Do most older people get macular degeneration?

Oct 18, 2025 5 min read •

senior care Healthy Aging eye health

While age-related macular degeneration is a leading cause of vision loss in older adults, the answer to "Do most older people get macular degeneration?" is more nuanced than a simple yes or no. The risk and prevalence increase significantly with age, but it does not affect the majority of the senior population.

Quick Summary

Though the risk increases dramatically with age, especially after 75, macular degeneration does not affect the majority of older people, but it is a leading cause of vision loss in that demographic.

Key Points

Prevalence Increases with Age: While not all older people get AMD, the risk increases dramatically with age, especially for those over 75.
Dry AMD is Most Common: Most cases are the less severe 'dry' form, which progresses slowly, but it can evolve into the more serious 'wet' form.
Smoking is a Major Risk Factor: Lifestyle choices matter, and smoking significantly increases the risk of developing AMD.
Early Detection is Crucial: Regular dilated eye exams are essential, as early AMD is often asymptomatic, but early intervention can slow progression.
Treatment Options Exist, Especially for Wet AMD: While there's no cure for dry AMD, treatments like anti-VEGF injections can effectively manage the more aggressive wet form.
Lifestyle Management is Key: A healthy diet, exercise, and sun protection can help reduce the risk or slow the progression of AMD.

Is macular degeneration a universal fate for seniors?

Contrary to a common misconception, macular degeneration is not an inevitable outcome for every older person. While it is true that age is the single most significant risk factor for age-related macular degeneration (AMD), and the prevalence rises sharply with each decade, it does not affect the majority of the elderly population. The progression and severity of the condition vary widely among individuals. For instance, studies have shown that while approximately one-third of people over the age of 75 have some form of AMD, the vision-threatening late stage is much less common. This statistic highlights that while awareness and preventative care are crucial for all seniors, a diagnosis is far from a certainty.

The two types of age-related macular degeneration

Macular degeneration is not a single, uniform disease. It primarily exists in two forms, each with a different progression and prognosis:

Dry macular degeneration

This is the most common form, accounting for about 80-90% of all cases.
It is caused by the macula thinning and the buildup of small, yellow protein and fat deposits called drusen underneath the retina.
Vision loss is typically slow and gradual, often taking many years to become noticeable.
There is currently no medical cure for dry AMD, though its progression can be managed with lifestyle changes and nutritional supplements.

Wet macular degeneration

This is the less common but more severe form, responsible for more rapid and dramatic vision loss.
It occurs when abnormal blood vessels grow beneath the macula. These fragile vessels can leak fluid and blood, damaging the light-sensitive cells.
Vision loss can be sudden and dramatic, with a rapid decline in central vision.
Fortunately, treatments are available for wet AMD, primarily anti-VEGF injections that can stabilize vision and, in some cases, improve it.

Key risk factors beyond age

While increasing age is an unavoidable risk factor, several other elements contribute to a person's likelihood of developing AMD. Many of these factors are within an individual's control:

Smoking: This is one of the most significant modifiable risk factors. Smokers are at a much higher risk of developing AMD compared to non-smokers, and smoking can also accelerate disease progression.
Genetics and family history: A family history of AMD can increase your risk, suggesting a genetic predisposition.
Race and eye color: Caucasians have a higher risk of developing AMD, and individuals with light-colored eyes may also have slightly increased odds for dry AMD.
Diet: A diet high in saturated fat and processed foods and low in fruits, vegetables, and omega-3 fatty acids is linked to a higher risk of AMD.
Obesity and heart health: Conditions like high blood pressure and obesity increase the risk of AMD. Maintaining a healthy weight and cardiovascular health is beneficial for eye health.
Sun exposure: Some evidence suggests that cumulative exposure to UV radiation from the sun may contribute to AMD risk.

The stages of AMD

Macular degeneration progresses through several stages. Early detection is key, as managing risk factors can help slow progression.

Early AMD: Often asymptomatic. An eye doctor may detect medium-sized drusen during a dilated eye exam. Loss of dark adaptation may be an early sign.
Intermediate AMD: Vision may still be good, but signs like large drusen or pigment changes appear. Some individuals may experience blurry central vision. This is the stage where AREDS2 supplements are most often recommended.
Late AMD: At this point, vision loss is noticeable. It can manifest as geographic atrophy (advanced dry AMD) or the more severe wet AMD.

