A 70-year-old with central vision loss and preserved peripheral vision, with a clear lens, most likely has which condition?

• A. Glaucoma
• B. Cataracts
• C. Detached retina
• D. Macular degeneration

Answer: (D)

Central vision loss with preserved peripheral vision points to macular disease, specifically age-related macular degeneration. The macula is the central part of the retina responsible for sharp, detailed vision; when it deteriorates, you lose the ability to see fine details or read with the center of gaze, while the outer, peripheral vision remains. The fact that the lens is clear argues against cataracts, which typically cause overall blurred vision due to lens opacity rather than a central loss with intact periphery. Glaucoma usually starts with peripheral field loss and progresses inward, not isolated central decline. A detached retina presents with sudden, unilateral vision loss often described as a curtain coming across the field, along with flashes or floaters. Thus, the described pattern most consistently fits age-related macular degeneration.