Learn About Macular Degeneration Treatment Options

Understanding Macular Degeneration: What Happens to Your Vision

Macular degeneration is a condition that affects the macula, which is a small but crucial part of the retina at the back of your eye. The retina is the tissue that captures light and sends signals to your brain so you can see. The macula is responsible for your central vision — the area you use when reading, recognizing faces, or looking at details directly in front of you. When the macula becomes damaged, your central vision becomes blurry or develops dark spots, though your peripheral (side) vision usually remains intact.

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According to the National Eye Institute, age-related macular degeneration (AMD) affects approximately 2.1 million Americans age 50 and older. This number is expected to grow as the population ages. There are two main types: dry AMD and wet AMD. Dry AMD occurs when light-sensitive cells in the macula slowly break down over time. This is the most common form, accounting for about 85 to 90 percent of cases. Wet AMD happens when abnormal blood vessels grow beneath the macula and leak fluid or blood, causing more rapid vision loss.

Risk factors include age (the condition is more common after age 60), family history, smoking, high blood pressure, high cholesterol, obesity, and spending excessive time in bright sunlight without protection. People with lighter eye colors may also face higher risk. Understanding these factors can help you recognize warning signs early.

Early stages of macular degeneration may cause minimal symptoms. Some people notice that straight lines appear wavy, colors seem less bright, or a blurry area develops in the center of their vision. As the condition advances, reading and recognizing faces become increasingly difficult. Regular eye exams can catch the condition before significant vision loss occurs. An ophthalmologist or optometrist can perform tests like visual acuity screening and optical coherence tomography (OCT) imaging to diagnose macular degeneration and determine which type you have.

Practical Takeaway: Schedule regular eye exams, especially if you are over 50, have a family history of macular degeneration, or have other risk factors. Early detection gives you more treatment options and better chances of slowing vision loss.

Dry AMD Treatment: Current Medical Options

Dry AMD develops when drusen (small yellowish deposits) accumulate under the macula and the light-sensitive cells gradually deteriorate. While there is no cure for dry AMD, several treatment approaches can slow its progression. The most established intervention involves vitamin supplementation. A landmark clinical trial called the Age-Related Eye Disease Study (AREDS) found that a specific combination of vitamins and minerals reduced the risk of progression to advanced dry AMD by about 25 percent in people with intermediate AMD or advanced AMD in one eye.

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The AREDS formula includes vitamin C (500 mg), vitamin E (400 IU), zinc oxide (80 mg), cupric oxide (2 mg), and lutein and zeaxanthin (the AREDS2 modification added these two ingredients while removing beta-carotene). These supplements are available over the counter and do not require a prescription. However, the formula works best for people with intermediate or advanced dry AMD — it does not prevent AMD from developing in people with early-stage disease or no disease.

Beyond supplements, lifestyle modifications play a significant role in slowing dry AMD progression. Research shows that smoking accelerates macular degeneration, so quitting smoking is one of the most impactful steps someone with dry AMD can take. A diet rich in leafy green vegetables (such as spinach and kale), fish high in omega-3 fatty acids, nuts, and colorful fruits provides natural sources of lutein, zeaxanthin, and other protective compounds. Regular physical exercise, maintaining a healthy weight, managing blood pressure and cholesterol levels, and wearing sunglasses that block ultraviolet light all contribute to protecting remaining vision.

Additional monitoring approaches include home monitoring with an Amsler grid — a simple checklist pattern you can view daily to detect changes in your central vision. If you notice new waviness, blurriness, or dark areas when looking at the grid, contact your eye doctor. Some eye care providers may recommend more frequent visits (every 4 to 8 weeks) to track progression. For certain cases of dry AMD, a newer treatment called Avacincaptide (Fovminc) was approved by the FDA in 2023. This treatment is injected into the eye and may slow vision loss in people with geographic atrophy, a severe form of dry AMD where patches of cells die off.

Practical Takeaway: If you have been diagnosed with intermediate or advanced dry AMD, discuss the AREDS2 vitamin formula with your eye doctor, stop smoking if applicable, modify your diet to include lutein-rich foods and omega-3 sources, and use an Amsler grid at home to track any changes in your vision.

Wet AMD Treatment: Injectable Medications and Procedures

Wet AMD requires more aggressive treatment because abnormal blood vessels leak fluid, causing rapid central vision loss. Without treatment, many people with wet AMD can lose significant vision within weeks or months. The good news is that several treatment options can stop or slow vision loss when started early. Anti-vascular endothelial growth factor (anti-VEGF) medications are the primary treatment. These drugs block a protein called VEGF that signals the body to grow new blood vessels. By stopping this process, anti-VEGF medications prevent abnormal vessel growth and leakage.

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Common anti-VEGF medications include bevacizumab (Avastin), ranibizumab (Lucentis), aflibercept (Eylea), and brolucizumab (Beovu). These medications are injected directly into the eye, typically through the white part (sclera) under local anesthesia. The procedure takes only a few minutes, though preparation and recovery time extend the total appointment duration. Most people receive injections every 4 to 8 weeks, though some newer formulations allow for longer intervals between doses. A 2023 clinical trial showed that aflibercept given every 8 weeks maintained vision as effectively as monthly injections, offering patients fewer office visits.

Photodynamic therapy (PDT) is an older treatment that is now less commonly used but remains an option for certain cases. This procedure involves injecting a light-sensitive medication into the bloodstream and then shining a special laser into the eye to activate the drug. The activated drug damages abnormal blood vessels. PDT typically requires multiple treatments over time and has been largely replaced by anti-VEGF medications because anti-VEGF treatments tend to produce better vision outcomes.

Thermal or laser photocoagulation uses a focused laser beam to seal leaking blood vessels. This treatment can cause a small scar and may not preserve vision as well as anti-VEGF therapies, so it is usually reserved for specific situations where abnormal vessels are located away from the center of the macula or when anti-VEGF medications are not effective. Combination therapy — using anti-VEGF injections along with PDT or laser treatment — is sometimes recommended by eye specialists in particular cases.

Response to wet AMD treatment varies among individuals. Some people experience significant vision improvement or stabilization, while others show slowing of vision loss. Early detection and treatment initiation within days or weeks of symptoms appearing greatly improves outcomes. People with wet AMD typically require ongoing monitoring with monthly or periodic eye exams and imaging studies to assess treatment response and decide on retreatment timing.

Practical Takeaway: If you experience sudden changes in your central vision — such as new floaters, flashing lights, dark spots, or wavy lines — contact your eye doctor immediately. Wet AMD requires rapid diagnosis and treatment to preserve vision. Ask your doctor about the different anti-VEGF options and how often you will need injections.

Emerging Treatments and Clinical Trials

The field of macular degeneration treatment is advancing rapidly. Several new medications and approaches are in clinical trials or have recently received FDA approval, offering hope for better outcomes. Gene therapy represents an exciting frontier. One gene therapy called Luxturna received FDA approval for a rare inherited retinal disease, and researchers are developing similar approaches specifically for AMD. These treatments work by introducing healthy genetic material into the eye to compensate for genetic defects or to produce protective proteins.

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Another emerging approach involves stem cell therapy, though most stem cell treatments for macular degeneration remain in research phases. The concept behind stem cell therapy is that it could replace damaged retinal