Overview
Age-related macular degeneration (AMD) affects the macula, the central part of the retina responsible for sharp, detailed central vision. Dry AMD (atrophic) progresses slowly and accounts for 80 to 90% of cases. Wet AMD (neovascular) involves abnormal blood vessel growth and causes rapid central vision loss if untreated. AMD is the leading cause of severe visual impairment in people over 50 in the developed world.
How common is it?
AMD is a common cause of central vision problems in older adults. It usually first affects people in their 50s and becomes more likely with ageing.
Causes and risk factors
AMD involves changes in the macula, influenced by ageing, inherited susceptibility and environmental factors including smoking. Its exact cause is not fully understood.
Common risk factors
- Age (primary risk factor)
- Smoking (doubles the risk — single most modifiable factor)
- Family history (CFH, ARMS2, and HTRA1 gene variants)
- Cardiovascular disease and hypertension
- Fair skin and blue eyes
- High dietary fat intake
- UV light exposure
- Cataract surgery is not an established cause of AMD progression; discuss its individual benefits and risks with an eye specialist.
Symptoms
- Gradual loss of central vision (dry AMD)
- Difficulty recognising faces or reading fine print
- Straight lines appearing wavy or distorted (metamorphopsia — an early sign of wet AMD)
- Blurred or blank spot in the centre of vision
- Colours appearing less vivid
- Peripheral vision is preserved
When to see a doctor
Seek urgent eye assessment for new wavy lines, a central blank patch or rapidly worsening vision. Sudden major loss of sight needs emergency assessment. Prompt treatment of wet AMD gives the best chance of protecting vision but cannot guarantee recovery.
Diagnosis
Fundal examination identifies drusen (characteristic deposits) and pigmentary changes. OCT (optical coherence tomography) detects fluid and structural changes. Fluorescein angiography (FFA) maps abnormal vessel growth in wet AMD. Amsler grid for home monitoring.
Treatments
Anti-VEGF injections (wet AMD)
Anti-VEGF injections into the eye can slow or stop wet AMD and sometimes improve vision. The eye specialist selects the medicine and injection schedule according to disease activity and response. Regular monitoring remains essential.
AREDS2 supplements (dry AMD)
AREDS2 supplements may reduce progression risk in intermediate AMD or help protect the other eye when advanced AMD affects one eye. They do not prevent AMD or restore lost sight. Ask your eye specialist whether they are suitable and check interactions; avoid older beta-carotene formulas if you smoke or used to smoke.
Low-vision rehabilitation
Magnifiers, eccentric viewing training, and assistive technology (screen readers, audiobooks) maximise remaining vision and independence. Referral to visual impairment services is important.
Self-care and lifestyle
- Stop smoking — most important modifiable risk factor
- Eat a diet rich in leafy green vegetables (lutein and zeaxanthin: kale, spinach), fish, and fruit
- Take AREDS2 supplements if you have moderate AMD (discuss with ophthalmologist)
- Use the Amsler grid to monitor for sudden changes in dry AMD
- Protect eyes from UV light with wraparound sunglasses
Prevention
Avoid smoking and follow a balanced diet to support eye health. These measures do not guarantee prevention. AREDS2 supplements are for selected stages of established AMD, not general prevention.
Sources for targeted updates
Updated: 24 October 2026. Targeted corrections to urgent-care guidance, treatment, prevention, key facts, risk factors, frequency, causes. This update covers the named sections; a full review of the remaining guide is pending.