Age-Related Macular Degeneration: How Anti-VEGF Treatments Stop Central Vision Loss

Imagine looking at a loved one’s face and not being able to make out their eyes. Or trying to read the clock on the wall, but the numbers blur into a smudge. This isn’t just aging-it’s age-related macular degeneration (AMD), the leading cause of central vision loss in people over 55 in the UK and the US. Unlike cataracts, where vision can be restored with surgery, AMD attacks the very center of what lets you see detail: the macula. And if it turns wet, it can steal your sight in months. But there’s a treatment that’s changed everything-anti-VEGF injections.

What Happens When Your Macula Deteriorates

The macula is a tiny spot in the center of your retina, packed with light-sensing cells called cones. It’s what lets you read, drive, recognize faces, and see color clearly. When AMD hits, it doesn’t blind you completely-you still see shapes and movement around the edges. But the center goes dark, fuzzy, or warped. It’s like looking through a smudged lens that only blurs what’s directly in front of you.

There are two types: dry and wet. Dry AMD makes up about 90% of cases. It starts with yellow protein clumps called drusen building up under the retina. Over time, the retinal tissue thins out. This is slow-years, sometimes decades. Many people live with dry AMD for years without major vision loss. But it can turn into wet AMD at any point.

Wet AMD is the scary one. It’s only 10-15% of cases, but it causes 90% of severe vision loss. Here, abnormal blood vessels grow under the retina, leaking fluid and blood. These vessels don’t belong there. They’re fragile, messy, and they destroy the photoreceptor cells that send visual signals to your brain. Without treatment, wet AMD can drop your vision from 20/40 to 20/200 in just a few months.

Why Age Is the Biggest Risk Factor

You can’t stop aging-but you can understand how it plays into AMD. The risk of AMD jumps from less than 1% in your 40s to over 35% if you’re over 75. Why? Because your eyes have been under constant stress for decades. Sunlight, oxygen, and metabolic waste build up. The retinal pigment epithelium (RPE), which feeds and cleans up the light-sensing cells, starts to fail. Lipofuscin, a toxic waste product, piles up. The immune system gets confused and starts attacking healthy tissue.

Smoking is the biggest thing you can change. If you smoke, your risk of AMD is nearly four times higher than someone who never smoked. High blood pressure and high cholesterol also raise your odds. Obesity? That bumps your risk by more than double. Genetics matter too-if a parent or sibling has AMD, your chance of getting it is 3 to 6 times higher. And while AMD affects all races, White people in the UK and US are 2.5 times more likely to develop it than African Americans.

How Anti-VEGF Therapy Stops the Leak

Anti-VEGF isn’t a cure. But it’s the most effective tool we have to stop wet AMD from destroying vision. VEGF stands for vascular endothelial growth factor-a protein that tells blood vessels to grow. In wet AMD, your body makes too much of it, causing those dangerous vessels to sprout under the retina.

Anti-VEGF drugs block that signal. They’re injected directly into the eye, right into the vitreous gel. Each injection takes less than five minutes and is done in a clinic. The needle is tiny, and numbing drops are used. Most patients feel only pressure, not pain. After the injection, you might see floaters or feel mild irritation, but that fades in a day.

These injections don’t fix the damage already done. But they stop it from getting worse-and in about one-third of patients, vision actually improves. A patient in Bristol, diagnosed with wet AMD in 2023, went from reading only large print to reading street signs again after six months of monthly injections. That’s not rare. Studies show that 68% of patients stabilize or improve their vision with regular anti-VEGF treatment.

The Burden of Treatment

There’s a catch. You can’t just get one injection and call it done. The first few months usually mean monthly shots. After that, doctors monitor your eye with OCT scans-high-res images of the retina. If fluid comes back, you get another injection. Some people need one every 6 to 8 weeks for years. That’s 6 to 10 visits a year. For older adults, that’s a lot of travel, waiting, and anxiety.

A 2023 survey by the Cleveland Clinic found that 82% of AMD patients found frequent injections to be their biggest challenge. Many worry about the procedure. Others struggle with transportation or balancing appointments with other health issues. Missing even a few injections can mean permanent vision loss. Studies show patients who skip more than 25% of their scheduled shots lose 30% more vision than those who stick to the plan.

New Hope: Longer-Lasting Treatments

The good news? The field is moving fast. In 2021, the FDA approved Susvimo, a tiny implant placed in the eye that slowly releases ranibizumab for up to six months. No monthly shots-just one surgery and refill every six months. It’s not for everyone, but for those who can’t manage frequent visits, it’s life-changing.

Then there’s Vabysmo, approved in early 2022. It’s the first drug that blocks two proteins at once-VEGF and angiopoietin-2. That means it may work longer and more effectively than older drugs. Early data shows some patients can go 12 weeks between injections.

Researchers are also testing gene therapies that could permanently turn off the VEGF signal or fix the faulty immune response behind AMD. Phase I trials are promising. If they work, we might one day treat AMD with a single injection that lasts for years.

What You Can Do Now

If you’re over 65, get a full eye exam every year-even if you think your vision is fine. AMD has no early symptoms. By the time you notice blurriness, it might already be advanced.

If you have dry AMD, take AREDS2 supplements. These aren’t regular vitamins. They’re a specific mix of lutein, zeaxanthin, zinc, copper, vitamin C, and vitamin E. Studies show they cut the risk of progression to wet AMD by 25%. Don’t buy any old “eye health” pill-check the label. It must match the AREDS2 formula.

Use an Amsler grid at home. It’s a simple checkerboard pattern you look at daily. If the lines look wavy, blurry, or missing, call your eye doctor immediately. That could mean wet AMD is developing. About 40% of patients catch the switch from dry to wet AMD this way before their next appointment.

Quit smoking. It’s the single most powerful thing you can do to protect your vision. And manage your blood pressure and cholesterol. These aren’t just heart issues-they’re eye issues too.

Living With AMD

AMD doesn’t mean the end of life. It means adapting. Many people keep driving with low-vision aids. Others use screen readers, magnifiers, or voice assistants. Bright lighting helps. Contrast matters-use dark text on white backgrounds. You can still read, watch TV, and connect with family.

One patient in Bristol, 78, started using a talking kitchen scale and a large-button phone after her diagnosis. She still gardens, still reads the newspaper with a magnifier, and still sees her grandchildren. “I lost the fine details,” she said. “But I didn’t lose the joy.”

What’s Next

AMD is rising. With more people living longer, global cases are expected to hit 288 million by 2040. But so are the tools to fight it. Anti-VEGF therapy has already turned a once-devastating condition into a manageable one. With longer-acting drugs, implants, and gene therapies on the horizon, the future isn’t just about preserving vision-it’s about restoring it.

The key is early detection and sticking with treatment. Don’t wait for symptoms. Get checked. Take your supplements. Ask about new options. Your central vision is worth fighting for.