Geographic Atrophy: Your Care Team

Hearing the words “geographic atrophy” (GA) in your eye doctor’s office can feel like someone just switched the lights off in the middle of the movie. It’s serious, it’s long term, and it affects how you see the world. The good news? You don’t have to manage it alone. Geographic atrophy care is a team sport, and you get to be the captain.

This guide walks you through what geographic atrophy is, who should be on your
GA care team, what each person actually does, and how you can work with them to protect your vision and your quality of life.

What Is Geographic Atrophy, in Plain English?

Geographic atrophy is an advanced form of dry age-related macular degeneration (AMD). Over time, cells in the macula – the part of the retina responsible for sharp, straight-ahead vision – slowly die off. These areas of damage are called “lesions” and look like well-defined patches on imaging tests. As they grow, they can cause blurry or missing spots in your central vision.

People with GA often notice:

• Blank or gray areas in the center of what they’re looking at
• Words dropping out of lines while reading
• Faces becoming harder to recognize
• Difficulty seeing in dim restaurants or at night
• Straight lines (like door frames) that look wavy or broken

GA usually progresses slowly, but it is considered irreversible damage to the retina. That’s why early detection, regular follow-up, and a coordinated care team matter so much.

How Geographic Atrophy Fits Into AMD

Age-related macular degeneration comes in two major types:

• Dry (atrophic) AMD – more common and often slower moving
• Wet (neovascular) AMD – less common but can cause rapid vision loss due to leaking or bleeding blood vessels

Geographic atrophy is the advanced stage of dry AMD. Millions of people worldwide are living with GA, and over a million are estimated to be affected in the United States alone. Even though GA can’t be reversed, there are now ways to slow progression and to maintain independence with the right support.

Why You Need a Whole Care Team (Not Just “an Eye Doctor”)

If you’ve ever tried to assemble furniture using only one tool, you already understand why GA calls for a team. No single professional can cover everything you need:

• A specialist to diagnose and treat the disease itself
• Experts to help you make the most of the vision you still have
• Support for managing other health conditions that influence eye health
• People to help you handle the emotional and practical side of vision loss

Think of your GA care team as a small, well-organized squad. Everyone has a role, and when they communicate with each other – and with you – the game plan works much better.

Meet the Core Members of Your Geographic Atrophy Care Team

1. Retina Specialist or Ophthalmologist: The Medical Captain

At the heart of GA management is the retina specialist or ophthalmologist. This is a medical doctor (MD or DO) with advanced training in diagnosing and treating diseases of the retina and macula.

Your retina specialist or ophthalmologist will:

• Confirm the diagnosis using imaging tests such as OCT and fundus photography
• Measure and track GA lesions over time
• Discuss treatment options, including injections designed to slow GA progression
• Screen for and manage wet AMD if it develops
• Coordinate with your optometrist and low-vision team

In recent years, two FDA-approved drugs – pegcetacoplan (Syfovre) and avacincaptad pegol (Izervay) – have become available to slow the growth of GA lesions in some patients. They’re delivered as injections into the eye on a regular schedule (often monthly or every other month). These medications do not restore lost vision, but they can help preserve vision for longer by slowing damage. Your retina specialist will walk you through whether you’re a good candidate, the risks and benefits, and what results to realistically expect.

2. Optometrist: The Front-Line Vision Manager

Your optometrist is often the first person to spot signs of AMD or GA. Optometrists perform routine eye exams, update your glasses or contact lens prescriptions, and monitor changes in your vision over time.

In geographic atrophy, an optometrist may:

• Pick up early changes on retinal imaging or during a dilated exam
• Refer you promptly to a retina specialist or ophthalmologist
• Adjust your prescription lenses to maximize remaining vision
• Help you choose lenses with contrast-enhancing tints or filters
• Coordinate with low-vision services when everyday tasks become challenging

When optometrists and ophthalmologists communicate regularly, your care becomes smoother and more proactive. If you’re seeing both, don’t hesitate to tell each provider what the other has said – or to ask them to share notes.

