see on a film set any more, and I can’t see to read. So I can’t see much,” Dench said.

“But, you know, you just deal with it. Get on.

“It’s difficult for me if I have any length of a part. I haven’t yet found a way … I have so many friends who will teach me the script.”

The BAFTA, Tony and Oscar-winning actor is far from alone in her struggle; AMD is one of the most common forms of vision loss.

In Australia, the most common causes of blindness and low vision are AMD, cataracts, glaucoma and diabetic retinopathy according to Vision Australia.

What is age-related macular degeneration?

AMD is the leading cause of blindness or severe vision loss in Australians over 50 years old.

During the early and intermediate stages, vision might not be significantly affected, but late-stage AMD can bring the most severe vision loss.

There are two types of late-stage AMD, dry and wet, both of which affect central vision.

Central vision is the most important part of a person’s vision, enabling people to engage in everyday activities such as reading, recognising faces and driving.

An example of what central vision loss from AMD can look like. Photo: Vision Australia

Virginia McDonald, Vision Australia orthoptist and clinical development lead, said dry AMD is the most common form of the disease, accounting for about 90 per cent of cases.

Dry AMD occurs when the retina’s cells die or atrophy over time due to the accumulation of small yellow deposits of a protein called drusen under the macula (the part of the retina that processes central vision).

This leads to a gradual loss of central vision.

Wet AMD is less common, but more severe; it involves the growth of abnormal blood vessels under the retina which can leak fluid and blood. This could lead to a sudden and significant loss of central vision.

Ms McDonald told TND having one form of the condition doesn’t preclude you from having the other; people with dry AMD can develop wet AMD, so it’s important to go to an ophthalmologist if you notice any changes in your vision.

What does central vision loss mean?

When many people think of blindness, they may think of a total loss of vision and being unable to see anything but pitch black.

But ‘black blindness’ is very rare, Ms McDonald said.

“In most people, there’s often usable vision, so we can make the best use of … what we call their ‘functional vision’,” she said.

“We have a lot of older people that are really afraid of going blind when they’re diagnosed with AMD … automatically they’re diagnosed, and they think that they’re going to go black blind overnight [but] it’s the central vision loss that’s affected, not the side vision.

“We can actually teach people to … maximise that peripheral vision to help overcome the challenges of the central vision loss.”

What causes AMD?

The exact cause of AMD is not fully understood, but there are many identified risk factors.

These include increasing age, family history of the condition, and environmental factors such as smoking and exposure to sunlight.

What are the main symptoms?

Symptoms can include a gradual or sudden decline in your ability to see things clearly.

Ms McDonald said vision could seem more blurry, distorted (straight lines start appearing as bent or wavy), or you could start finding it difficult to adapt to changes in lighting (for example, moving from a light room to a dark room).

Your ophthalmologist can help catch any potential issues early. Photo: Vision Australia

Other symptoms can include decreasing colour perception (ability to see colours brightly and clearly) and contrast sensitivity (detecting different shades of a particular colour).

She said one of the most distressing symptoms for many AMD sufferers is the inability to recognise faces.

“One of the sad things, and the main complaints that people with AMD have is, older people can’t see their grandkids’ faces,” she said.

“That’s really challenging for them to come to terms with.”

Is there a cure?

There is currently no cure for dry or wet AMD.

There are no official treatments for dry AMD, but people with the condition are encouraged to lead a healthy lifestyle to try and slow the progression of the disease.

This includes healthy eating habits, protecting eyes from sunlight, and not smoking.

Regular eye exams are important. Photo: Vision Australia

Wet AMD can cause rapid vision loss overnight, but sufferers may be able to receive regular anti-VEGF injections directly into the eye to reduce the growth of abnormal blood vessels, prevent leakage and slow vision loss.

“If you are aware that there’s a family history of AMD, [make] sure that you go and see the ophthalmologist every two years if you’re over the age of 50,” Ms McDonald said.

“And then when you start getting a bit older, over the age of 65, going in and having an annual eye health check is really important – and a comprehensive one where they’re taking images of the retina to detect any early stages of the disease.

“New treatment options and technologies are continually being developed … so it’s important for individuals with AMD to talk to their eye specialists to stay across the latest advancements and discuss treatment options.”