Drusen (yellow deposits in the eye): causes, types and diagnosis

Drusen, sometimes described as "yellow eyes" or a yellow retina, are small yellow or white deposits that build up under the retina, the light-sensing layer at the back of the eye. Some drusen are normal and harmless, while others can point to an underlying eye condition, including age-related macular degeneration (AMD). This guide explains the causes of drusen, the different types and how they are diagnosed and managed.

Normal and abnormal drusen

• Normal drusen: small, round deposits of cellular waste that build up in the retina over time. They are usually found in people over 40 and are considered a normal part of ageing.
• Abnormal drusen: larger and more numerous deposits that can be linked to eye conditions such as AMD. Abnormal drusen can interfere with vision and indicate a higher risk of developing AMD.

Causes of drusen

• Age: normal drusen are common in older people and are a natural consequence of ageing.
• Genetics: a family history of AMD or other eye conditions increases the chance of developing abnormal drusen.
• Smoking: smoking is a significant risk factor for AMD and may contribute to abnormal drusen.
• High blood pressure: hypertension can affect blood flow to the eyes and may contribute to drusen. Read more about high blood pressure and the eyes.

Types of drusen

• Hard drusen: small, distinct deposits that are usually considered normal and don't usually affect vision.
• Soft drusen: larger, less well-defined deposits linked to AMD, which can lead to vision loss if left untreated.

Symptoms of drusen

• Yellow or white spots: drusen appear as yellow or white spots on the retina, particularly in the macula, the central part of the retina responsible for sharp, central vision. They are seen by an eye doctor during an examination.
• Blurred vision: in advanced AMD, drusen can cause blurred or distorted vision, making it hard to read, drive or recognise faces.

Diagnosis of drusen

• Comprehensive eye examination: an eye doctor examines the retina with specialised instruments to look for signs of drusen.
• Optical coherence tomography (OCT): this scan gives detailed cross-sectional images of the retina, so the doctor can see and measure the size and position of drusen.
• Fluorescein angiography: a dye is injected into the bloodstream and photographs are taken as it passes through the blood vessels of the retina. This helps detect the abnormal blood vessel growth associated with AMD.

Treatment and management of drusen

• Monitoring: for people with normal drusen, regular checks of vision and eye health are usually recommended to spot any changes over time.
• Lifestyle changes: a healthy lifestyle, including a balanced diet rich in antioxidants, stopping smoking and controlling blood pressure, can help reduce the risk of AMD and abnormal drusen. See nutrition and diet for healthy eyes.
• Anti-VEGF therapy: for people with advanced AMD and soft drusen, injections of anti-VEGF medicines into the eye may be recommended to slow the disease and preserve vision. Read more about when to see a retina specialist.

In short

Drusen are common in ageing eyes, but they can also be a sign of an eye condition such as AMD. Understanding their causes, types, symptoms and diagnosis is important for early detection and the right care. Regular eye check-ups, a healthy lifestyle and prompt attention to any change in vision all help reduce the risk of vision loss from drusen and AMD.