# Macular degeneration (AMD): symptoms, causes and treatment > Source: World Aid Network — https://worldaidnetwork.org/eye-health/macular-degeneration > Last reviewed: 2026-06-19 ## In short Age-related macular degeneration (AMD) affects the macula, the small central part of the retina that gives you sharp, straight-ahead vision for reading and recognising faces. It is the leading cause of sight loss in older adults in wealthier countries. There are two types: 'dry' AMD develops slowly over years, while 'wet' AMD can damage central vision quickly but can often be treated with eye injections if caught fast. AMD does not usually cause total blindness, because it spares the outer (side) vision, but it can make everyday tasks difficult. Spotting changes early — especially straight lines appearing wavy — and getting seen quickly is vital. Age-related macular degeneration (AMD) is the most common cause of permanent vision loss in the UK, affecting an estimated 700,000 people with late-stage disease. Millions more have early or intermediate AMD — changes in the macula that may not yet affect their sight but place them at elevated risk of sight loss over time. AMD damages the macula — the small central area of the retina responsible for the sharp, detailed vision needed to read, drive, see faces and carry out most daily tasks. Unlike glaucoma, which affects peripheral vision first, AMD strikes at the centre of sight. Peripheral vision is usually preserved. There are two forms: dry AMD (the most common, slow-progressing) and wet AMD (less common but faster-progressing, responsible for most severe AMD-related sight loss). This guide answers the twenty most commonly searched questions about AMD in the UK, drawing on NHS and WHO sources. ## At a glance - Affects: Central vision - Most common in: Adults over 50 - Two types: Dry (slow) · wet (fast) - Wet AMD: Often treatable if caught fast ## When to see a doctor - Blurred or reduced vision in the centre of what you see - Straight lines (door frames, text) appearing wavy or distorted - A blurred or blank patch in the middle of your vision - Colours seeming less bright; difficulty recognising faces - URGENT: a sudden change in central vision can mean wet AMD — seek eye care quickly, as fast treatment protects sight ## Dry AMD versus wet AMD Dry AMD accounts for approximately 85–90% of all AMD cases. It progresses slowly over years as drusen (small yellow deposits) accumulate under the retina and retinal pigment epithelium (RPE) cells gradually deteriorate. Vision loss in dry AMD is usually gradual. In its most advanced form — geographic atrophy — central vision can be severely affected. There is currently no approved treatment that halts dry AMD, though AREDS2 nutritional supplements slow progression in people with intermediate dry AMD. Wet AMD (neovascular AMD) is less common but far more damaging. Abnormal new blood vessels grow beneath the retina (choroidal neovascularisation), leaking fluid and blood into the macular tissue and causing rapid, severe central vision loss — sometimes within weeks. Wet AMD requires urgent treatment with anti-VEGF injections to prevent irreversible damage. Approximately 10–15% of AMD cases are wet, but wet AMD causes the majority of AMD-related severe sight loss. ## Treatment: anti-VEGF injections for wet AMD The standard treatment for wet AMD is intravitreal injection of anti-VEGF (anti-vascular endothelial growth factor) drugs — ranibizumab (Lucentis), aflibercept (Eylea) or bevacizumab (Avastin, used off-label) — injected directly into the vitreous of the eye. These drugs block the abnormal blood vessel growth driving wet AMD. Treatment is given initially monthly, then at intervals determined by disease activity (treat-and-extend or pro re nata regimens). NICE approves ranibizumab and aflibercept for wet AMD on the NHS. For dry AMD — particularly intermediate AMD — the AREDS2 formula (vitamin C, vitamin E, zinc, copper, lutein, zeaxanthin) significantly reduces the risk of progression to advanced AMD in eligible patients. This supplement is available over the counter and is recommended by ophthalmologists for patients with intermediate AMD in one or both eyes. Photodynamic therapy (PDT) is sometimes used for specific subtypes of wet AMD. ## AMD and global sight loss Anti-VEGF treatment for wet AMD — which requires monthly or near-monthly injections in a hospital ophthalmology setting — is entirely unavailable to the vast