Patient guide

Macular degeneration: what it is, what to watch for, and what helps

By Dr. Sam Khoury, OptometristReviewed November 20265 min read

Call the same day if straight lines start to look wavy or bent, or a new blurry or dark spot appears in the center of your vision. These can be signs of the wet form, which is treated most successfully when treatment starts early. Call (609) 246-0236. A sudden loss of vision is an emergency: if the office is closed, or you cannot reach us, go to a hospital emergency room.

Age-related macular degeneration affects the macula, the small central part of the retina you use for reading, faces and driving. About 20 million Americans aged 40 and over have some form of it, and about one and a half million have the late stage.

In its early stages it typically causes no symptoms. Most people with early-stage disease keep good vision for years, and many never reach the advanced stage. The point of knowing is to catch the change that can be treated, quickly.

The stages, and dry and wet

Early

Drusen beyond those of normal aging, with no symptoms. It is found at an eye exam, not by you.

Intermediate

Large drusen, or changes in the pigment under the macula. The risk of moving on to the late stage is markedly higher from here, and this is the stage at which eye vitamins have been shown to help.

Late, dry

Called geographic atrophy. Patches of the macula waste away, and central vision is lost as they grow toward the center.

Late, wet

Also called neovascular: new blood vessels form under the macula. This is the form that needs treatment quickly, and the reason for the weekly home check.

About eight in ten people with macular degeneration have the dry form. The wet form accounts for most of the severe vision loss. Dry disease can turn wet, which is why the warning signs matter even when you have been told yours is early.

Who gets it

• Age. It usually appears after 50, and most often after 60.
• Smoking. The strongest risk factor you can change. Smoking about doubles the risk.
• Family history. It runs in families. Brothers, sisters and children of someone who has it should have regular eye exams.
• Ancestry. It is more common in white Americans than in Black or Hispanic Americans.

What helps

• Check each eye once a week. The grid and the instructions are on the page we give patients after their visit. If something looks different from last week, call the same day.
• Do not smoke.
• Take the AREDS2 vitamin formula only if your stage calls for it. It slowed progression in people with intermediate macular degeneration, or advanced disease in one eye. In early macular degeneration it has not been shown to help, so ask before buying. Many products sold as eye vitamins do not contain the AREDS2 formula.
• If you smoke or used to, use only the AREDS2 version. The original formula contains beta-carotene, which raised the risk of lung cancer in current and former smokers. AREDS2 uses lutein and zeaxanthin instead. After ten years of follow-up, lutein and zeaxanthin showed no significant increase in lung cancer, and that group was 20% less likely to progress to late disease than the group given beta-carotene.
• Eat leafy green vegetables and fish. Both are linked with lower risk in long-term studies.
• Keep the interval set at your exam.

A home monitoring device has also been tested, in a randomized trial of people at higher risk of the wet form. Those who used it regularly had lost less vision by the time the wet form was found than those relying on other methods.

Common questions

Will I go blind?

Macular degeneration does not take away side vision. Most people with early-stage disease keep good vision for years, and many never reach the advanced stage. What is at risk in the late stage is central vision, and protecting that is what the follow-up is for.

Should I start taking eye vitamins now?

Only if your exam shows intermediate disease, or advanced disease in one eye. In early macular degeneration the AREDS2 formula has not been shown to help. Ask at your visit which stage you are in before buying anything.

My parent had it. Should I be checked?

Yes. Macular degeneration runs in families, and brothers, sisters and children should have regular eye exams. Mention the family history when you book.

Do the injections hurt?

Most people feel pressure. The eye is numbed thoroughly and cleaned first, and the injection takes a few seconds. Some people have a scratchy, gritty feeling for a day afterwards. Increasing pain, redness or light sensitivity after an injection, or any drop in vision, is a same-day call to the retina office.

I take Ozempic or a similar medication. Does that matter?

One 2025 study linked these medications with the wet form in older adults with diabetes, and studies since then have been mixed. It is a reason to keep your follow-up visits, not a reason to stop the medication. GLP-1 medications and your eyes covers it.

Does this go through my vision plan or my medical insurance?

Vision plans cover routine exams and eyewear; medical insurance covers conditions, symptoms and monitoring. Vision plan or medical insurance explains how the reason for your visit decides which applies.