3. Low-Vision Specialist: The Creative Problem-Solver

A low-vision specialist can be an optometrist, ophthalmologist, or certified low-vision therapist with advanced training in helping people live well with reduced vision.

They don’t “fix” your eyes – they help you work smarter with the vision you have. That may include:

• Recommending magnifiers, handheld telescopes, or high-powered reading glasses
• Teaching you how to use electronic devices such as video magnifiers or screen readers
• Suggesting lighting strategies (for example, flexible gooseneck lamps with warmer tones)
• Training you to use your “next-best spot” in your visual field if you have central blind areas
• Working with occupational therapists to adapt your home for safety and independence

A good low-vision visit is part eye exam, part gadget lab, and part coaching session. You’ll usually try out devices, practice tasks, and leave with a customized plan rather than a one-size-fits-all solution.

4. Occupational Therapist: Turning Your Home into “Accessible Mode”

Occupational therapists (OTs) who specialize in vision rehabilitation help you safely do the activities that matter most – cooking, bathing, managing medications, using the computer, or moving around your home and community.

With GA, an OT may:

• Suggest contrast-boosting tricks, like dark cutting boards for light foods and vice versa
• Help label medication bottles with large print or tactile markers
• Reorganize your kitchen or bathroom so items are easy to locate by habit
• Recommend apps and devices for reading mail, recipes, or text messages
• Coach you on safe navigation at home and outdoors

Think of occupational therapy as “real-life training mode” for your visual changes – practical, hands-on, and deeply personalized.

5. Primary Care Provider: Protecting the Rest of Your Health

Your primary care provider (PCP) might not check your retinas, but they play a huge role in GA care. Many of the risk factors for AMD and GA – like high blood pressure, high cholesterol, diabetes, and smoking – are managed in primary care.

In partnership with your GA care team, your PCP can:

• Help you stop smoking if you currently smoke
• Manage blood pressure, blood sugar, and cholesterol levels
• Review supplements like AREDS2 vitamins and check for interactions
• Encourage heart-healthy and eye-friendly lifestyle habits (exercise, diet, sleep)

Healthy blood vessels and good circulation benefit your eyes as well as your heart. Keeping chronic conditions under control is one of the most powerful things you can do for your long-term vision.

6. Pharmacist: Your Medication Co-Pilot

Your pharmacist is the person who sees all your medications in one place – injections, pills, eye drops, and supplements. They are a valuable, often underused member of your GA team.

A pharmacist can:

• Explain how GA injections fit with your other medications
• Flag potential interactions between eye medicines, blood thinners, and supplements
• Help you understand side effects you should report to your retina specialist
• Suggest strategies for managing injection schedules and reminders

Pro tip: bring a complete list of everything you take – prescriptions, over-the-counter drugs, and supplements – and ask, “Is there anything here that could affect my eyes or these injections?”

7. Mental Health Professionals and Social Workers: Protecting Your Mood and Independence

Vision loss doesn’t just affect your eyes; it can take a real emotional toll. Anxiety about the future, grief over changes, and fear of losing independence are all common – and not a sign that you’re “weak” or “overreacting.”

Counselors, psychologists, and social workers can:

• Help you process the diagnosis and the uncertainty it brings
• Teach coping skills for anxiety, low mood, or frustration
• Connect you with support groups and community resources
• Assist with transportation, home services, or financial aid programs when needed

If your mood has been stuck in a low place, you’re avoiding activities you used to enjoy, or you feel constantly worried about “what’s coming,” it’s absolutely appropriate to ask for mental health support. It’s just as important as treating your eyes.

8. Family, Friends, and Peer Support: The Unsung MVPs

Finally, we have the people who can’t write prescriptions but who may be your biggest lifeline: family, friends, and peers who also live with GA.

Loved ones can:

• Drive you to appointments or help you organize rides
• Read small print or set up devices and accessibility features
• Practice low-vision strategies with you at home
• Watch for changes in your day-to-day functioning and encourage timely check-ins with your doctors

Peer support groups – whether local, through low-vision agencies, or online – add something special: the “you’re not the only one” factor. Hearing from others who have walked the GA path can turn fear into practical ideas and hope.

