Understanding Age-Related Macular Degeneration

Age-related macular degeneration, commonly called AMD, is an eye disease that affects central vision.

Central vision provides the fine detail used for reading, recognizing faces, driving, cooking, and looking directly at an object. AMD can make these activities difficult while leaving much of a person’s peripheral, or side, vision available.

AMD is more common in older adults. Its progression and functional effects vary significantly from person to person—and sometimes between the two eyes of the same person.

What part of the eye does AMD affect?

AMD affects the macula, a small area near the center of the retina.

The retina is the light-sensitive tissue at the back of the eye. The macula provides the detailed, straight-ahead vision needed to:

• Read
• Recognize faces
• See fine details
• Distinguish colors
• Drive
• Complete close-up tasks

Because AMD primarily affects the macula, a person may have difficulty seeing an object they are looking directly at while still seeing surrounding shapes or movement.

Dry and wet AMD

There are two main forms of AMD.

Dry AMD

Dry AMD develops as the macula changes and thins over time. Small deposits called drusen may accumulate beneath the retina.

Dry AMD commonly progresses gradually, although the rate varies. Doctors may describe it as early, intermediate, or late AMD.

Late dry AMD may include geographic atrophy, in which areas of retinal tissue involved in central vision become damaged.

Any stage of dry AMD can develop into wet AMD. Regular monitoring is important even when vision seems stable.

Wet AMD

Wet AMD—also called neovascular or advanced neovascular AMD—occurs when abnormal blood vessels grow beneath or near the retina.

These fragile vessels may leak fluid or blood, damaging the macula and causing faster changes in central vision.

Wet AMD is less common than dry AMD, but it can progress more rapidly. Prompt evaluation and treatment can be important when new symptoms appear.

What AMD may look like

AMD does not look the same for everyone.

Possible changes include:

Distorted lines

Straight lines may appear wavy, bent, broken, or crooked. Doorframes, window blinds, tile lines, and rows of text may no longer look straight.

A central blurry, blank, or missing area

A person may notice a blurred, dark, gray, or blank area near the center of vision. The area may seem to move as the person changes where they are looking.

Difficulty reading

Letters may look distorted, incomplete, crowded, or hidden. Stronger lighting or larger print may help temporarily, but magnification cannot remove a central blind spot.

Difficulty recognizing faces

Facial details may become harder to see even when the person can detect the individual’s outline, hair, clothing, or movement.

Reduced contrast

A white cup may be difficult to distinguish from a pale counter. Light-gray print, steps without clear edges, and objects against similar-colored backgrounds may be hard to locate.

Greater lighting needs

Some people need more direct task lighting for reading and detailed work. Others also experience glare, so the position and adjustability of the light matter.

Slower adjustment between light levels

Moving between a bright outdoor area and a dim interior may require more time.

When a change requires prompt medical attention

Do not assume that a sudden central-vision change is ordinary progression, fatigue, or poor lighting.

Contact your ophthalmologist or retina specialist promptly—and follow any urgent-response instructions they have given you—if you notice:

• Straight lines suddenly appearing wavy or broken
• A new or expanding blurry, dark, gray, or blank area
• A sudden drop in central vision
• New distortion
• A sudden change in reading ability
• A meaningful difference between the two eyes
• New flashes, many new floaters, or a curtain-like shadow

A new change may indicate wet AMD or another retinal problem that requires timely evaluation.

Low Vision Guide cannot determine whether a symptom is urgent. When in doubt, contact an eye-care professional.

Risk factors

Age is the strongest risk factor for AMD.

Other factors associated with increased risk include:

• Smoking
• Family history and genetics
• Certain cardiovascular risk factors
• AMD already being present in the other eye

Smoking is a major modifiable risk factor. If you smoke, ask a healthcare professional about support for quitting.

Having one or more risk factors does not mean a person will develop AMD, and people without obvious risk factors may still be diagnosed.

How AMD is diagnosed

AMD is diagnosed through a professional eye examination.

Testing may include:

Dilated eye examination

Dilating drops allow the eye-care professional to examine the retina and macula.

Optical coherence tomography

Optical coherence tomography, or OCT, creates detailed cross-sectional images of the retina. It can help detect retinal changes, fluid, or other signs that affect treatment and monitoring.

Retinal imaging

Photographs or other imaging may document the appearance of the retina and help monitor changes over time.

Angiography

In some circumstances, imaging with injected dye—or other vascular imaging—may help identify abnormal or leaking blood vessels.

The testing used depends on the person’s symptoms, AMD type, stage, and treatment history.

Monitoring vision at home

An eye-care professional may recommend home monitoring between appointments.

This may involve an Amsler grid or an electronic monitoring system.

An Amsler grid is a pattern of straight horizontal and vertical lines with a central point. It is used one eye at a time to check for new distortion, missing areas, or changes in central vision.

Follow the exact instructions provided by your eye-care team. Home monitoring does not replace scheduled examinations or professional imaging.

Report a new change promptly, even if a future appointment is already scheduled.

Treatment for wet AMD

The most common treatment for wet AMD is an injection of medicine into the eye that blocks vascular endothelial growth factor, commonly called VEGF.

