Drusen are tiny yellow or white accumulations of extracellular material (likened to glittering geode when seen through an opthalmoscope) that build up between Bruch's membrane and the retinal pigment epithelium of the eye. The presence of a few small ("hard") drusen is normal with advancing age, and most people over 40 have some hard drusen. However, the presence of larger and more numerous drusen in the macula is a common early sign of age-related macular degeneration.