- Medically Reviewed by: Mr Mfazo Hove, Consultant Ophthalmic Surgeon
- Author: Mr Mfazo Hove
- Published: November 8, 2024
- Last Updated: October 29, 2026
TL;DR: Age-related macular degeneration (AMD) damages the macula, the small central part of the retina, the light-sensitive layer at the back of your eye, responsible for sharp detail and colour vision. It affects the central vision used for reading, driving and recognising faces, but does not cause total blindness because side vision is spared. Dry AMD usually develops slowly and is more common, while wet AMD can damage sight within weeks and is treatable with injections if caught quickly.
In wet AMD, time is sight. New distortion or a central blur deserves an appointment within days, not months.
How Our Medical Retina Service Works
Blue Fin Vision® provides rapid access to assessment and treatment, followed by an organised next step. Medical retina care focuses on conditions affecting the retina that are managed with medicines, monitoring and other non-surgical treatments.
Access
Contact our eye clinic, and we arrange a consultant consultation and optical coherence tomography (OCT) scan, typically the same day at the nearest suitable site. OCT uses light to create detailed images of the layers of your retina.
Treatment
Where an injection is indicated, it is given at our Harley Street clinic the same day or the following day.
Continuity
Your next appointment is at four weeks, either with us or through an agreed NHS pathway.
We write to your NHS team, GP and optometrist so the handover is clear. If NHS treatment cannot be arranged in time, we can give the next injection.
Your Circumstances
Anti-vascular endothelial growth factor (anti-VEGF) medicines block signals involved in abnormal blood vessel growth and leakage. They are available on the NHS, and most people continue long-term treatment there; we often provide the first treatment and bridge to NHS care.
We also treat overseas patients and others who are not eligible for NHS-funded treatment, with transparent costs:
- Medical retina consultation: £325.
- OCT scan: £200.
- Injection including aflibercept (Eylea), an anti-VEGF medicine: from £2,000.
For subsequent injections, we typically do not charge a separate consultation or OCT fee. If an injection is not needed at a follow-up visit, the consultation and OCT fees still apply.
Complication Readiness
We keep medication on hand to treat an acute rise in eye pressure after an injection. Every patient has the direct number of the consultant who performed their injection.
If pain, redness or worsening vision develops, even on a Sunday afternoon, you call your consultant directly rather than being sent to a general accident and emergency (A&E) department.
We arrange urgent assessment, with vitreoretinal management through Professor Mahmut Dogramaci where infection is suspected. Vitreoretinal care involves the retina and the vitreous, the clear gel inside the eye.
If you cannot reach your consultant promptly, do not wait: go to your nearest eye casualty or A&E department.
We plan for complications we have never had.
How Common Is AMD?
AMD is a leading cause of sight loss in older adults worldwide. A global analysis projected around 196 million people with AMD in 2020, rising to around 288 million by 2040 as populations age. These are population projections rather than observed case counts.¹
Who Is at Risk of AMD?
- Age: the main risk factor, with risk rising steeply after 50.
- Smoking: the most important risk you can change.
- Family history: AMD has a strong genetic component.
- Diet and cardiovascular health, meaning the health of your heart and blood vessels, contribute to overall risk.¹
Dry and Wet AMD
Dry AMD
Dry AMD is a gradual thinning of the macula, often with yellow deposits called drusen. Vision changes over years.
In people with intermediate dry AMD, or advanced AMD in one eye, specific vitamin and mineral supplements reduced the risk of progression in the Age-Related Eye Disease Study (AREDS).¹
The later Age-Related Eye Disease Study 2 (AREDS2) formulation replaced beta-carotene with lutein and zeaxanthin, nutrients found in the retina. This formulation is safer for current and former smokers.¹ Our article on dry AMD explains it in detail.
Wet AMD
Wet AMD occurs when abnormal blood vessels grow beneath the macula and leak fluid or blood. It can cause rapid, severe loss of central vision.
Anti-VEGF injections, which block the signal driving these vessels, transformed its outlook. In the landmark MARINA clinical trial, most treated eyes avoided substantial vision loss, and around a third improved.²
Different anti-VEGF medicines have been shown to be effective.¹ Read more about wet AMD.
Symptoms of Macular Degeneration Disease
Symptoms of macular degeneration disease include:
- Straight lines that look wavy.
- A blurred or dark patch in the centre of your vision.
- Faces becoming harder to recognise.
Our article on the signs of macular degeneration covers them in full.
What Causes AMD?
The macula works harder than almost any other tissue in the body. Its light-sensing cells depend on a supporting layer beneath them, the retinal pigment epithelium, which clears waste and supplies nutrients.
With age, waste material builds up as drusen, inflammation increases and the supporting layer begins to fail.
In some people, the failing tissue thins away, causing dry AMD. In others, the retina sends out distress signals that trigger abnormal blood vessel growth, causing wet AMD. Genes, smoking and diet influence how quickly this happens.¹
What Happens at Your Eye Clinic Appointment?
- Vision testing, including reading vision and, where useful, a check for distortion.
- Dilating drops to widen your pupils, so the consultant can examine the macula in detail.
- An OCT scan, which shows the layers of the retina and any fluid, in seconds and without touching the eye.
- Further imaging if needed, such as angio OCT, which maps blood flow without dye, or fluorescein angiography, which uses an injected dye and photographs to show blood flow and leakage.
- A clear explanation of the type and stage of your AMD, and a written plan.
Bring your glasses and a list of your medicines. Dilating drops blur your vision for a few hours, so do not drive yourself home.
Anti-VEGF Injections, Step by Step
For wet AMD, injections are given into the vitreous gel inside the eye, where they act directly on the leaking vessels.
