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Health condition · Clinically reviewed

Age-related macular degeneration, central vision loss — dry and wet AMD, and anti-VEGF care.

The leading cause of severe sight loss in over-50s. Dry AMD is managed by lifestyle and AREDS supplements; wet AMD needs prompt anti-VEGF injections to preserve vision.

Jump to treatment See red-flag symptoms
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Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a registered UK clinician before publication.

  • 02

    Sourced, not summarised

    Every claim is checked against NICE, the Royal College of Ophthalmologists or a peer-reviewed source you can see at the end.

  • 03

    Updated for 2026

    Reflects current UK guidance on AREDS2 supplementation, Amsler-grid monitoring and anti-VEGF therapy.

Key facts

AMD at a glance.

The essentials, in plain English — what AMD is, the two forms, how it’s diagnosed, and how each form is treated in the UK today.

  • What it is

    Degeneration of the macula — the central part of the retina — that reduces the sharp, straight-ahead vision needed for reading, faces and driving.

  • Dry (atrophic) AMD

    The commoner, slower form — drusen and gradual thinning over months to years. No injection treatment; lifestyle and AREDS2 supplements.

  • Wet (neovascular) AMD

    Sudden distortion or central loss from abnormal new vessels leaking under the retina. Needs urgent treatment to preserve vision.

  • Amsler grid at home

    A simple square grid used weekly — new distortion or a missing patch is the key prompt to be seen quickly.

  • AREDS2 for intermediate dry AMD

    A specific vitamin and mineral formulation shown to reduce progression to advanced disease.

  • Anti-VEGF for wet AMD

    Intravitreal ranibizumab, aflibercept, faricimab or brolucizumab — repeated injections that halt and often reverse vision loss.

Why this guide matters

Central sight, worth protecting quickly.

Wet AMD can be halted — and often reversed — if treated within days. Dry AMD is slower, but there are still real steps that shift the outcome.

  • Time matters in wet AMD

    Sudden distortion or a missing central patch is an urgent (2-week) macula-clinic referral.

  • Lifestyle changes really do change outcomes

    Stopping smoking and AREDS2 supplementation both slow progression in the eyes with intermediate dry AMD.

  • The Amsler grid is your best home test

    A weekly one-minute check catches a wet conversion at its most treatable moment.

How the diagnosis is made

From first symptom to a clear plan.

The steps a UK optometrist and ophthalmologist will normally follow, in order — so you know what to expect and why.

  1. 01

    Recognising

    Symptom review (Amsler grid)

    Central distortion, a missing patch or blurred reading vision is checked against an Amsler grid at home or in clinic.

  2. 02

    Recognising

    Visual acuity

    A standard letter chart, and near-vision reading, quantifies the drop in central sight.

  3. 03

    Recognising

    Fundus examination

    Dilated slit-lamp examination looks for drusen, pigment change, atrophy or haemorrhage at the macula.

  4. 04

    Imaging

    OCT macula

    A non-contact scan that images each retinal layer — the single most useful test for suspected wet AMD.

  5. 05

    Imaging

    Fluorescein angiography (wet AMD)

    A dye study to map neovascular leakage when OCT alone is inconclusive.

  6. 06

    Managing

    OCT angiography

    A dye-free angiographic scan increasingly used to characterise the neovascular membrane.

  7. 07

    Managing

    Urgent retinal referral (if wet)

    A 2-week macula-clinic pathway for suspected wet AMD so that anti-VEGF treatment can start promptly.

Typical timeline: days to 2 weeks from first symptom to a settled plan.

Symptoms

What AMD actually feels like.

The signs that matter, and the ones that should send you to the eye clinic today rather than next month.

  • Blurred central vision

    A soft or greyed-out patch in the middle of the picture, while side vision stays normal.

  • Distortion (metamorphopsia)

    Straight lines — door frames, window edges, text on a page — appear bent or wavy.

  • Dark central spot

    A black or grey area in the centre of vision, often first noticed reading or looking at faces.

  • Reduced central acuity

    Difficulty with small print, faces or fine detail, even in good light and with up-to-date glasses.

  • Family history

    A parent or sibling with AMD roughly doubles your own risk — worth telling the optometrist.

  • Smoking history

    Smoking is the single largest modifiable risk factor for both onset and progression.

  • Amsler-grid distortion

    New wavy lines or a missing square while checking each eye separately is a prompt to be seen quickly.

  • Red flag — sudden distortion

    Sudden onset distortion or central loss needs an urgent (2-week) macula-clinic referral to exclude wet AMD.

Treatment

How AMD is treated in the UK.

Lifestyle and supplements for dry AMD; intravitreal anti-VEGF injections for wet AMD — what each option does, and where it fits.

  • Smoking cessation

    Stopping smoking is the most powerful modifiable step — it slows progression in both eyes.

  • AREDS2 supplements

    A specific vitamin and mineral formulation for intermediate dry AMD, shown to cut progression to advanced disease.

