Treatment for age-related macular degeneration (AMD) depends on which type you have and how far it has progressed. Dry AMD, the more common form, has historically had no direct treatment, but two new drugs were approved in 2023 for its advanced stage. Wet AMD is treated with regular eye injections that can stabilize or even improve vision. Both types benefit from specific nutritional supplements, lifestyle changes, and consistent monitoring.
Dry AMD: Slowing Progression With Supplements
Most people diagnosed with AMD have the dry form, which progresses slowly as light-sensitive cells in the macula break down over years. There is no way to reverse the damage already done, but a specific vitamin formula can meaningfully slow things down.
The AREDS2 formula is the gold standard. In a large clinical trial funded by the National Eye Institute, people taking these supplements were about 25% less likely to progress to advanced AMD over five years. The current recommended formulation contains 500 mg of vitamin C, 400 IU of vitamin E, 80 mg of zinc, 2 mg of copper, 10 mg of lutein, and 2 mg of zeaxanthin. You can find AREDS2-labeled supplements over the counter at most pharmacies.
The formula has evolved. The original version contained beta-carotene instead of lutein and zeaxanthin, but beta-carotene was linked to higher lung cancer rates in smokers and former smokers. The updated AREDS2 version swapped it out. People who took the lutein and zeaxanthin version had an 18% lower risk of progressing to advanced AMD compared to those on the older beta-carotene formula, and about 91% of participants who developed lung cancer during the trial were former smokers. If you smoke or used to smoke, the AREDS2 version without beta-carotene is the only safe option.
New Drugs for Geographic Atrophy
Geographic atrophy is the advanced stage of dry AMD, where patches of cells in the macula die off completely, creating permanent blind spots. Until recently, there was nothing to treat it. In 2023, the FDA approved two complement inhibitor drugs that slow the expansion of these dead zones. Both work by dialing down part of the immune system’s inflammatory response that drives cell death in the retina.
These treatments require regular eye injections, either monthly or every other month. They do not restore lost vision. They slow further loss. One of the two drugs carries a small risk of triggering a conversion to wet AMD (about 7% to 12% depending on the injection schedule), so your eye doctor will monitor for that. These medications represent a genuine shift for people with geographic atrophy, who previously had no treatment option at all.
Wet AMD: Anti-VEGF Injections
Wet AMD occurs when abnormal blood vessels grow beneath the retina and leak fluid or blood, causing rapid vision loss. The primary treatment is injections of drugs that block a protein called VEGF, which fuels that abnormal blood vessel growth. These injections are given directly into the eye, a procedure that sounds alarming but typically takes only a few minutes with numbing drops.
Several anti-VEGF drugs are available. The most commonly used include aflibercept (Eylea), ranibizumab (Lucentis), and faricimab (Vabysmo), which targets two different proteins involved in leakage. Bevacizumab (Avastin) is used off-label and costs significantly less. Brolucizumab (Beovu) is another option. All of them work by starving the abnormal blood vessels, reducing leakage, and often improving vision.
Treatment typically starts with a loading phase of monthly injections for the first few months. After that, your ophthalmologist will adjust the schedule based on how your eye responds. Two common approaches exist: “treat and extend,” where the interval between injections gradually gets longer as long as the disease stays quiet, and “as needed,” where you receive an injection only when imaging shows active leakage. Either way, you will need ongoing monitoring with OCT scans, a painless imaging test that shows fluid levels in the retina. Most people require treatment indefinitely, though the frequency often decreases over time.
The Refillable Eye Implant
For people who respond well to anti-VEGF injections but find the frequent visits burdensome, a surgically placed refillable implant is available. It continuously delivers medication into the eye and only needs to be refilled roughly every six months in a quick office procedure. You qualify if you’ve already responded to at least two anti-VEGF injections. This option is particularly useful for people who live far from their retina specialist or have mobility challenges that make frequent trips difficult.
Lifestyle Changes That Make a Difference
Smoking is the single biggest modifiable risk factor for AMD. Current smokers have roughly double the odds of developing AMD compared to people who have never smoked. The good news is that quitting works. After more than 20 years without cigarettes, former smokers’ risk drops back to essentially the same level as someone who never smoked. The benefit applies to both forms of advanced AMD.
Diet matters too. Eating at least 150 grams (about 5 ounces) of fruit daily is associated with a 15% lower risk of developing AMD. A Mediterranean-style diet, rich in leafy greens, fish, nuts, and olive oil, provides many of the same nutrients found in the AREDS2 formula naturally. Lutein and zeaxanthin, the two pigments in the supplement, are concentrated in kale, spinach, and other dark leafy greens. For people whose diets are already low in these nutrients, supplementation provides the greatest benefit.
Monitoring at Home With an Amsler Grid
Catching changes early, especially the shift from dry to wet AMD, can save vision. The simplest tool is an Amsler grid, a square of crisscrossing lines with a dot in the center. Use it once a day, every day. Wear your reading glasses, hold the grid 12 to 15 inches from your face in good light, cover one eye, and stare at the center dot. Without moving your eye from the dot, notice whether any of the surrounding lines look wavy, blurry, dark, or missing. Then repeat with the other eye.
If lines that were previously straight suddenly appear bent or if new blank spots appear, contact your ophthalmologist that day. This can signal new fluid leakage from wet AMD, and treatment within the first days to weeks produces the best outcomes.
Living With Vision Loss From Advanced AMD
When AMD does cause permanent central vision loss, a range of tools and strategies can help you maintain independence. Low vision rehabilitation specialists can assess your specific needs and recommend devices tailored to your daily life.
- Magnifying spectacles keep your hands free while enlarging text or objects in front of you.
- Video magnifiers use a camera and screen to enlarge printed pages, photos, or medicine labels, available in both portable and desk formats.
- Smartphone and tablet apps can magnify, read text aloud, or identify objects using the built-in camera.
- Large-print and audio formats for books, newspapers, and playing cards.
- High-contrast home adjustments like using a colored tablecloth with white dishes, bold felt-tip markers for notes, and higher-wattage light bulbs aimed directly at tasks.
Reducing glare by covering shiny surfaces indoors and wearing wrap-around sunglasses or a wide-brimmed hat outside also helps maximize your remaining vision. Many people with advanced AMD retain their peripheral vision entirely and, with the right adaptations, continue reading, cooking, and navigating daily life.