Preparation
The eye is numbed with drops and cleaned with antiseptic, and a small clip holds the eyelids gently open.
The Injection
A very fine needle passes through the white of the eye. It takes a few seconds, and most people feel pressure rather than pain.
Afterwards
Mild grittiness, a small red patch on the white of the eye, or a few floaters, small shapes drifting across your vision, are common and settle within days.
Serious complications, such as infection inside the eye, are rare. You will be told which symptoms need urgent attention: increasing pain, redness or a drop in vision.
How Often
Treatment usually starts with a course of injections a month or so apart.
After that, many consultants use a treat-and-extend approach, lengthening the gap between injections while OCT scans show the macula staying dry, meaning there is no fluid from leaking vessels.
Most people need treatment for months or years; stopping too early risks the fluid returning.¹
Living With AMD
- Stop smoking. It is the most important thing you can do to protect your eyes.
- Eat well. Diets rich in leafy green vegetables and oily fish are associated with a lower risk of AMD progressing.¹
- Use good light and magnification. Task lighting, large print and magnifiers make a real difference.
- Check each eye regularly for new distortion, so wet AMD is caught early.
- Get support. Low vision services, which help you make the most of your remaining sight, the Royal National Institute of Blind People (RNIB) and the Macular Society offer practical help.
Some people with sight loss see images that are not there. This is called Charles Bonnet syndrome; it is common and not a sign of mental illness.³
For information about driving, read our article on macular degeneration and driving.
Frequently Asked Questions
Will I go blind from AMD?
AMD affects central vision, not side vision, so it does not cause total blindness. Many people keep useful sight for life, particularly when wet AMD is treated promptly.
Is AMD hereditary?
Genes play a significant part, and having a parent or sibling with AMD increases your risk.¹ It is worth telling your optometrist, so your macula is checked at every eye test.
Can AMD be prevented?
Not completely, but not smoking, a healthy diet and, for the right patients, AREDS2 supplements reduce the risk of progression.¹
Can Wet AMD come back?
Yes. Fluid can return when injections are spaced out, which is why regular OCT monitoring continues even when the eye is stable.¹
Can both eyes be affected by AMD?
Yes. If one eye has AMD, the other is at higher risk, so both eyes are examined at every visit, and early changes in the second eye are acted on quickly.
Why We Plan for Infection
Serious infection inside the eye, called endophthalmitis, is rare after an injection.
In a regional study in England, the risk was around 1 in 4,000 injections, similar per procedure to cataract surgery. Because far more injections were performed, they accounted for more cases.⁴ Those figures describe that population, not our own patients.
Intracameral antibiotics, antibiotics placed inside the front chamber of the eye, are standard infection prophylaxis, or preventive treatment, in cataract surgery.⁵ Anti-VEGF injections do not provide that antibiotic protection, so meticulous prevention and a clear emergency response pathway remain essential.
Mr Hove led the Eye Casualty service at the Western Eye Hospital for five years.
We have never had a case of endophthalmitis after an injection; we plan for it anyway, so that if symptoms develop, assessment and treatment are not delayed.
At Blue Fin Vision®
Suspected wet AMD is treated as a priority under our Rapid Medical Retina Pathway, described above.
We keep your GP and optometrist informed, and complex cases are escalated to Professor Mahmut Dogramaci, Consultant Vitreoretinal Surgeon, within the same team.
For more information about assessment, treatment and living with AMD:
- Explore our medical retina service.
- Read about private intravitreal injections, including published fees.
- Read RNIB’s free Understanding age-related macular degeneration guide.
- Explore our patient information.
Book a consultation with Blue Fin Vision® to discuss your AMD symptoms, assessment and treatment options.
References
- Royal College of Ophthalmologists. Commissioning guidance: age related macular degeneration services: evidence base. London: Royal College of Ophthalmologists; 2024.
- Rosenfeld PJ, Brown DM, Heier JS, Boyer DS, Kaiser PK, Chung CY, Kim RY. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006;355(14):1419-31.
- Royal National Institute of Blind People. Charles Bonnet syndrome. London: RNIB; 2024.
- Ong AY, Rigaudy A, Toufeeq S, Robins J, Shalchi Z, Bindra MS, Charbel Issa P. Intravitreal injections as a leading cause of acute postoperative endophthalmitis: a regional survey in England. Eye (Lond). 2023;37(1):163-9. doi:10.1038/s41433-021-01886-3.
- ESCRS Endophthalmitis Study Group. Prophylaxis of postoperative endophthalmitis following cataract surgery: results of the ESCRS multicenter study and identification of risk factors. J Cataract Refract Surg. 2007;33(6):978-88.
ABOUT THE AUTHOR
Mr Mfazo Hove
MBChB MD FRCOphth CertLRS
Consultant Ophthalmic Surgeon | Founder and Medical Director, Blue Fin Vision®
Mr Mfazo Hove is a Consultant Ophthalmic Surgeon with more than two decades of experience across NHS and private practice and more than 57,000 ophthalmic procedures performed. He trained for six and a half years at Moorfields Eye Hospital and served for five years as an NHS consultant at the Western Eye Hospital, Imperial College Healthcare NHS Trust.
He specialises in cataract surgery, refractive lens replacement, laser vision correction and implantable Collamer lenses (ICL). He is the founder and Medical Director of Blue Fin Vision®, a private ophthalmology group providing consultant-delivered care across London, Hertfordshire and Essex. His cataract surgery outcomes are publicly reported through the National Ophthalmology Database.
A ZEISS Key Opinion Leader and international speaker, Mr Hove is a contributing author to The Ophthalmologist. His writing examines how clinical governance and the organisation of ophthalmic services shape patients’ experiences and outcomes, with a focus on transparent outcome reporting, surgical training and long-term accountability for patient care.