majority of poor patients in low-income countries. Even in middle-income countries, the cost of anti-VEGF agents places them beyond reach without subsidisation. Dry AMD progression-slowing supplements are similarly inaccessible to the rural poor in many regions. World Aid Network funds sight-restoring eye care and surgery for poor patients through locally-licensed ophthalmologists. A donation supports access to diagnosis and treatment that would otherwise be completely out of reach. ## Key takeaways - AMD is the most common cause of sight loss in the UK, affecting central vision used for reading, driving and recognising faces. Peripheral vision is usually preserved. - Dry AMD (85–90% of cases) progresses slowly. Wet AMD (10–15%) progresses rapidly and causes the majority of severe AMD-related sight loss — it requires urgent anti-VEGF injections. - The Amsler grid is a simple home-monitoring tool. Any distortion or new blank area should prompt an urgent ophthalmology referral — wet AMD can damage sight within weeks. - AREDS2 supplements significantly slow progression from intermediate to advanced dry AMD. They are not proven to prevent AMD in people who do not yet have the condition. - Anti-VEGF treatment — the only effective wet AMD treatment — is unavailable to most poor patients in low-income countries, where AMD-related blindness is irreversible. ## Frequently asked questions ### What is age-related macular degeneration (AMD)? Age-related macular degeneration (AMD) is a progressive disease affecting the macula — the central area of the retina responsible for detailed, central vision. It is the most common cause of sight loss in the UK, affecting approximately 700,000 people with late-stage disease. AMD does not usually cause total blindness because peripheral vision is typically preserved, but loss of central vision severely affects the ability to read, drive and recognise faces. ### What are the symptoms of AMD? Early AMD may produce no symptoms. As it progresses, symptoms include: a blurred or blank spot in the centre of vision (a scotoma); difficulty reading — letters appear blurred, distorted or missing; straight lines appearing wavy or bent (metamorphopsia); colours appearing less vivid; and increased difficulty in low-light conditions. In wet AMD, symptoms can develop rapidly over days to weeks. Any distortion of straight lines or a new blank area in central vision requires urgent ophthalmology assessment. ### What is the difference between dry and wet AMD? Dry AMD is the most common form (85–90% of cases), characterised by the gradual accumulation of drusen (yellow deposits) under the retina and slow deterioration of retinal pigment epithelium cells. It progresses slowly over years and has no approved treatment, though AREDS2 supplements slow progression in intermediate disease. Wet AMD (10–15% of cases) involves the growth of abnormal new blood vessels beneath the retina that leak and cause rapid, severe central vision loss — sometimes within weeks. Wet AMD requires urgent anti-VEGF injections. ### How common is AMD in the UK? AMD is the most common cause of sight loss in the UK. Approximately 700,000 people have late AMD, and millions more have earlier-stage disease. Around 200 people in the UK begin to lose their sight from AMD every day. Prevalence increases significantly with age: AMD is rare before 55 but affects approximately 30% of people over 75. With an ageing population, AMD prevalence in the UK is projected to increase substantially over the coming decades. ### What causes AMD? AMD is caused by a combination of ageing, genetic susceptibility and environmental factors. The primary cause is the gradual deterioration of the retinal pigment epithelium with age. Smoking is the most significant modifiable risk factor — it approximately doubles the risk of AMD and is associated with earlier onset and faster progression. Other risk factors include: family history of AMD (genetics account for approximately 50% of AMD risk), high blood pressure, obesity, UV exposure, diet low in antioxidants, and being female (though this may reflect longer life expectancy). ### Who is at highest risk of AMD? Risk is highest in: people over 65 (AMD is primarily an age-related disease); smokers (or ex-smokers); people with a first-degree relative with AMD (genetic risk is substantial); those with high cardiovascular risk; people with light iris colour; and those with a diet low in leafy green vegetables