Age-related macular degeneration (AMD) is an eye disease that causes vision loss. According to the National Eye Institute, AMD is one of the leading causes of vision loss in adults. If you or a loved one has been diagnosed with this disease, you likely have lots of questions about how it’ll affect you.

This article covers seven facts about AMD — topics like types, risk factors, diagnosis, and available treatments. To learn more about AMD, talk to your ophthalmologist (eye doctor).

1. About 15 Percent of People With AMD Become Legally Blind

AMD is an eye disease that affects the retina — the tissue located at the back of the eye. The center of the retina is known as the macula, which is responsible for your clear, sharp central vision. When the macula becomes damaged with age, you may have vision problems.

The BrightFocus Foundation notes that up to 20 million American adults have some form of macular degeneration. AMD is one of the leading causes of vision loss and irreversible blindness. It’s most common in people ages 50 and older.

Only some people with AMD will experience vision loss. However, around 15 percent of those with this disease will eventually develop legal blindness (defined as 20/200 vision or worse).

2. There Are Two Types of AMD: Dry and Wet

Eye doctors divide AMD into two types — dry and wet. Around 90 percent of AMD cases are the dry form. If you have dry AMD, protein deposits known as drusen form in the eyes. Over time, the drusen progress, and damage occurs to the light-sensitive cells in the macula. This condition leads to blind spots and vision loss.

The advanced form of dry AMD is called geographic atrophy. People with geographic atrophy have patches of dead cells in their eyes that resemble a map, which is why it’s called geographic atrophy.

Wet AMD sometimes develops in people with dry AMD. Retinal pigment epithelium (RPE) cells are a layer of cells located just outside the retina, essential for eye health and vision. After the macula thins out and RPE cells die, the eye sometimes creates new, abnormal blood vessels. These vessels are extremely fragile and leak fluid into the eye. This is why this type of AMD is referred to as “wet.” If left untreated, the extra fluid causes macular scarring and can cause severe, rapid vision loss.

3. Risk Factors for AMD Include Smoking and Family History

Doctors and researchers aren’t quite sure exactly what causes AMD. They believe it may develop from a combination of genetics and environment. Some people are at a higher risk of AMD than others. Risk factors for AMD include:

• Older age
• Assigned female at birth
• Cigarette smoking
• A parent or sibling also has AMD
• A personal history of AMD in one eye
• Variations in the HTRA1 gene, which helps maintain healthy tissues, or the ARMS2 gene, which is important for retina health
• Obesity
• An unhealthy diet high in cholesterol, saturated fats, and sugar
• High blood pressure
• Light-colored eyes
• Extended periods of sun exposure

4. Central Vision Loss Is the Main Symptom of AMD

In the early stages of AMD, you may not experience any symptoms. This is especially true if you have one eye unaffected by AMD. However, you’ll eventually begin to notice central vision loss, which means it becomes harder to see details in the center of your field of vision. As your disease progresses:

• Your eyes may have trouble adjusting to changes in lighting levels, like when walking from a brightly lit room into a dark room.
• You may have difficulty seeing in low light or at night.
• Colors look more dull or washed out.
• You may have blurry vision that affects your ability to read or see fine details.
• It may be harder to recognize other people’s faces.
• You may develop dark or blank spots in your vision.

Some people with AMD — but not all — develop vision loss. This means that glasses or contact lenses can’t help correct your vision.

5. Eye Doctors Diagnose AMD With a Series of Tests

If you begin experiencing symptoms of AMD, it’s time to make an appointment with your eye doctor for a diagnosis. They’ll take your medical history to learn about your risk factors. Be sure to tell your eye doctor if you have a family history of AMD.

Tests your eye doctor may perform during your visit include:

• Visual acuity test — Measures your vision by having you read letters or numbers from a chart across the room
• Dilated eye exam — Dilates or opens your pupils so your doctor can look in the back of your eye
• Optical coherence tomography — Takes pictures of your eyes in layers to look for drusen, new blood vessels, fluid beneath the macula, macular swelling, or macular thinning
• Fluorescein angiography — Uses a special dye to check for leaky blood vessels beneath the macula
• Autofluorescence imaging — Checks the RPE cells for signs of thinning or damage

Eye doctors also use the Amsler grid to diagnose AMD. The grid has straight lines — similar to graph paper — with a black dot in the center. Your doctor will have you focus your vision on the dot. If the lines become wavy or if they disappear, it may mean you have AMD.

6. Treatment Options Can Slow AMD Progression

Unfortunately, there’s no cure available for AMD. Doctors and researchers have developed several treatments that help slow disease progression. Your treatment options depend on your AMD type and stage.

If you have intermediate AMD, your eye doctor may recommend AREDS2 supplements. They contain a combination of key vitamins and minerals that support eye health, including the antioxidants zeaxanthin and lutein.

In 2023, the U.S. Food and Drug Administration (FDA) approved two treatments for geographic atrophy. Avacincaptad pegol (Izervay) and pegcetacoplan (Syfovre) injections work by calming inflammation and the immune system to treat geographic atrophy.

If you have wet AMD, your eye doctor may prescribe anti-VEGF injections. These medications stop abnormal blood vessels from leaking by blocking VEGF (vascular endothelial growth factor), a protein that causes these leaky vessels to grow.

Examples of anti-VEGF treatments include:

• Ranibizumab (Lucentis)
• Aflibercept (Eylea)
• Faricimab-svoa (Vabysmo)
• Bevacizumab (Avastin)
• Brolucizumab (Beovu)

Laser therapy targets and destroys leaky blood vessels to treat wet AMD. Two examples of laser therapy include photodynamic therapy (PDT) and laser photocoagulation surgery. Laser treatments are seldom used for AMD these days.

Along with supplements and medications, your eye doctor will likely encourage you to make lifestyle changes. These changes help treat your symptoms and slow disease progression. Examples include:

• Attending regular eye exams
• Quitting smoking
• Wearing sunglasses
• Eating a healthy diet high in antioxidants and low in added sugars and fats
• Getting regular exercise

7. Other Health Conditions Can Worsen AMD

Some people have other health conditions — known as comorbidities — along with their AMD. Diabetes causes abnormally high blood sugar levels. These high blood sugar levels can damage the delicate blood vessels in the eyes and lead to AMD or diabetes-related macular degeneration. Studies show that people with diabetes have a 48 percent higher risk of AMD than those without.

Your heart health is also closely related to your eye health. People with heart disease and high blood pressure are also more likely to have AMD. These conditions can also tighten or damage blood vessels. This stops oxygen and nutrients from reaching the retina.

If you notice changes in your vision, it’s important to see an eye doctor. They can run tests to diagnose AMD and recommend treatments to help slow its progression. Although there’s no cure, vitamins, medications, and lifestyle changes can help manage the condition.

Talk With Others Who Understand

On myAMDteam, the social network for people with age-related macular degeneration and their loved ones, members come together to ask questions, give advice, and share their stories with those who understand.

Are you or a family member living with AMD? What other questions do you have about this disease? Share them in a comment below or on your Activities page.