For adults who already know they have a scar in the retina or choroid near the center of vision. Use this guide with the eye doctor you already see.
Know your usual. Report what’s new.
For adults who already know they have a scar in the retina or choroid near the center of vision. Use this guide with the eye doctor you already see.
Start with what you know
Your eye doctor can tell you where your scar is, what likely caused it (for example an eye injury, histoplasmosis or high nearsightedness) and how often you should be seen. This guide does not diagnose anything, and it cannot tell you what a change in your vision means.
Why an old scar still deserves attention
Some central scars can later become a site for abnormal new blood vessels. When that happens, a prompt visit matters, and the problem is often treatable.
What this guide helps you do
Understand how an old scar and new vessels can be connected. Recognize changes worth a prompt call. Describe a change clearly on the phone. Bring focused questions to your next visit. Keep a short record of your own eye history.
An old scar. A possible new problem.
A scar is healed tissue. Near the center of the retina, it can leave a lasting change in how things look. That long-standing picture is your usual.
What a central scar can do
A scar in or near the center of the retina can make things look irregular, doubled, bigger or smaller than they are. If your view has looked that way for a long time, that is your baseline, not a new warning sign.
What CNV means
Choroidal neovascularization (CNV) means abnormal new blood vessels growing from the choroid, the layer beneath the retina. Some scars in or near the macula, the part of the retina you use for sharp central vision, can later become a site for CNV.
Can, not will
Eye specialists describe this as a possibility, not a certainty. It is described for scars from presumed ocular histoplasmosis, for choroidal rupture after an eye injury, and for lacquer cracks in severe (pathologic) nearsightedness. After a choroidal rupture, CNV may appear at any time, sometimes months later.
A change from your usual is the signal.
Call your eye doctor promptly if you notice something new in the eye with the scar:
New waviness or bending
Straight lines such as door frames, tile or lines of text look newly bent, or bend more than they used to.
New blur in the center
Faces or print look newly blurry, even with your usual glasses.
A new dark, gray or missing spot
A spot near the center of your vision that was not there before.
A sudden drop in central vision: call today
Do not wait for your next routine visit. If you cannot reach your eye doctor, ask where you can be seen today.
What these changes cannot tell you
They do not show the cause. Only an eye exam can. Report the change and let the exam sort it out.
Which eye. When. What it looks like.
A clear description helps the office decide how soon to see you. Three details do most of the work.
Which eye
Cover one eye, then the other, and note which eye shows the change. This is only to describe it, not to test yourself.
When it started
The day you first noticed it, and whether it came on suddenly or over days or weeks. Say if it is getting worse.
What it looks like
Illustrative language, use only if true: “Since Tuesday, the door frame looks bent in my right eye, and there is a gray smudge just left of center. My old scar never did that.”
How it differs from your usual
Compare it with how that eye has looked for a long time. The difference is what the office needs to hear.
Bring these. Add your own.
Short questions that help you understand your own risk and plan.
Where exactly is my scar, and does its location matter?
Scars in or near the macula are the ones described as possible sites for CNV. Ask what that means for your eye.
Which changes should make me call, and how fast?
Get the office’s own guidance, including who to call after hours.
How often should I be seen?
Ask for a follow-up schedule and what it depends on.
Do you recommend an Amsler grid or another way to check at home?
Ask how to use it and what counts as a change worth reporting.
If I develop CNV, what are the treatment options?
Ask what treatment involves and what follow-up comes afterward.
A grid can help. It does not replace exams.
Home checks, treatment and your own records each play a part.
If your eye doctor recommends an Amsler grid
Use it the way they explain, and report changes you notice even if you are unsure. In a 2023 review of studies in age-related macular degeneration, the grid’s detection rate (its sensitivity) was about 71%: it flagged roughly 7 in 10 eyes that had the disease and missed the rest. Regular eye exams still matter, whatever the grid shows.
CNV is often treatable
Eyes with CNV often respond to treatment, commonly eye injections that target abnormal vessel growth (anti-VEGF). Treated CNV can come back, so follow-up visits matter.
Keep a short record of your own
Write down when your scar was found, the likely cause if known, which eye, any treatments with dates and your follow-up schedule. If a visit note gets a fact wrong, such as the wrong eye or date, ask the office how to correct it.
Sources behind this guide
- AAO EyeWiki: Presumed Ocular Histoplasmosis Syndrome
- AAO EyeWiki: Choroidal Rupture
- AAO EyeWiki: Pathologic Myopia (Myopic Degeneration)
- AAO: Ask an Ophthalmologist: wavy Amsler grid (2012)
- AAO Editors’ Choice: Amsler grid may not be as reliable as once thought
- 38 CFR §4.79: Schedule of ratings, eye (DC 6011)
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