and oily fish. Having intermediate AMD in one eye significantly increases the risk of progression to wet AMD in either eye — regular ophthalmology monitoring is essential. ### How is AMD diagnosed? AMD is diagnosed through a dilated retinal examination, supported by optical coherence tomography (OCT) — a non-invasive imaging scan that provides cross-sectional images of the retinal layers, detecting drusen, geographic atrophy and subretinal fluid characteristic of wet AMD. Fundus photography documents the appearance of the macula. Fluorescein angiography or OCT-angiography may be used to characterise abnormal blood vessel growth in wet AMD. Diagnosis is made by a hospital ophthalmologist or through the NHS AMD service. ### What is the Amsler grid and how do I use it? The Amsler grid is a simple black grid of horizontal and vertical lines on a white background with a central dot. It is used to monitor central vision for early signs of wet AMD. Hold the grid approximately 33 cm from your face, cover one eye, and look at the central dot whilst wearing reading glasses if needed. Report immediately to your ophthalmologist if any lines appear wavy, distorted, blurred or if any area of the grid disappears. The Amsler grid is used at home as a monitoring tool for patients already diagnosed with AMD — it is not a substitute for a clinical eye examination. ### What is the treatment for wet AMD? Wet AMD is treated with intravitreal injections of anti-VEGF drugs — ranibizumab (Lucentis) or aflibercept (Eylea), both NICE-approved for the NHS — injected directly into the vitreous of the eye under local anaesthetic drops. These block vascular endothelial growth factor (VEGF), the protein driving abnormal blood vessel growth. Treatment is initially monthly, then at intervals based on disease activity. The goal is to prevent further vision loss and, in many patients, achieve some improvement in vision. Injections are continued long-term in most patients. ### What is the treatment for dry AMD? There is currently no approved drug treatment that halts dry AMD progression. For patients with intermediate dry AMD (bilateral drusen or drusen with pigmentary changes), the AREDS2 supplement formula — containing high-dose vitamins C and E, zinc, copper, lutein and zeaxanthin — reduces the risk of progression to advanced AMD by approximately 25–30%. Stopping smoking, a healthy diet rich in leafy greens and oily fish, and regular ophthalmology monitoring are the main management strategies. Gene therapy and complement inhibition drugs are in advanced clinical trials for geographic atrophy. ### Are AREDS supplements available on the NHS? AREDS2 supplements are not routinely prescribed on the NHS but are recommended by ophthalmologists for patients with intermediate AMD and are available over the counter at pharmacies and health shops. Look for products labelled 'AREDS2 formula' containing: 500 mg vitamin C, 400 IU vitamin E, 80 mg zinc, 2 mg copper, 10 mg lutein and 2 mg zeaxanthin. Original AREDS formula contained beta-carotene, which increases lung cancer risk in smokers — the AREDS2 formula replaced beta-carotene with lutein/zeaxanthin and is recommended for all patients including smokers. ### Can AMD be prevented? AMD cannot be entirely prevented, but modifiable risk factors can be addressed. The NHS advises: stopping smoking (most important — smoking doubles AMD risk); eating a diet rich in lutein/zeaxanthin (kale, spinach, broccoli), omega-3 (oily fish) and antioxidants; maintaining a healthy weight and managing blood pressure and cardiovascular risk; wearing UV400-rated sunglasses; and having regular eye examinations, which allow early detection and monitoring. ### Can AMD cause total blindness? AMD rarely causes total blindness because it affects central vision while peripheral vision is usually preserved. However, advanced AMD — particularly bilateral geographic atrophy (late dry AMD) or untreated wet AMD — can cause severe central vision loss that makes reading, driving and face recognition impossible, profoundly affecting independence and quality of life. People with advanced AMD often retain enough peripheral vision to navigate their environment but cannot carry out detailed visual tasks. ### Can I drive with AMD? Driving with AMD is subject to DVLA regulations. You must inform the DVLA if AMD affects your ability to meet the driving visual standards (visual acuity of at least 6/12 on the Snellen chart in the