Anti-VEGF treatment can:

• Reduce leaking or bleeding from abnormal vessels
• Slow or prevent additional vision loss
• Stabilize vision
• Improve vision for some people

Treatment often requires repeated injections and monitoring. The medicine, schedule, response, and risks vary by individual.

Do not delay or change treatment based on general information from a website. Questions about injections, intervals, side effects, or alternatives belong with the treating retina specialist.

Treatment and management of dry AMD

Management depends on the stage of dry AMD.

Early AMD

People with early AMD may not have noticeable symptoms. Monitoring and attention to overall health and modifiable risk factors may be recommended.

Intermediate AMD

For some people with intermediate AMD, a specific combination of vitamins and minerals called the AREDS2 formulation can reduce the risk of progression to late AMD.

AREDS2:

• Does not prevent AMD
• Does not cure AMD
• Does not restore lost vision
• Is not appropriate or useful for everyone
• Should be discussed with an eye-care professional

Do not assume that an ordinary multivitamin or a supplement labeled “eye health” is equivalent to the studied AREDS2 formulation.

Current and former smokers should avoid older AREDS formulations containing beta-carotene because beta-carotene has been linked to increased lung-cancer risk in these groups. Discuss the appropriate formulation with your healthcare team.

Geographic atrophy

FDA-approved complement-inhibitor injections are available for geographic atrophy secondary to AMD.

These treatments may slow the enlargement of atrophy for some patients. They do not restore retinal tissue or vision that has already been lost. Treatment involves repeated eye injections and has potential risks and burdens that should be discussed with a retina specialist.

Will AMD cause total blindness?

AMD can cause severe central-vision impairment, but AMD alone usually does not eliminate all vision because it primarily affects the macula.

Peripheral vision commonly remains available and may support:

• Moving through familiar spaces
• Locating large objects
• Detecting movement
• Using visual landmarks
• Completing activities with adaptations

Other eye or neurological conditions may also affect peripheral vision. An eye-care professional can explain the expected functional effects of the conditions present in each eye.

Practical strategies for daily life

Medical treatment and practical adaptation serve different purposes.

Treatment addresses the disease. Adaptations help a person complete daily activities with the vision currently available.

Helpful strategies may include:

Adjustable task lighting

Direct light toward the activity while keeping the source out of the eyes. Test different brightness levels and angles.

Strong contrast

Use dark objects against light backgrounds and light objects against dark backgrounds.

Examples include:

• A dark cutting board for pale food
• A light cup for coffee
• Dark switch plates on light walls
• A contrasting tray for frequently used objects

Magnification

Optical or electronic magnification may enlarge print and objects. The appropriate device depends on the task, required field of view, working distance, and reading duration.

Text-to-speech

Phones, tablets, computers, and specialized devices can read digital or recognized printed text aloud.

Eccentric-viewing training

Some people with central vision loss learn to use a clearer area outside the damaged central region. This technique may benefit from training by a qualified vision-rehabilitation professional.

Organization and tactile identification

Consistent placement, raised markers, tactile labels, and spoken identification can reduce dependence on central visual detail.

Vision rehabilitation

Vision rehabilitation helps people adapt to established vision loss and continue meaningful activities.

Services may include:

• Low-vision evaluation
• Occupational therapy
• Magnification training
• Accessible-technology instruction
• Independent-living skills
• Orientation and mobility services
• Employment support
• Emotional-adjustment resources

A person does not need to wait until vision loss becomes severe before asking for a referral.

Emotional adjustment

Changes in reading, facial recognition, driving, work, and independence can be frustrating or emotionally difficult.

Grief, anger, anxiety, and uncertainty are understandable responses. Support may come from:

• Family and friends
• Peer-support groups
• Vision-rehabilitation programs
• Counselors familiar with disability or vision loss
• Community organizations

Seeking support is part of adapting—not evidence that someone has failed to cope.

Questions to ask your eye-care team

• Do I have dry AMD, wet AMD, or both?
• What stage is the condition in each eye?
• What changes should prompt an urgent call?
• How should I monitor my vision at home?
• How often should I be examined?
• Is AREDS2 appropriate for me?
• What benefits and risks apply to my treatment options?
• Could other eye conditions be affecting my vision?
• Can you refer me for a low-vision evaluation or vision rehabilitation?
• Are there activities or medications I should discuss with my healthcare team?

Where to go next

Continue with:

• Reading With Low Vision
• Lighting and Contrast for Low Vision
• Choosing a Magnifier
• Video Magnifiers and Digital CCTV Systems
• Vision-Rehabilitation Resources

This guide provides general educational information. It does not provide medical advice, diagnose AMD, interpret imaging, recommend supplements, select treatment, or replace care from an ophthalmologist or retina specialist. Contact a qualified eye-care professional about symptoms, monitoring, supplements, and treatment decisions.

Sources

• National Eye Institute: Age-Related Macular Degeneration
• National Eye Institute: Treatments for Wet AMD
• National Eye Institute: AREDS2 Supplements
• National Eye Institute: Vision Rehabilitation

Clinical-content review date: August 6, 2026