An Amsler grid is a square grid of lines with a dot in the center. The American Academy of Ophthalmology (AAO) suggests people with AMD use it once a day: wear your reading glasses, hold it 12 to 15 inches away in good light, cover one eye, keep looking at the dot, and notice any lines that look wavy, blurry, dark or blank, then repeat with the other eye. If anything looks that way, contact your eye doctor right away. A home grid check does not replace regular eye exams.
If you have age-related macular degeneration (AMD), your eye doctor may have given you a small printed grid and asked you to look at it every day. It can seem too simple to matter.
This guide covers how to use the grid, what to report, why eye doctors suggest it, and what the research does and does not show about how well it works. The steps are paraphrased from the AAO's guide to the Amsler grid. Warning signs come from the National Eye Institute (NEI) and MedlinePlus.
What an Amsler grid is
The AAO describes the Amsler grid as a square grid pattern with a dot in the middle. You look at the dot and pay attention to how the lines around it appear.
The same grid is used in the office. MedlinePlus explains that during an eye exam, "You may be asked to cover one eye and look at a pattern of lines called an Amsler grid. If the straight lines look wavy, it may be a sign of AMD."
For home use, ask your eye doctor for a grid. MedlinePlus also points readers to the American Macular Degeneration Foundation for a grid you can download, along with instructions for using it at home.
Who a home grid check is for
The AAO's daily grid guidance is written for people with AMD. MedlinePlus puts it this way: "If you have AMD, your eye doctor may recommend that you check your vision every day with an Amsler grid."
If you have not been diagnosed with AMD, or you are not sure which stage you have, ask your eye doctor whether a home grid makes sense for you. The answer depends on what your exams show.
How to use an Amsler grid, step by step
The AAO suggests checking once a day, every day. Here are its steps, in our own words:
- Put on your reading glasses. Use the glasses you normally wear to read, if you wear them.
- Find good light. Check the grid somewhere well lit.
- Hold the grid 12 to 15 inches from your face.
- Cover one eye.
- Look straight at the center dot. Keep your eye on the dot the whole time instead of looking around the grid.
- Notice the lines. While still looking at the dot, pay attention to whether any lines look wavy, blurry or dark, or whether part of the grid looks blank.
- Switch eyes. Cover the other eye and do the same check.
Why one eye at a time? Our article on the symptoms of macular degeneration explains how one eye can cover for the other.
What to look for, and what to do
The AAO says that if any area of the grid looks darker, wavy, blank or blurry, you should contact your ophthalmologist right away. The NEI is just as direct: "Straight lines looking wavy is a warning sign for late AMD. If you notice this symptom, see your eye doctor right away."
These are the kinds of changes NEI and the AAO describe:
- Wavy or crooked lines. NEI says many people with late AMD notice straight lines start to look wavy or crooked.
- A blurry area near the center. NEI notes that over time this blurry area may get bigger.
- Blank spots. NEI lists blank spots as a later change, and the AAO includes blank areas on the grid as a reason to call.
- Dark areas. The AAO lists darker areas on the grid as a reason to call.
Because you check each eye on its own, note which eye showed the change when you call. NEI offers a guide called "Talk with Your Doctor About Age-Related Macular Degeneration" that includes a symptom tracker, which can help you keep notes between visits.
Keep in mind: do not wait for your next scheduled visit if the lines change. MedlinePlus advises: "Contact your eye doctor right away if the lines look wavy."
Why eye doctors suggest daily checks
AMD develops in stages, and the early stages are often quiet. NEI says early dry AMD doesn't cause any symptoms, and that in intermediate dry AMD some people still have no symptoms while others notice mild blurriness in their central vision or trouble seeing in low light.
The AAO explains that dry AMD can turn into wet AMD. Because vision loss from AMD is often gradual, the AAO says a daily grid check can help you catch changes that would not otherwise be obvious. MedlinePlus adds that "The most common early symptom of wet AMD is that straight lines look distorted and wavy."
Wet AMD has treatments. NEI's page on treatments for wet AMD says the most common treatment doctors use to slow vision loss from wet AMD is anti-VEGF injections. For a plain explanation of the two forms, see our article on dry vs. wet macular degeneration.
What the research shows, and what it does not
How accurate is the Amsler grid?
A 2014 systematic review and meta-analysis in the journal Eye (Faes and colleagues) pooled 12 studies with 903 patients. It looked at how well the Amsler grid and a different test, preferential hyperacuity perimetry, picked up wet AMD.
Two numbers describe a test like this. Sensitivity is how often it flags the condition in people who have it. Specificity is how often it gives a normal result in people who do not.
| Test (pooled results, Faes 2014) | Sensitivity | Specificity |
|---|---|---|
| Amsler grid, for wet AMD | 78% (95% CI 64% to 87%) | 97% (95% CI 91% to 99%) |
| Preferential hyperacuity perimetry | 85% (95% CI 80% to 89%) | 87% (95% CI 82% to 91%) |
In plain terms, the grid caught about 78 of every 100 cases of wet AMD in these studies, which means it missed roughly 1 in 5. It rarely gave an abnormal result for people without wet AMD.