Early signs and detection

Many early cases of AMD are asymptomatic, which is why regular dilated eye exams are essential for seniors, especially those with increased risk factors. For those who experience symptoms, here's what to look for:

Distorted or wavy lines: Use an Amsler grid test at home. A classic sign of wet AMD is when straight lines appear bent.
Blurred central vision: Difficulty reading or recognizing faces can be an early indicator.
Difficulty adapting to low light: Taking longer to adjust to dim lighting, such as in a restaurant, can be a symptom.
Faded or diminished colors: Colors may appear less vibrant.

Managing risk and supporting eye health

While some risk factors like age and genetics are beyond control, many lifestyle choices can significantly impact eye health.

Healthy diet: Incorporate foods rich in antioxidants, lutein, and zeaxanthin, such as leafy green vegetables (kale, spinach), corn, eggs, and fruits. Fatty fish like salmon and mackerel, rich in omega-3s, are also beneficial.
Nutritional supplements: For individuals with intermediate AMD, the AREDS2 supplement formula (containing vitamins C, E, lutein, zeaxanthin, and zinc) has been shown to slow progression. Consult an eye doctor before starting any supplement regimen.
Quit smoking: This is a critical step to reduce AMD risk and protect overall health.
Protect your eyes from the sun: Wear UV-blocking sunglasses and a hat when outdoors to protect against sun damage.
Maintain overall health: Managing conditions like high blood pressure and obesity benefits both cardiovascular and eye health.

A comparison of dry vs. wet AMD


Feature	Dry AMD (Atrophic)	Wet AMD (Neovascular)
Prevalence	Approximately 80-90% of cases	Approximately 10-20% of cases
Underlying Cause	Thinning of the macula, formation of drusen (fatty deposits)	Abnormal, leaky blood vessel growth beneath the macula
Vision Loss Speed	Gradual and slow	Can be rapid and sudden
Key Symptoms	Blurred central vision, difficulty in low light, faded colors	Wavy or distorted straight lines, blind spots, rapid central vision loss
Treatment	No cure; management focuses on slowing progression with supplements and lifestyle changes	Anti-VEGF injections, photodynamic therapy, or laser surgery to stop blood vessel leakage

Living with macular degeneration

For those diagnosed with AMD, especially in its later stages, various strategies and resources can help maintain quality of life. Low-vision devices, such as magnifiers and specialized glasses, can assist with reading and other close-up tasks. Vision rehabilitation programs can teach new skills and adaptive techniques to help individuals remain independent. Support groups and educational resources also provide valuable information and emotional support, helping people cope with the challenges of vision loss.

For more comprehensive information on macular degeneration, including the latest research, the National Eye Institute is an excellent resource.

Conclusion

In summary, while macular degeneration is a serious and prevalent concern among older adults, it is not a given for most. A person's risk increases significantly with age, but a combination of proactive lifestyle choices, regular comprehensive eye exams, and early intervention can dramatically impact the progression and severity of the disease. By understanding the risk factors and being vigilant for early symptoms, seniors can take control of their eye health and preserve their vision for as long as possible.

Frequently Asked Questions

The risk of developing age-related macular degeneration (AMD) increases significantly with age. While not a certainty, studies show prevalence rising sharply with each decade, with approximately one-third of people over 75 showing signs of the disease.

The main difference is the cause and progression. Dry AMD, the most common type, involves the gradual thinning of the macula, leading to slower vision loss. Wet AMD, though less common, involves abnormal blood vessel growth and leakage, which can cause rapid and severe vision loss.

Early-stage macular degeneration often has no noticeable symptoms. As the disease progresses, individuals may experience blurred central vision, difficulty seeing in low light, or faded colors. Regular dilated eye exams are the best way to detect early changes.

Yes. Research shows that a healthy diet rich in leafy greens, fruits, vegetables, and fatty fish can support eye health. For those with intermediate AMD, AREDS2 supplements, containing specific vitamins and minerals, have been proven to slow the disease's progression.

Smoking is one of the most significant modifiable risk factors for macular degeneration. Smokers have a substantially higher risk of developing AMD and can also experience faster disease progression compared to non-smokers.

Treatment varies by type. For intermediate dry AMD, nutritional supplements like AREDS2 are recommended. For wet AMD, treatments like anti-VEGF injections, photodynamic therapy, and laser surgery are used to stop blood vessel leakage and can help preserve or improve vision.

Complete vision loss is extremely rare. Macular degeneration primarily affects central vision, leaving peripheral (side) vision intact. While it can make activities like reading and driving difficult, it does not typically result in total blindness.

References

Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider regarding personal health decisions.