Macular Degeneration After 60: Warning Signs, Prevention, AREDS2, Treatment and Medicare Coverage (2026)
Age-related macular degeneration (AMD) damages the macula, the part of the retina that gives you sharp, straight-ahead vision. It doesn’t cause total blindness, but losing central vision can make it hard to read, drive, recognize faces or cook. The National Eye Institute calls it a leading cause of vision loss in older adults.
The good news: catching AMD early matters. Wet AMD can often be slowed with eye injections that Medicare Part B covers. Certain people with intermediate AMD can lower their risk of advanced disease with a specific vitamin formula, AREDS2. And a few habits measurably lower your risk.
I’m a researcher, not an eye doctor. This guide summarizes guidance from the National Eye Institute and Medicare’s coverage rules to help you talk with your eye care provider. It isn’t a substitute for an eye exam.
Dry vs. wet AMD
Dry AMD is far more common. The macula thins over time, and yellow deposits called drusen build up. It moves through early, intermediate and late stages, usually over years. The late form is called geographic atrophy.
Wet AMD is a late form in which abnormal blood vessels grow under the retina and leak fluid or blood. It can damage vision quickly, sometimes over days or weeks, which is why sudden changes need urgent attention. Dry AMD can turn into wet AMD at any stage.
Warning signs
Early AMD often has no symptoms, which is why regular dilated eye exams matter. As it progresses, you may notice:
- Blurry or fuzzy central vision
- Straight lines that look wavy or bent, like door frames, window blinds or tile lines
- A blurry, dark or empty spot in the center of your vision
- Needing more light to read
- Colors that look less bright
- Trouble recognizing faces
A sudden change, like new wavy lines or a dark spot, needs a call to your eye doctor right away. It can signal wet AMD, and treatment works best when it starts early.
Check yourself with an Amsler grid
Many eye doctors suggest checking each eye regularly with an Amsler grid. That’s a square of straight lines with a dot in the center.
- Hold it at reading distance in good light, wearing your reading glasses.
- Cover one eye and look at the center dot.
- Notice whether any lines look wavy or broken, or any areas look blurry or missing.
- Switch eyes and repeat.
Report any change to your eye doctor. The grid doesn’t replace an exam, but it can catch changes between visits.
Who’s at risk
According to the NEI, your risk is higher if you:
- Are 55 or older, with risk rising steadily with age
- Have a family history of AMD
- Are white
- Smoke, which the NEI lists as a major, changeable risk factor
What lowers your risk
The NEI’s evidence-based suggestions are simple:
- Quit smoking, or don’t start. This is the most important step you can control.
- Stay physically active.
- Keep blood pressure and cholesterol in a healthy range.
- Eat leafy greens and fish. Spinach, kale and collards are rich in lutein and zeaxanthin, and fish provides omega-3s.
Sunglasses protect your eyes from UV light, and regular eye exams catch AMD before you notice symptoms.
AREDS2 vitamins: who they help, and who they don’t
This is where a lot of supplement marketing goes wrong. The AREDS2 formula is backed by large NEI clinical trials, but only for specific people.
According to the NEI’s AREDS/AREDS2 FAQ, the original AREDS formula reduced the risk of advanced AMD by about 25% over five years in people with intermediate AMD, or late AMD in one eye. The AREDS2 formula swapped beta-carotene for lutein and zeaxanthin, because beta-carotene raised lung cancer risk in smokers.
| Nutrient | AREDS2 daily dose |
|---|---|
| Vitamin C | 500 mg |
| Vitamin E | 400 IU |
| Zinc | 80 mg |
| Copper | 2 mg |
| Lutein | 10 mg |
| Zeaxanthin | 2 mg |
Who it’s for: people their eye doctor says have intermediate AMD, or late AMD in one eye.
Who it isn’t for: people with no AMD or only early AMD. The trials didn’t show a benefit for preventing AMD in the first place. These are high doses, so ask your doctor before starting, especially if you take other supplements or have kidney problems. Many products say “eye health” without matching the AREDS2 formula, so compare the label to the table.
Medicare doesn’t cover AREDS2 supplements.
Treatment for wet AMD
The main treatment is anti-VEGF injections into the eye. Common drugs include aflibercept (Eylea), ranibizumab (Lucentis), faricimab (Vabysmo) and bevacizumab (Avastin, used off-label). The drugs block the signal that drives abnormal blood vessel growth. They can slow vision loss and sometimes improve vision.
Injections are given in the office after numbing drops, often monthly at first and then spaced out based on how your eye responds. It sounds worse than it is: most people describe pressure rather than pain. Sticking to the schedule matters, because missed injections can mean lost vision.
Some people may also be treated with photodynamic therapy.
Treatment for geographic atrophy (late dry AMD)
Until recently, late dry AMD had no treatment. In 2023, the FDA approved two injected drugs, pegcetacoplan (Syfovre) and avacincaptad pegol (Izervay), that can slow geographic atrophy’s growth. They don’t restore lost vision, and they require regular injections, so talk with a retina specialist about whether the benefit is worth it for you.
What Medicare covers
According to Medicare.gov, Part B covers certain diagnostic tests and treatments for people with AMD. That includes eye exams to diagnose and monitor it, and injectable drugs given in your doctor’s office.
- You pay 20% of the Medicare-approved amount after the Part B deductible ($283 in 2026). Injections can be expensive, so the 20% adds up with monthly treatment. A Medigap plan usually covers it.
- Medicare Advantage plans cover the same services but set their own copays. Many require prior authorization or “step therapy,” meaning you try a lower-cost drug like bevacizumab first.
- Not covered: routine eye exams for glasses, most glasses, AREDS2 supplements and most low-vision aids.
Living well with low vision
If AMD has already affected your sight, low-vision rehabilitation can help you keep doing what you love. A low-vision specialist can recommend magnifiers, brighter task lighting, large-print and audio options, and phone and tablet accessibility features. Ask your eye doctor for a referral.
AMD affects central vision, so peripheral vision usually remains, and many people learn to use it more effectively. For other age-related eye conditions, see my guides to cataract surgery, glaucoma and eye floaters and flashes.
FAQ
What are the first signs of macular degeneration?
Often none at first. Later signs include blurry central vision, straight lines that look wavy, and a blurry or dark spot in the center of your vision.
Do AREDS2 vitamins prevent macular degeneration?
No evidence shows they prevent AMD in people who don’t have it. They lower the risk of progression to advanced AMD in people with intermediate AMD, or late AMD in one eye.
Does Medicare cover eye injections for macular degeneration?
Yes. Part B covers anti-VEGF injections given in a doctor’s office. You pay 20% after the deductible, unless Medigap or your plan covers it.
Can dry AMD turn into wet AMD?
Yes, at any stage. That’s why sudden changes, like new wavy lines, need prompt attention.
Will I go blind from macular degeneration?
AMD doesn’t cause complete blindness, because side vision usually remains. But advanced AMD can seriously affect central vision. Early treatment and low-vision rehabilitation help.
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