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Age-Related Macular Degeneration

Age-related macular degeneration, (shortened as AMD or ARMD) is an eye condition affecting a part of the retina known as the macula. AMD causes vision loss in the central view, preventing you from seeing fine details at a far and close distance. With AMD, peripheral or side vision is less or unaffected. People with AMD might see the numbers on a clock but not the hands of the clock.

AMD is a common vision problem in developing countries and is a leading cause of blindness in people over 50 years old.

Types of AMD

There two different types of ARMD:

  • Wet ARMD (exudative)
  • Dry ARMD (atrophic)
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This is the most common AMD, affecting about 80% of AMD patients. Dry AMD occurs when some parts of the macular (centre of retina) become thinner as you age, and the growth of tiny protein clumps called drusen occurs. The result is a gradual loss of central vision. No treatment is available for dry AMD, but you can manage the condition to slow the rate of vision loss.

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Symptoms that need emergency care


Wet AMD is a less common condition but more serious. This condition occurs when new but abnormal blood vessels develop under the retina. The blood vessels eventually leak blood and other fluids, resulting in scarring of the macula. Wet AMD causes faster vision loss than dry AMD.

Most people with AMD do not know they have the condition until their vision becomes blurry. This makes regular visits to the ophthalmologist necessary as gradual changes may not be noticeable in the early stages. The eye doctor can check for early signs of wet AMD during the visit before vision problems occur.

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Who is at risk of developing AMD?

You are likely to have AMD if you:

Diagnosing AMD

The ophthalmologist will ask you to use an Amsler grid during your eye exam. Looking at the Amsler grid will help the ophthalmologist notice the location of distorted, blank or blurry spots in your vision. The eye doctor will also look inside your eye/s through a special lens. This helps check for changes in the macula and retina. 

The ophthalmologist will put eye drops in to dilate your eyes. The eye drop will widen the pupil, allowing the doctor to look through the special lens to see inside the eye. 

Another option to examine the retina is an Optical Coherence Tomography (OCT) scan. This machine scans the back of your eye, providing a better view of the macular, retina and optic disc. 

The doctor may also carry out a fluorescein angiography to check the retina. The doctor will inject a yellow dye, known as fluorescein, into a vein (usually in the arm). The yellow dye will travel through the blood vessels. Then, a special camera will take photos of the retina as the dye travels through the retinal blood vessels. The images can detect abnormal new cells in the retina.

Another method for detecting abnormal blood vessels in the retina is optical coherence tomography (OCT) angiography. This method is similar to the fluorescein angiography but doesn’t require a dye. Optimal Vision doctors have access to advanced technology for diagnosis and investigation for easy detection.

Treatment for AMD

Dry AMD treatment

No treatment is available for dry AMD, but people with serious vision loss or lots of drusen can take nutritional supplements to manage the condition by slowing down its progress.

There are some studies which suggest taking the following minerals and vitamins daily slows the progress of advance dry AMD, one suggestion for taking regular supplement is as below:

You need to discuss with your doctor for best advise on vitamins and supplements as certain forms of dry AMD won’t respond to the AREDS supplements. Smokers should avoid taking beta carotene and zinc as it increases the risk of lung cancer. Eating dark, leafy greens, fish, and fruits, including healthy, nutrient-dense foods, can also help people with AMD.


Medications known as anti-VEGF can treat wet AMD or at least stop its progression. Treatment with Anti-VEGF helps to reduce the number of abnormal retinal blood vessels. These medications also slow leaking from these abnormal blood vessels. The doctor will administer the medication into the eye through a small needle. This treatment is done under local anaesthesia and is well tolerated. No needle can be seen and it has minimal discomfort and you can carry on with your daily activity immediately after treatment.

Another treatment option for wet AMD is laser surgery in some cases. The surgeon will shine a laser beam on the abnormal blood vessels during this procedure. This reduces the number of abnormal vessels and slows leaking in these vessels.

Few of the more popular macula degeneration drugs or Anti VEGF injection treatment are as below:

Symptoms that need emergency care

Managing your vision

If you have AMD, you can learn to manage your condition. You can still carry out different tasks using special vision tools such as handheld computers and magnifying tools. You can also learn to use your side vision for different tasks.

A vision rehabilitation specialist can assist you in maximising your side vision and recommend the right low vision tools and services. You can ask the our ophthalmologist to refer you to a vision rehabilitation specialist within our team.

