AMD stands for age-related macular degeneration, a condition that damages the central part of your retina and gradually erodes the sharp, detailed vision you use for reading, driving, and recognizing faces. It affects over 8 million people worldwide and is the leading cause of severe vision loss in adults over 55. By 2050, that number is projected to reach roughly 21 million.
AMD targets a small but critical area at the back of the eye called the macula. The rest of your peripheral vision typically stays intact, which is why people with AMD can still sense movement and shapes around them but struggle with anything that requires looking straight ahead.
What the Macula Does
The macula sits at the center of the retina and is responsible for high-resolution color vision. At its very core is the fovea, a tiny region about 1.5 millimeters across that contains the highest concentration of cone photoreceptors in the entire eye. These cones are what let you read fine print, distinguish between similar colors, and see small details at a distance. When AMD damages these cells, the sharpest part of your visual field is the first thing to go.
Your peripheral retina, by contrast, relies more on rod photoreceptors, which handle low-light vision and motion detection. That’s why someone with advanced AMD might not be able to read a street sign but can still walk through a room without bumping into furniture.
Dry AMD vs. Wet AMD
The two forms of AMD are classified by whether abnormal blood vessels have grown into the retina.
Dry AMD is the more common form and accounts for 85 to 90 percent of cases. It begins when tiny yellowish deposits called drusen accumulate beneath the retina. In its early stages, dry AMD causes no symptoms at all. Over years, though, the buildup can lead to thinning and breakdown of the light-sensing cells and the support layer underneath them. The advanced stage of dry AMD, called geographic atrophy, produces patches of dead tissue in the macula that cause permanent blind spots.
Wet AMD affects only 10 to 15 percent of AMD patients, but it’s far more aggressive. It develops when fragile new blood vessels grow from beneath the retina upward into the macula. These immature vessels leak fluid and blood, which can distort your vision within days or weeks. Left untreated, wet AMD can rapidly progress to severe vision loss. Because wet AMD always develops on a background of existing dry AMD, the dry form is essentially a precursor to the wet form.
How AMD Is Staged
Doctors classify AMD into stages based on the size of drusen deposits and any pigment changes visible in the retina:
- Normal aging: Only very small drusen (63 micrometers or less) with no pigment changes. This is not considered AMD.
- Early AMD: Medium-sized drusen (between 63 and 125 micrometers) with no pigment abnormalities. Usually no noticeable symptoms.
- Intermediate AMD: Large drusen (over 125 micrometers) or pigment changes in the macula. Some people begin noticing mild blurriness.
- Late AMD: Either geographic atrophy (advanced dry) or wet AMD with abnormal blood vessel growth. Significant central vision loss.
One study of patients with intermediate dry AMD found that over roughly five years, about 14 percent converted to wet AMD and about 7 percent developed geographic atrophy. So progression is not inevitable, but the risk is real and increases with time.
Symptoms to Recognize
Early AMD is silent. Most people don’t know they have it until a routine eye exam reveals drusen. As the disease progresses, the first symptom is often a subtle blurriness in your central vision, especially in dim lighting.
The hallmark symptom of advancing AMD is metamorphopsia, a distortion where straight lines appear wavy or bent. Door frames may look curved, text on a page may seem warped, or a grid pattern may have missing sections. This is often tested with an Amsler grid, a simple chart of evenly spaced lines that you look at with one eye at a time. If the lines appear distorted or parts of the grid seem to disappear, that suggests macular damage.
With wet AMD, you may notice a dark spot or blank area in the center of your vision that appears suddenly. This happens when blood or fluid collects under the macula. Any abrupt change in your central vision warrants an urgent eye exam, because catching wet AMD early makes treatment far more effective.
What Causes AMD and Who Gets It
Age is the single biggest risk factor. AMD is rare before 55 and becomes increasingly common with each decade after. Beyond aging, a few factors significantly raise your risk.
Smoking is the strongest modifiable risk factor. Current smokers face roughly double the risk of developing AMD compared to people who have never smoked. Heavy smokers (those with more than 40 pack-years of cigarette use) have nearly three times the risk. Even secondhand smoke exposure raises the odds by about 87 percent in nonsmokers.
Genetics also play a major role. Variants in the complement factor H gene are strongly linked to higher AMD risk. If you have a parent or sibling with AMD, your own risk is substantially elevated. Other contributing factors include obesity, high blood pressure, a diet low in leafy greens and fish, and prolonged UV exposure. Women are affected more often than men: in 2021, roughly 4.7 million women had vision impairment from AMD compared to 3.4 million men.
How AMD Is Diagnosed
A dilated eye exam can reveal drusen, pigment changes, and signs of fluid leakage. But the most important diagnostic tool today is optical coherence tomography, commonly called OCT. This painless imaging scan takes cross-sectional pictures of your retina, almost like an ultrasound but using light. It can detect tiny amounts of fluid beneath or within the retina, measure macular thickness down to the micrometer, and identify early tissue breakdown that isn’t visible to the naked eye.
OCT is used both for initial diagnosis and for ongoing monitoring. If you’re being treated for wet AMD, you’ll likely get OCT scans at every visit so your doctor can track whether fluid is accumulating or resolving. It’s also valuable for catching the transition from dry to wet AMD before symptoms become obvious.
Treatment for Wet AMD
Wet AMD is treated with injections of medication directly into the eye. These drugs block a protein called VEGF that drives the growth of abnormal blood vessels. By suppressing this protein, the injections can stop leakage, reduce swelling, and in many cases stabilize or even improve vision.
The procedure sounds daunting, but the eye is numbed beforehand, and most people describe the injection as brief pressure rather than sharp pain. Treatment typically starts with monthly injections for the first two to three months. After that initial phase, the interval between injections is gradually extended based on how your eye responds. Most patients need around 7 or 8 injections in the first year. If the disease stays quiet, visits can eventually stretch to every 12 to 16 weeks.
The key challenge with wet AMD treatment is that it’s ongoing. Stopping injections too soon often leads to fluid returning. Newer medications approved in recent years can last longer between doses, which reduces the treatment burden, but regular monitoring remains essential.
Managing Dry AMD
There is currently no treatment that reverses dry AMD, but a specific combination of nutritional supplements has been shown to slow progression in people with intermediate or advanced disease. The formula, developed through a large clinical trial called AREDS2, contains 500 mg of vitamin C, 400 IU of vitamin E, 80 mg of zinc, 10 mg of lutein, and 2 mg of zeaxanthin, taken daily.
These supplements are not helpful for people with early AMD or no AMD at all. They’re specifically recommended for those at intermediate or later stages who want to reduce their risk of progressing to advanced disease. You can find AREDS2-formula supplements over the counter, but check the label carefully, as many eye vitamins use different formulations that don’t match the studied doses.
Beyond supplements, quitting smoking is the single most impactful thing you can do to slow AMD progression. Eating a diet rich in dark leafy greens, fish, and colorful fruits provides many of the same nutrients found in the AREDS2 formula. Maintaining a healthy weight, managing blood pressure, and protecting your eyes from excessive sunlight also help reduce the strain on your macula over time.