Treatments, Monitoring, and Follow-Up: What Your Team Actually Does

Regular Monitoring and Eye Imaging

GA doesn’t usually change overnight, but your care team watches it closely so you and your doctor can act at the right time. Monitoring often includes:

• Dilated eye exams to look at the retina directly
• Optical coherence tomography (OCT) scans to see cross-sections of the retina
• Fundus photographs or autofluorescence imaging to map GA lesions over time
• Home testing like an Amsler grid to check for new blank or distorted areas

If your vision suddenly worsens, especially if it’s distorted or dark in one area, your care team may check urgently for wet AMD, which requires different treatment.

Understanding GA Injections and Treatment Expectations

If you and your retina specialist decide to try injections such as pegcetacoplan or avacincaptad pegol, here’s what the process usually looks like:

• You’ll be scheduled for injections every month or every other month.
• Your eye will be numbed and cleaned to reduce discomfort and risk of infection.
• The injection itself is quick; many patients describe pressure more than pain.
• You may have some scratchiness or redness afterward that usually resolves in a day or two.
• Over time, your doctor will compare imaging to see how quickly the GA lesions are growing.

It’s important to remember that these medicines are designed to slow down damage, not to restore sharp vision that’s already been lost. Think of them as tapping the brakes, not putting the car in reverse. That’s why staying on schedule – and sticking with follow-up visits – is critical.

Your team will also watch for side effects, including rare but serious issues such as infection inside the eye (endophthalmitis) or increased risk of developing wet AMD. If you notice severe pain, sudden vision loss, a curtain over your vision, or intense redness, you should call your eye doctor immediately or seek urgent eye care.

Clinical Trials and New Frontiers

GA research is moving fast. Clinical trials are exploring:

• Stem cell therapies to replace damaged retinal cells
• Gene-based treatments targeting pathways involved in AMD
• Implantable devices and visual prostheses that might restore some functional central vision

If you’re interested in clinical trials, your retina specialist is the best person to ask. Trials have strict eligibility criteria and involve extra visits and testing, but they can provide access to cutting-edge therapies and help advance care for everyone with GA.

Low-Vision Rehabilitation and Everyday Strategies

While your medical team focuses on slowing the disease, low-vision rehab focuses on upgrading your day-to-day life. Strategies often include:

• Using large-print books, bold-line paper, and high-contrast pens
• Switching device settings to dark mode or high-contrast themes
• Using tablet or phone cameras to magnify menus, labels, and receipts
• Adding task lighting where you read, cook, sew, or work on hobbies
• Decluttering walkways and adding contrast tape on stairs or step edges

These changes may seem small individually, but together they can dramatically improve safety, confidence, and independence.

How to Build and Work With Your GA Care Team

Step 1: Start With a Comprehensive Eye Exam

If you’ve been told you have dry AMD or possible GA – or if straight lines look wavy, words vanish while reading, or you’re struggling with dim light – the first step is a full, dilated exam with an eye care professional. From there, you can be referred to a retina specialist if GA is suspected or confirmed.

Step 2: Ask “Care Team” Questions

At your visits, try asking:

• “Can you explain where my GA is and how advanced it is?”
• “How often should I come back, and what imaging will we use?”
• “Would I benefit from injections to slow GA progression?”
• “When should I see a low-vision specialist or occupational therapist?”
• “Who on my team can help with driving decisions, work, or home safety?”

These questions signal that you’re thinking in terms of a coordinated care plan, not just one appointment at a time.

Step 3: Bring Your Life Into the Exam Room

Don’t just say, “My vision is kind of worse.” Say:

• “I’m having trouble reading my favorite mystery novels.”
• “I can’t see people’s faces clearly across a room.”
• “I’m nervous about night driving.”
• “I’ve stopped doing hobbies I love because I can’t see the details.”

