Age-Related Macular Degeneration

Early and intermediate AMD usually have no symptoms at all. The macula is changing on the inside, but vision still feels normal. As the disease moves toward advanced age-related macular degeneration, common signs include:

• Trouble reading in dim light — needing a much brighter lamp than before.
• Words on a page look broken or blurry in the middle, even with up-to-date glasses.
• A dim, gray, or blurry spot right in the center of your vision.
• Colors look less bright in one eye than the other.
• Trouble recognizing faces, even up close.
• Straight lines look wavy or bent — this can be the first sign that age-related macular degeneration has turned wet.

Age-related macular degeneration is not painful. The eye looks normal from the outside. Side (peripheral) vision usually stays normal — only the central vision is affected ¹. If you have drusen or AMD in either eye, an Amsler grid at home can help you catch new distortion early ⁸.

The exact cause of age-related macular degeneration is not fully known, but it comes from a mix of normal aging, genes, and lifestyle. With age, the macula has more trouble cleaning up waste, and yellow deposits called drusen build up under the retinal pigment layer. Inflammation and changes in the complement (immune) system slowly damage the light-sensing cells ⁵.

Things that raise your risk of age-related macular degeneration:

• Age 55 and older — risk rises sharply after age 70.
• Smoking — the strongest changeable risk factor. Smokers are about 2-4 times more likely to develop AMD.
• Family history of macular degeneration — gene variants like CFH and ARMS2 raise risk.
• White race / European ancestry — late AMD is more common in people of European descent.
• Light-colored eyes — less protective pigment.
• Heart disease, high blood pressure, and high body weight.
• A diet low in leafy greens and fish and high in saturated fat or sweets.
• Long-term sunlight exposure without UV protection (a smaller, debated risk).

None of these guarantee you will get AMD. Quitting smoking, eating leafy greens and fish, and keeping blood pressure under control can lower risk over time.

There is no cure for dry age-related macular degeneration, but several things can slow it down or save vision. Treatment depends on the stage ⁹.

Early dry AMD (small drusen):

• No medical treatment is needed today. The most important steps are stopping smoking, eating leafy greens and fish, and getting a dilated eye exam every 1-2 years.
• AREDS2 vitamins are usually not started this early — studies did not show a benefit for very early disease.

Intermediate dry AMD (large drusen in one or both eyes):

• AREDS2 vitamins are the main treatment. The mix has vitamin C, vitamin E, zinc, copper, lutein, and zeaxanthin. They lower the chance of moving to advanced age-related macular degeneration by roughly 25% over 5 years.
• Same lifestyle steps as early disease: do not smoke, eat well, control blood pressure.
• Use an Amsler grid at home and call your eye doctor the same day if straight lines start to look wavy.

Advanced dry AMD (geographic atrophy):

• Complement-inhibitor eye injections (pegcetacoplan, avacincaptad pegol) can slow how fast geographic atrophy patches grow. In phase 3 trials, lesion growth slowed by about 14-27% over 1-2 years. Important caveat: these drugs did not improve vision on trial eye charts, and they slightly raised the risk of converting to wet AMD ⁷.
• Talk with a retina specialist about whether injections make sense for your eyes, and what the realistic goal is.

Wet (neovascular) AMD:

• Anti-VEGF eye injections (aflibercept, ranibizumab, bevacizumab, faricimab) are the standard of care. Started early, they save vision in most eyes.
• See the Wet AMD page for full details.

Most people with dry age-related macular degeneration keep useful vision for many years. A few habits make a big difference day to day:

• Stop smoking. Quitting slows the disease in both eyes and lowers the chance of moving to advanced AMD.
• Eat for the macula. Leafy greens (kale, spinach), colorful vegetables, and fatty fish (salmon, sardines) support the retinal pigment layer. A Mediterranean-style diet is linked with slower progression of age-related macular degeneration.
• Ask about AREDS2 vitamins. They help most for intermediate AMD or for the second eye when one already has advanced AMD. Take them every day if your eye doctor recommends them.
• Use an Amsler grid at home. Check each eye on its own, on a regular schedule. If lines that were straight start to look wavy, call your eye doctor the same day ¹⁰.
• Wear UV-blocking sunglasses. Wraparound sunglasses cut down on glare and may protect the macula.
• Use bright, even light for reading, and large-print books, magnifiers, or screen-reader apps if you need them.
• Keep blood pressure, cholesterol, and weight in a healthy range. These also protect the eye.
• Get a low-vision exam. A low-vision specialist can match you with tools that make reading, cooking, and computer use easier.