Macular Society
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Hi folks! I'm new to this site and looking for advice on Drusen and the link with developing Macular Degeneration? I have RA as well as other auto immune conditions... and cataracts in both eyes and Weiss circles too. I was at my optometrist yesterday and told that there are Drusen in my left eye. I googled it (of course) and read that Drusen can precede Macular Degeneration which rather alarmed me. Hence looking for info and learning from others? Thanks!

6 Replies

It depends on where the Drusen is in your eye. The location of the Drusen is the key! If he didn't tell you and you want a proper answer you will need to get an appointment for a scan at the hospital. The optometrist can automatically give you a referral. You don't need to see your GP/ if you are in the UK.

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thank you Caroline! X


Hi docas

You may have read that there are two kinds of drusen - the hard ones and the soft ones. The hard ones do not necessarily lead to AMD. The soft ones are more serious and need to be monitored more regularly. So if your optometrist has asked you to come back for an eye test in a year's time it is more likely that yo have the hard ones. But optometrists at the opticians are not infallable, as I found out. So, it is best to ask for a referral to an opthalmologist at a hospital where your eyes can be tested more thoroughly. And of course, it will also put your mind at rest.

Good luck!

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thank you Ayaya. The Drusen weren't there a year ago so I will follow the good advice given to seek referral. Thanks!


Dear dorcas,

In terms of drusen, please see the following links.


Age-Related Macular Degeneration: Guidelines for Management September 2013

The Royal College of Ophthalmologists

“4.1 Definitions

Age-related macular degeneration (AMD) is the term applied to ageing changes without any other obvious precipitating cause that occur in the central area of the retina (macula) in people aged 55 years and above (1) . In the early stages lipid material accumulates as deposits beneath the retinal pigment epithelium (RPE) and within Bruch’s membrane. When focal collections of lipid material are present these are referred to as drusen and can be seen as pale yellow deposits on a clinical examination of the retina. The retinal pigment epithelium also undergoes morphological alteration seen clinically as areas of hyperpigmentation and hypopigmentation. Generally drusen and RPE irregularities are not associated with disturbances of central visual function. A proportion of people (12.9 and 17.8% respectively) (2) with these early changes will progress to advanced AMD. When vision loss occurs it is usually due to the development of geographic atrophy and/or exudative disease.”

pp. 8-9

and, the abstract from:

Differentiating drusen: Drusen and drusen-like appearances associated with ageing, age-related macular degeneration, inherited eye disease and other pathological processes

Kamron N. Khana, b; Omar A. Mahrooa, et al.


“Drusen are discussed frequently in the context of their association with age-related macular degeneration (AMD). Some types may, however, be regarded as a normal consequence of ageing; others may be observed in young age groups. They also occur in a number of inherited disorders and some systemic conditions. Whilst drusen are classically located external (sclerad) to the retinal pigment epithelium, accumulations of material internal (vitread to) this layer can display a drusen-like appearance, having been variously termed pseudodrusen or subretinal drusenoid deposits. This review first briefly presents an overview of drusen biogenesis and subclinical deposit. The (frequently overlapping) subtypes of clinically detectable deposit, seen usually in the context of ageing or AMD, are then described in more detail, together with appearance on imaging modalities: these include hard and soft drusen, cuticular drusen, reticular pseudodrusen and "ghost drusen". Eye disorders other than AMD which may exhibit drusen or drusen-like features are subsequently discussed: these include monogenic conditions as well as conditions with undefined inheritance, the latter including some types of early onset drusen such as large colloid drusen. A number of systemic conditions in which drusen-like deposits may be seen are also considered. Throughout this review, high resolution images are presented for most of the conditions discussed, particularly the rarer ones, providing a useful reference library for images of the range of conditions associated with drusen-like appearances. In the final section, some common themes are highlighted, as well as a brief discussion of some future avenues for research.”

I hope that this addresses your query.

Please do not hesitate to contact us if we can be of any further help.

The Macular Society helpline is open 9am – 5pm Monday to Friday on 0300 3030 111.

Alternately, you can contact us via:

Kind regards,

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oh thank you Rosalyn! I read the extracts twice .... and won't pretend I understood all of it.... but it certainly has increased my knowledge, and provided a pointer for further enquiry. Much appreciated! 😊


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