The more specific you are, the easier it is for your care team to suggest targeted solutions – whether that’s adjusting your lighting, recommending a magnifier, or checking if your GA has progressed.

Step 4: Stay Organized Between Visits

GA care often involves multiple providers and repeated treatments. To keep everything straight:

• Use a notebook or notes app for questions that pop up between appointments.
• Keep an updated list of all medications and supplements.
• Write down injection dates and which eye was treated.
• Ask a family member or friend to come along as a second set of ears when big decisions are on the table.

Remember: you are not “bothering” your doctors by asking questions. You’re being an excellent team captain.

Real-Life Experiences: Living With a Geographic Atrophy Care Team

Medical facts are important, but life doesn’t happen in bullet points. To bring this closer to home, here are some composite experiences (based on many real stories) that show what a GA care team can look like in everyday life.

Maria, 72: Finding Her Reading Life Again

Maria loved book clubs. When she developed geographic atrophy, the words on the page began to disappear, especially in low light. She stopped going to meetings and told her friends she was “too busy,” but really she was embarrassed that she couldn’t keep up.

Her optometrist noticed new central blank spots during an exam and referred her to a retina specialist, who diagnosed GA and started injections to slow progression. The specialist also suggested a low-vision clinic. At first, Maria hesitated – “Isn’t that for people who are almost blind?” – but she went.

The low-vision specialist set her up with a high-contrast reading lamp, a handheld electronic magnifier, and tips for using a tablet to enlarge text. An occupational therapist helped rearrange her favorite reading chair with better lighting and taught her how to position her eyes slightly off center to avoid her blind spot.

Within a few weeks, Maria was back to book club – reading a little slower, but reading. Her care team didn’t “cure” GA, but together they rebuilt a piece of her normal life.

James, 68: Navigating Work, Driving, and Tough Decisions

James still worked part-time as an accountant when GA started to interfere with spreadsheets and nighttime driving. His retina specialist managed his injections and imaging, but the toughest conversations were about independence.

A low-vision optometrist introduced James to screen-magnification software and large-print check registers. A driving rehab specialist evaluated his on-road safety and suggested limiting driving to daytime on familiar routes. When James’ anxiety spiked at the idea of “losing” driving altogether, his primary care provider referred him to a counselor who specializes in chronic illness.

With his team’s support, James gradually transitioned from driving everywhere to using ride-shares for night outings and weekly carpools for work. It wasn’t an easy change, but having professionals and family involved made it feel like a plan, not a punishment.

Lena, 59: Caregiver, Scheduler, and Cheerleader

Lena’s mother, age 84, has advanced GA and mild memory changes. As the primary caregiver, Lena is an honorary member of the care team – and sometimes the unofficial coordinator.

She keeps a shared calendar with injection dates, transportation arrangements, and follow-up visits. She sits in on appointments, asking questions her mom forgets and repeating key instructions at home. A social worker helped them apply for paratransit, and a low-vision agency arranged a home safety assessment.

Lena also gently nudges her mom to keep attending a weekly seniors’ group and to call friends instead of staying home alone. When her mom gets discouraged – “What’s the point, my eyes are bad anyway” – Lena reminds her of the progress they’ve made with better lighting, larger labels, and new devices that let her read recipes again.

Caregivers like Lena are often the glue that holds the care team together. If you’re in that role, you deserve support too – from professionals, family, and community resources.

Bringing It All Together

Geographic atrophy is serious, but it is not a reason to give up on the things and people you love. With today’s treatments, low-vision tools, and a strong care team, many people continue reading, socializing, cooking, and enjoying hobbies for years after diagnosis.

The key is to treat GA as a team effort:

• Work closely with your retina specialist and optometrist.
• Ask for referrals to low-vision specialists and occupational therapists early.
• Keep your overall health in good shape with your primary care provider.
• Lean on pharmacists, mental health professionals, caregivers, and peer support.

You didn’t choose geographic atrophy, but you can choose how prepared and supported you are. Build your care team, ask questions, and remember: you’re the most important person on the roster.