  • Diet + omega-3

    A Mediterranean-style diet, dark leafy greens and oily fish supports retinal health alongside supplementation.

  • Amsler grid at home

    Weekly self-check of each eye separately — the earliest sign of a wet conversion is new distortion.

  • Anti-VEGF (ranibizumab)

    An intravitreal injection that blocks abnormal vessel growth — usually monthly at first, then extended.

  • Anti-VEGF (aflibercept)

    A longer-acting anti-VEGF agent that allows treatment intervals to be stretched to 8–16 weeks.

  • Anti-VEGF (faricimab, brolucizumab)

    Newer agents that further extend intervals for suitable patients under specialist supervision.

  • Low-vision support + rehabilitation

    Magnifiers, task lighting, screen readers and Certificate of Vision Impairment registration when appropriate.

What this guide is based on

The sources behind every statement on this page.

UK national guidance and specialist society standards, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your optometrist and ophthalmologist know your eyes and can tell you which parts apply to you. If in doubt about new distortion, get seen quickly.

  • National Institute for Health and Care Excellence (NICE). Age-related macular degeneration (NG82).

  • Royal College of Ophthalmologists. Age-related macular degeneration: guidelines for management.

  • Macular Society. Patient information on dry and wet AMD.

  • European Society of Retina Specialists (EURETINA). Guidelines on the management of neovascular AMD.

Red flags

When AMD becomes an emergency.

Situations where AMD, or a treatment for it, needs same-day or same-week attention rather than a routine review.

  • Sudden distortion or scotoma

    New wavy lines or a missing central patch — arrange an urgent macula-clinic assessment within 1–2 weeks.

  • Sudden central vision loss

    A rapid drop in central sight in one eye is a wet-AMD emergency until proven otherwise.

  • Post-injection endophthalmitis

    Increasing pain, redness or vision loss in the days after an intravitreal injection — same-day ophthalmology assessment.

  • Post-injection retinal detachment

    Flashes, a shower of new floaters or a curtain over vision after treatment — attend eye casualty the same day.

  • Bilateral rapid progression

    Fast worsening in both eyes together is unusual for AMD alone — needs urgent specialist review.

  • Coexistent diabetic macular oedema

    Diabetes plus new macular symptoms may reflect DMO rather than AMD — different treatment pathway.

  • Central serous retinopathy (differential)

    A younger patient with sudden central distortion may have CSR — a different condition needing OCT to distinguish.

  • Post-radiotherapy maculopathy

    Previous head, orbit or brain radiotherapy can cause a delayed maculopathy that mimics AMD on scanning.

  • Choroidal neovascular membrane in a young adult

    AMD is rare under 55 — a CNVM at this age needs work-up for myopia, uveitis or inflammatory causes.

Living with it

A long-term condition, but one you can actively steer.

Four things that make the biggest difference day to day — habits, monitoring, sticking with injections and living well with reduced central sight.

A quiet reminder

Consistency beats intensity, every time.

A weekly Amsler check and every planned injection matter more than any one-off heroic effort.

  1. 01 Daily habits

    Small changes, real protection

    Stopping smoking, a Mediterranean-style diet and daily AREDS2 supplementation each slow progression.

  2. 02 Monitoring

    The Amsler grid is your alarm

    A weekly one-minute check of each eye separately catches a wet conversion at its most treatable point.

  3. 03 Injections

    Sticking with the plan

    Anti-VEGF works best when the treat-and-extend schedule is kept — missed visits are the commonest cause of lost gains.

  4. 04 Living well

    Lighting, magnification, rehab

    Good task lighting, hand and electronic magnifiers, and low-vision rehab keep reading and independence for longer.

Frequently asked

Everything we get asked about AMD.

Quick answers on dry vs wet, diagnosis, supplements, anti-VEGF injections and when to worry.

  • What is age-related macular degeneration?

    AMD is a degeneration of the macula — the central part of the retina — that reduces the sharp, straight-ahead vision used for reading, driving and recognising faces. Side vision is preserved.

  • What is the difference between dry and wet AMD?

    Dry (atrophic) AMD is the commoner, slower form with drusen and gradual thinning. Wet (neovascular) AMD is sudden, caused by leaking new vessels, and needs urgent anti-VEGF injections.

  • How is AMD diagnosed?

    Symptom review, an Amsler-grid check, visual acuity, a dilated fundus examination and — most importantly — an OCT scan of the macula. Fluorescein or OCT angiography may be added for wet AMD.

  • Do AREDS2 supplements really work?

    For intermediate dry AMD, the AREDS2 formulation is shown to reduce progression to advanced disease. It does not help early AMD or people without AMD.

  • What does an anti-VEGF injection involve?

    A short outpatient procedure — the eye is numbed and antiseptic drops used, then a fine needle delivers medicine into the vitreous. It usually takes only a few minutes.

  • When should I be seen urgently?

    New central distortion, a missing central patch or sudden central vision loss needs an urgent (2-week) macula-clinic referral to exclude wet AMD.

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