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Using an Amsler grid

AMD will result in changes in vision over time. You may not notice the changes, but noticing changes in your vision early will help improve your prognosis. Treating AMD early can stop or slow down further vision loss.

You can use the Amsler grid daily to monitor your vision. Below is information on how to use the Amsler grid.

  • Place the Amsler grid in a location where you can see it daily. Most people keep the Amsler grid on the refrigerator door or bathroom mirror.
  • When there is good light, stand about 12 to 15 inches away from the grid and look at it. Ensure you wear your reading glasses while looking at the grid.
  • Cover one eye, then look directly at the dot in the middle of the grid with the uncovered eye. Check if lines look wavy or bent and if any part of the Amsler grid looks dim, blurry, or irregularly-shaped.
  • Cover the second eye and check your vision with that eye.
  • If you notice changes in your vision, such as dim, blurry, or wavy lines, ensure you contact your ophthalmologist immediately.
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You can contact Optimal Vision on 020 7183 3725 to schedule an appointment with our ophthalmologist.


Medications known as anti-VEGF can treat swelling and bleeding related to macula degenerations. These medications slow or stop damage from the abnormal blood vessels and therefore slow down vision loss.In fact many feel even improvement in their vision.

The doctor will administer small amount of the medication through a very small needle from white part of the eyes. This treatment is done under local anaesthesia, take few minutes and is well tolerated, can even be given while sitting in examination chair, no needle can be seen and has minimal discomfort and you can get on with the rest of your day

Example of these medications are:

  • aflibercept (brand name Eylea)
  • bevacizumab (brand name Avastin)
  • brolucizumab (brand name Beovu)
  • ranibizumab (brand name Lucentis)
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What is Eylea (Aflibercept)?

Eylea, the brand name for the drug aflibercept, is a medication used to address various retinal conditions, primarily focusing on wet age-related macular degeneration (AMD), diabetic eye disease, and other retinal problems. Administered through eye injections, Eylea plays a crucial role in slowing down vision loss caused by abnormal blood vessels in the back of the eye.

Mechanism of Action:

  • VEGF Blocker: Abnormal blood vessels require VEGF (Vascular Endothelial Growth Factor) to grow. Eylea acts as an anti-VEGF drug, blocking the growth and leakage of fluid from these abnormal vessels, thereby slowing their growth in the eye.

Conditions Treated with Eylea:

Eylea is employed for the treatment of several eye problems, including:

  • Wet age-related macular degeneration (AMD)
  • Macular edema (swelling of the retina)
  • Diabetic retinopathy
  • Choroidal neovascularization (abnormal blood vessels leading to vision loss)
  • Retinal vein occlusion

IntraVitreal Anti-VEGF Treatment Procedure:

  • Outpatient Procedure: Administered during an outpatient procedure, the eye is numbed to minimise discomfort.
  • Injection Process: The drug is injected directly into the white part of eye called sclera using a very thin needle, usually not visible to the patient.
  • Repetitive Treatments: In some cases, multiple injections may be necessary over several months for optimal results.

Risks and Side Effects:

Common side effects include:

  • Eye redness
  • Sensation of foreign body in the eye
  • Dry or itchy eyes
  • Eye discomfort
  • Temporarily blurry vision
  • Floaters

Rare complications may include:

  • Eye infection
  • Detached retina
  • Cataracts
  • Light sensitivity
  • Eye pain
  • Swelling inside the eye

Monitoring and Reporting:

It is crucial to report any unusual symptoms or side effects promptly to your ophthalmologist. Regular communication with your healthcare provider is essential for maintaining eye health and addressing any concerns during the course of Eylea treatment.

If you have any questions or need further clarification about Eylea treatment or your eye health, don't hesitate to consult with your ophthalmologist. They are dedicated to preserving your sight and providing comprehensive care for your vision needs.

At Optimal Vision, we are committed to providing accessible and affordable options for advanced treatments. Our offerings include:

  1. Comprehensive Consultation Packages:affordable packages available to include primary consultation, treatment , medications and follow up under one discounted rate.
  2. Flexible Payment Plans:monthly flexible instalment available to spread the costs.ask our team for more information
Dr Amir Mani - Specialist refractive surgeon

One of the most experienced refractive surgeons in London

Dr Mani has performed more than 20,000 ophthalmic procedures, including LASIK, LASEK, PRK, Femto Cataract, RLE, Lens ICL and Phakic IOL Surgery

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