Simply put, macular degeneration is when a person's eyesight straight ahead begins to become blurry, and as it advances, they see a dark spot straight ahead that ultimately moves them to a place where they only have peripheral vision. My mother had it. I am told it is hereditary.
Some congregations develop macular degeneration to where their vision of the future is blurred and ultimately blocked. They have no clarity about what is ahead of them. They can only see to one side or another.
I had an interesting discussion today with a ministry colleague about congregational experience similar to mine. It is that we both grew up in parts of North America where our denomination of heritage was not present in large numbers, and our families were part of starting new congregations affiliated with our denomination. As he pointed out, the vision of many congregations was blurred and they only had peripheral vision.