better eye, and an adequate field of vision). An ophthalmologist or optician can assess whether you meet the standard. It is illegal to drive if you do not meet the DVLA visual standards. Many people with early or intermediate AMD continue to drive legally, but this must be formally assessed. ### What is geographic atrophy? Geographic atrophy (GA) is the advanced form of dry AMD, in which the retinal pigment epithelium and photoreceptors of the macula progressively die and are lost, leaving areas of atrophy (tissue loss) that appear as pale patches on retinal imaging. GA causes slowly progressive, irreversible loss of central vision. In February 2024, the FDA approved the first treatment for GA — pegcetacoplan (Syfovre) and avacincaptad pegol (Izervay) — though neither is yet approved by NICE for NHS use. ### What does AMD look like on an OCT scan? An OCT (optical coherence tomography) scan provides cross-sectional images of the retinal layers. In dry AMD, OCT shows drusen (dome-shaped deposits beneath the retinal pigment epithelium), areas of RPE atrophy (geographic atrophy), and outer retinal thinning. In wet AMD, OCT shows subretinal fluid (fluid beneath the retina), intraretinal fluid, pigment epithelium detachment, and sub-RPE fluid — all signs of active choroidal neovascularisation. OCT is the key monitoring tool used at every hospital AMD appointment. ### Is AMD hereditary? Yes. Genetics account for approximately 50% of AMD risk. Having a first-degree relative (parent or sibling) with AMD significantly increases your own risk. Several genes have been identified that increase AMD susceptibility, including CFH (complement factor H), ARMS2 and HTRA1. Commercial genetic testing for AMD risk genes is available, though it is not routinely used in NHS clinical practice to guide management. A family history of AMD is an indication for earlier and more regular eye examinations. ### What is the difference between AMD and macular degeneration in younger people? AMD is age-related and occurs in people typically over 55. Macular degeneration in younger people is usually caused by inherited conditions — the most common is Stargardt disease (an autosomal recessive macular dystrophy), caused by mutations in the ABCA4 gene, causing progressive central vision loss in children and young adults. Other inherited macular dystrophies include Best disease (vitelliform macular dystrophy) and pattern dystrophies. These are managed at specialist medical retina clinics separate from the AMD service. ### What support is available for people with AMD? People with AMD in the UK can access: the Macular Society (helpline, peer support, local groups, information); RNIB (Royal National Institute of Blind People — equipment, benefits advice, emotional support); NHS low vision services providing magnifiers, lighting advice and rehabilitation; the Certificate of Visual Impairment (CVI) for registration as sight-impaired or severely sight-impaired, which unlocks benefits and support; and Access to Work for people of working age. ### Does AMD affect one eye or both? AMD typically affects both eyes, but may begin in one eye and progress to the other at a different rate. When one eye develops wet AMD, the risk of wet AMD developing in the fellow eye is significantly elevated — approximately 12% per year. Patients with wet AMD in one eye are given home Amsler grids and advised to monitor the other eye closely and report any new symptoms immediately. Regular bilateral OCT monitoring is performed at NHS AMD clinics. ### How does AMD affect people in developing countries? Anti-VEGF injections — the only effective treatment for wet AMD — require regular hospital visits, specialist equipment and drugs costing hundreds to thousands of pounds per treatment course. In low-income countries, these services are entirely unavailable to the vast majority of poor patients, meaning wet AMD progresses to irreversible central vision loss. World Aid Network funds eye care for poor patients through locally-licensed ophthalmologists, working to close the global inequality in access to sight-saving treatment. ## How you can help World Aid Network funds sight-restoring eye care for poor patients in Pakistan, Indonesia and Malaysia through locally-licensed surgeons. Donate at https://worldaidnetwork.org/donate --- This is general information, not medical advice, published by World Aid Network. Always consult a qualified clinician about your own health.