The evidence has limits. All but two of the 12 studies had a case-control design. The authors described their results as coming from small preliminary studies and said that how well the findings carry over to everyday clinical practice still needs to be established.
The HOME study tested a home device, not a paper grid
You may see the HOME study mentioned in discussions of home vision monitoring. It is a real randomized trial, but it did not test the Amsler grid.
The HOME study, published in Ophthalmology in 2014, tested a home monitoring device called ForeseeHome (Notal Vision). The device uses preferential hyperacuity perimetry with telemonitoring. The trial enrolled 1,520 people with an average age of 72.5 at 44 AREDS2 clinical centers. Of these, 763 used the device plus standard care and 757 received standard care alone. People in both groups were told to monitor their vision at home, and the device group was also given recommendations for daily testing.
Over an average of 1.4 years, 82 people developed choroidal neovascularization, the blood vessel growth of wet (neovascular) AMD: 51 in the device group and 31 in the standard care group. By the time it was detected, people in the device group had lost a median of 4 letters on the eye chart, compared with 9 letters in the standard care group. The study's Data and Safety Monitoring Committee recommended ending the trial early for efficacy, meaning the results already favored the device group.
So the HOME study supports that specific device used alongside standard care. It does not show that a paper Amsler grid preserves vision. We did not find a randomized trial showing that using a paper grid by itself protects sight.
A grid check is not an eye exam
A normal grid does not mean your eyes are healthy. The grid missed about 1 in 5 cases of wet AMD in the Faes review, and it was studied as a check for AMD, not for other eye diseases.
NEI says AMD is checked as part of a comprehensive dilated eye exam, and your eye doctor may also recommend a scan called optical coherence tomography (OCT). NEI's dilated eye exam page also points out: "Since many eye diseases have no symptoms or warning signs, you could have a problem and not know it."
Other common eye conditions show up differently. NEI says glaucoma usually affects side vision first, and that the only way to find out if you have glaucoma is a comprehensive dilated eye exam; see our guide to glaucoma after 60. Cataracts can blur vision too, and our article on cataracts vs macular degeneration explains why only an exam can tell them apart. For how often to get checked, see eye health after 50.
Frequently asked questions
How often should I use an Amsler grid?
The AAO suggests once a day, every day, for people with AMD. Your eye doctor may give you different instructions based on your eyes, so follow the plan you agreed on together.
Does a normal grid mean I can skip my eye exam?
No. In the Faes review the grid missed roughly 1 in 5 cases of wet AMD, and NEI notes that many eye diseases have no warning signs. Keep your regular exams.
Some lines already look a little off to me. What counts as a change?
Tell your eye doctor what the grid looks like to you on a normal day, and ask which kinds of change should prompt a call. If you notice anything new, such as lines turning wavy or a spot going blank, the AAO says to contact your eye doctor right away, and NEI says to see your eye doctor right away if straight lines look wavy.
If I take AREDS2 supplements, do I still need to check the grid?
Yes. NEI says the supplements "may delay progression of intermediate to advanced AMD", which is not a guarantee that changes will not happen. Our article on how long AREDS2 takes to work explains what the trials measured.
Related reading
- The Symptoms of Macular Degeneration: What to Watch For
- Dry vs. Wet Macular Degeneration
- Cataracts vs Macular Degeneration
- Eye Health After 50
- What Is AREDS2 and Who Needs It?
- Browse the Eye Health Library
References
- American Academy of Ophthalmology. All about the Amsler grid and daily vision checks for AMD (published December 19, 2025). aao.org
- National Eye Institute. Age-related macular degeneration (AMD) (updated June 22, 2021). nei.nih.gov
- National Eye Institute. Treatments for wet AMD (advanced neovascular AMD) (updated December 5, 2024). nei.nih.gov
- National Eye Institute. Get a dilated eye exam (updated November 26, 2025). nei.nih.gov
- National Eye Institute. AREDS/AREDS2 frequently asked questions (updated November 19, 2020). nei.nih.gov
- MedlinePlus. Macular degeneration, age-related (review date July 24, 2025). medlineplus.gov
- Faes L, Bodmer NS, Bachmann LM, Thiel MA, Schmid MK. Diagnostic accuracy of the Amsler grid and the preferential hyperacuity perimetry in the screening of patients with age-related macular degeneration: systematic review and meta-analysis. Eye (Lond). 2014;28(7):788-796. doi:10.1038/eye.2014.104
- Chew EY, Clemons TE, Bressler SB, et al. Randomized trial of a home monitoring system for early detection of choroidal neovascularization home monitoring of the Eye (HOME) study. Ophthalmology. 2014;121(2):535-544. doi:10.1016/j.ophtha.2013.10.027
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