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Age-Related Macular Degeneration

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The macula is a specialized portion of the retina responsible for central vision. Located at the back of your eye in the center of your retina, the macula provides the sharp vision you need to drive, to read and to see details. However, if you’re over the age of 50, age-related macular degeneration (AMD) may affect your ability to see. In fact, among older people, AMD is the main reason for irreversible legal blindness . The disease runs in families and is much more severe in people who smoke. 

There are two types of AMD:

  • Dry AMD is the first stage of the disease. It starts slowly, eventually leading to loss of central vision. While the disease affects both eyes and progresses faster in one eye compared to the other, most people eventually lose their central vision in both eyes.
  • Wet AMD arises from dry AMD and is characterized by the growth of abnormal blood vessels in your macula. These abnormal blood vessels leak fluid and blood. If untreated, then this fluid and blood causes a scar to form and significant vision loss occurs. If the wet AMD is treated, then it can be converted back to dry AMD.

This condition happens when cells on the back of the cornea (endothelial cells) die off, causing fluid buildup and corneal swelling. Symptoms include:

  • Glare affecting vision in low light conditions
  • Blurred vision in the morning that improves throughout the day
  • Distorted vision
  • Light sensitivity
  • Poor night vision
  • Seeing halos around lights at night
  • Small painful blisters on the cornea
  • Cloudy or hazy cornea
When you have a vision-impairing disease, you need a knowledgeable eye care team to provide a fast, accurate diagnosis and effective treatment plan. Preserving your eyesight through excellent care is the goal of every eye care professional at Bascom Palmer Eye Institute, part of the University of Miami Health System.

Dry AMD Treatment

We have a new revolutionary treatment for dry atrophic age-related macular degeneration (AMD) that was approved by the Food and Drug Administration on February 17, 2023. This new drug, which has been in development for the past 18 years, is known as Syfovre®. Syfovre® slows the progression of geographic atrophy in AMD, which is the major cause of blindness from AMD. AMD, a common cause of vision loss as people age, begins slowly as dry AMD. As AMD progresses, the dry form of AMD progresses to the late-stage known as geographic atrophy or to the late-stage of AMD known as wet AMD. Wet AMD arises from dry AMD and occurs when abnormal blood vessels grow and leak fluid and blood into the central macula. Only about 15% of patients with dry AMD ever progress to wet AMD. Learn more about advances in the treatment of dry AMD.

Wet AMD Treatments

Injections of drugs into the eye that block vascular endothelial growth factor (anti-VEGF injections) prevent the severe vision loss that normally occurs in WET AMD, and in many patients, vision is improved.  If this treatment is recommended, then the injections need to be given every month at first, and then the injections can be spaced out and become less frequent. By stopping or limiting the growth of new blood vessels, this medication helps preserve your vision. Since 2005, we’ve had great treatments for wet AMD, starting with Avastin®, followed by Lucentis®, then Eylea®, and now Vabysmo®. All these treatments are highly effective and convert the wet AMD back to dry AMD.

July 18, 2025, marks the 20th anniversary of the meeting presentation that changed the global management of wet AMD, preventing blindness in millions of patients and saving healthcare systems hundreds of billions of dollars worldwide. Twenty years ago, Dr. Philip J. Rosenfeld and his research team presented his breakthrough therapy using Avastin® injections into the eye of patients with wet AMD at the annual meeting of the American Society of Retinal Specialists (ASRS) in Montreal.

First used on a patient in May 2005 to prevent blindness after all conventional therapies had failed, the phenomenal success of Avastin led to more compassionate use to prevent blindness, and the therapy rapidly spread throughout the world due to its effectiveness, low cost, and availability. The presentation in Montreal was the first public announcement of this breakthrough therapy, and this therapy continues to be used today as the cornerstone of treatment for wet AMD, diabetic retinopathy, retinal vein occlusions, and a wide range of retinal diseases characterized by neovascularization and exudation.

How is geographic atrophy treated?

As AMD progresses, the disease eventually causes geographic atrophy to form, which is the loss of retinal tissue that causes the relentless progression of vision loss.
Even before legal blindness occurs, patients with early geographic atrophy can still have good reading vision, but they are aware of significant symptoms such as needing brighter lights to read, having difficulty with glare, losing the ability to drive at night, and complaining that they can’t recognize people in dim light. While Syfovre® isn’t a cure, the drug will slow down the overall vision loss and allow patients to have useful vision for longer resulting in a better quality of life.
Syfovre® won’t improve vision, but it will gradually slow and hopefully stop the progression. However, there is a significant treatment burden. For the first two years, most patients will need monthly injections of Syfovre® into their eyes. However, the eye must first qualify for treatment. To know if an eye qualifies, patients need to be evaluated by a retina specialist. While injections into eyes are routinely performed for wet AMD and everyone is nervous when they get their first injections, the procedure quickly becomes less stressful and well tolerated.
The procedure performed by the retina specialist is the same as for wet AMD, but the drug we inject is different. Most patients do experience mild discomfort after the injection, and this discomfort lasts for about one day. Other promising drugs are also being developed for dry AMD

Tests

Comprehensive Eye Exam
Comprehensive Eye Exam The standard way of diagnosing macular degeneration is with a dilated exam. During your examination, your ophthalmologist will search for retinal damage and may perform other tests.
Distance Visual Acuity Measurement
In this test, you cover one eye, read a standard eye chart from a distance and then repeat the process with the other eye. Your eye care professional records how well your eyes see at a distance.
Amsler Grid
In this test, you look at an Amsler grid’s pattern of straight horizontal and vertical lines. If you have AMD, you will see wavy lines, distorted or missing lines or a black spot in the center of the grid.
Optical Coherence Tomography (OCT)

This non-invasive imaging procedure uses dim light and produces a cross-sectional, three-dimensional (3-D) images of the inside of your eyes. By performing OCT imaging, you doctor can determine if your AMD is getting worse and whether you need an injection into your eye.

Fluorescein Angiography
Using this method, your doctor can see changes in the structure or function of your retinal blood vessels. To perform the test, your eye care professional injects dye into a vein in your arm or hand, then photographs your retina as the dye outlines your blood vessels.

Why Choose Bascom Palmer Eye Institute?

#1 in the Nation
  • Ranked #1 for ophthalmology in the nation by U.S. News & World Report, our retinal specialists offer the most advanced imaging techniques and latest treatments.
Patient-Centered Care and Support
  • If you’re facing vision loss, you deserve expert care that considers your individual needs. Our low vision support services help you manage AMD and preserve your quality of life.
Research-Driven Medicine
  • Our physician-researchers continuously study this disease to develop effective treatments. As our patient, you gain access to innovative clinical trials and state-of-the-art treatments.
What this means for you
  • As an older adult, you may be coping with more than one condition. The world-class specialists within Bascom Palmer can treat any eye condition, from the common to the complex.