Judi Dench on Losing Her Eyesight: Discover the Symptoms of Macular Degeneration
Learn the risk factors for AMD, plus how to manage the condition
From her Oscar-winning turn as Queen Elizabeth I in Shakespeare in Love to her famously gender-swapped role as “M” in the James Bond film series, Dame Judi Dench, 90, is renowned for playing formidable women. Now, the iconic actress is showing just how strong she is off-camera as she adapts to the challenges posed by the progressive eye condition age-related macular degeneration (AMD). Here’s what we know about Judi Dench’s eyesight and the early symptoms of macular degeneration you shouldn’t ignore.
What Judi Dench has said about changes in her eyesight
On a recent episode of Trinny Woodall’s Fearless podcast, Dench revealed that someone has to accompany her when she leaves the house due to her deteriorating eyesight. “I have to now because I can’t see and I will walk into something or fall over,” she said. She continued that she’s never been a fan of attending events alone anyway. “I’m not good at that at all! Nor would I be now,” Dench said, adding, “Fortunately, I don’t have to be now because I pretend to have no eyesight.”
Dench was first diagnosed with AMD in 2012 and has been dealing with changes in her eyesight ever since. “Millions of people have got it,” she told Anderson Cooper at the time. “It doesn’t mean I’m going blind.”
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While it’s true that AMD does not cause complete blindness, the condition can cause loss of your central vision—something that has affected Dench’s ability to read scripts. In a 2023 episode of the The Graham Norton Show, she revealed, “[Learning lines] has become impossible… But I have a photographic memory, so I’ve got to find a machine that not only teaches me my lines but also tells me where they appear on the page.” Despite such challenges, she quickly added, “I’ll find a way.”
Changes in her eyesight have also affected Dench’s ability to paint. During an appearance on BBC’s Countryfile, she confessed, “I am still painting, I can’t see anymore. Perhaps it’s no worse than it used to be,” before adding she had “no choice” but to remain positive about her condition.
What is AMD?
The leading cause of vision loss in people over 50, AMD affects the macula, part of the eye responsible for the detailed images that we see directly in front of us.
“Think of your eyeball as a hollow ball,” says ophthalmologist Lylas G. Mogk, MD, Director, Center for Vision Rehabilitation and Research at Henry Ford Health System. “The cornea is like a clear glass dome and the whole inside lining of the eyeball is the retina, like wallpaper lining the eyeball. What happens with AMD is a little spot dead-center on the retina, the macula, starts to degenerate over time affecting central, not peripheral, vision.”
So while reading and seeing details directly in front of her is difficult for Dench, objects off-center typically remain clear in those with AMD.
There are two types of AMD: dry and wet. Dry AMD occurs when the macular thins with age. It’s more common, accounting for about 80 percent of AMD cases. Over time, it may progress to wet AMD, a more severe form of the condition that causes significant vision loss. “With wet AMD, blood vessels grow and break through a barrier in the retina,” Dr. Mogk explains.
Recognizing macular degeneration symptoms
In most cases, people with AMD may not notice symptoms until the condition progresses. When it does, common symptoms of macular degeneration may include:
- Blurry vision
- Difficulty seeing in low light
- Straight lines may appear wavy
- Dark spots in the center of your vision
- Trouble recognizing faces
Risk factors for AMD
While the root cause of AMD is still unknown, there are a few key risk factors. Here, the main culprits thought to increase the likelihood of developing the condition:
Smoking
Smoking is by far the biggest risk factor for AMD, as it “causes oxidative stress that promotes the progression of the disease and makes smokers three to four times likelier to develop AMD,” says Ines Lains, MD, PhD, vitreoretinal surgeon, scientist in Mass Eye and Ear’s Retina Service and Instructor of Ophthalmology at Harvard Medical School.
Indeed, smoking increases inflammation and toxins in the body thought to both lead to and exacerbate AMD. If you need help quitting, check out our top tips here.
Family history
Fair-skinned Caucasians are at higher risk for AMD, says Dr. Mogk, because their skin and eyes tend to contain less melanin that protects against damaging UV rays.
Having a direct relative, a parent or sibling, with AMD also significantly increases the risk of developing the disease. “This doesn’t necessarily mean the condition is inherited,” reveals Dr. Mogk. “It could also be that one family is exposed to the same environmental factors or toxins—like sunlight, air pollutants or herbicides—over the course of decades.” That’s why wearing sunglasses that block UVA and UVB rays when outdoors is so important.
The standard American diet (SAD)
From pizza to potato chips, the highly-processed foods that characterize the typical American diet trigger inflammation and introduce toxins thought to increase the risk of AMD. The simple Rx: “Recent research shows the Mediterranean diet—fish, nuts, seeds and moderate amounts of cheese—lowers the risk of AMD and may help prevent the disease,” reveals Dr. Lains. Plus, the antioxidants in fruits and vegetables help tame the free radicals that contribute to AMD, adds Dr. Mogk.
How to manage AMD
“Since most people are asymptomatic until the condition is advanced, it’s important to get a dilated eye exam every year after the age of 50 so that we can catch it early and start treatment.”
If you do have the condition, here’s what can help safeguard your eyesight and make life easier to manage with limited vision:
Take an AREDS 2 eye vitamin
The AREDS 2 supplement contains nutrients that support eye health like vitamin C and lutein. “Though the formulation doesn’t stop or reverse AMD, one study showed it decreased the rate of progression for 30 percent of people with the disease,” says Dr. Mogk.
Consider injections for wet macular degeneration
“EYLEA injections turn off the ‘switch’ that causes the abnormal growth of blood vessels in the eyes, helping slow the progression of wet AMD,” says Dr. Mogk. Depending on your condition, you may need multiple injections over the course of several months. Ask your doctor if EYLEA is right for you.
Swap your dishes
AMD decreases contrast sensitivity, the ability to discern a light-colored object against a light background or a dark object against a black background. This makes it hard to see light-colored food like oatmeal in a white bowl, for example, or black coffee in a dark cup, Dr. Mogk explains. “I always recommend getting one set of dark dishware to make it easier to see light foods and vice versa—increasing contrast is key.”
Adjust your lighting
Lighting, of course, is critical to helping you see more clearly. But it’s important to be strategic about it. “A ceiling fixture’s indirect light, for example, isn’t going to cut it,” says Dr. Mogk, who instead recommends a “goose neck” lamp. “Its flexible neck is easy to adjust so that you can beam it directly on close-up work or reading material.”
Ask about visual rehabilitation
Just as there is stroke rehabilitation, there is visual rehabilitation to help you remain as independent as possible, Dr. Mogk says. “There are a number of agencies that specialize in vision rehabilitation and that offer all sorts of wonderful devices that do everything from magnify print to read books aloud.”
Visual rehab can also help you use the vision you do have more effectively. For example, since AMD blurs the middle of your visual field, you might learn techniques to help you get a clearer picture by looking slightly to the left or right of an object, Dr. Mogk explains. To find resources near you, head to VisionAware or the American Foundation for the Blind.
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