Whether you’ve just been diagnosed with age-related macular degeneration (AMD) or have been living with it for years, you may wonder what the future holds for your vision, eye health, and quality of life. It can be helpful to learn about typical AMD progression and what the condition can look like five, 10, or even 20 years down the road.

Disease progression isn’t the same for everyone with AMD. Various factors can speed up or slow AMD progression. Here, we cover the general outlook for AMD over the years and decades as well as the factors that influence the rate of progression.

How Macular Degeneration Progresses

AMD always starts as dry AMD, which progresses through stages over time. For 10 percent to 15 percent of people with AMD, the condition develops into an advanced form called wet AMD. This usually happens later in the disease but can happen at any point.

Even if you never develop wet AMD, your dry AMD can progress through the following macular degeneration stages.

Subclinical AMD

During the subclinical stage, your AMD likely hasn’t been diagnosed yet. One sign doctors look for is drusen, which are small yellow spots under the retina.

These deposits haven’t formed yet, but you might notice a decline in your night vision. More specifically, your eyes may have a hard time adjusting from bright light to darkness. This is called a loss of dark adaptation.

Early AMD

In early AMD, you still might not have any symptoms. However, a routine dilated eye exam may detect medium-sized drusen in the affected eye. This is how many people with AMD are first diagnosed.

Intermediate AMD

In intermediate AMD, wet AMD is more likely to develop than in the early and subclinical stages. At this stage, an eye exam may show numerous medium-sized drusen, at least one large druse, and/or changes in the retinal pigment (coloring in a layer of cells beneath the retina).

Some people still don’t notice symptoms when their AMD is in the intermediate stage, while others notice blurriness in their central vision. You might have a harder time reading fine print or seeing in low light, or you may notice that colors appear less vibrant.

Advanced AMD

As you develop advanced AMD, you may notice increasing vision loss. There are two main types of advanced AMD.

Geographic Atrophy

Geographic atrophy (GA) is the dry form of advanced AMD. GA can cause severe vision loss. About 20 percent of people who experience severely decreased vision from AMD have GA. This vision loss is irreversible.

Studies suggest that people with early or intermediate AMD may progress to GA faster than previously thought, with up to 19 percent of people with AMD progressing to GA within two years of being diagnosed.

Wet AMD

Wet AMD, also called neovascular AMD, is the other form of advanced AMD. It’s possible to have both wet AMD and GA. Up to 37 percent of people with wet AMD develop GA within two years of developing wet AMD. Up to 29 percent of people develop wet AMD within two years of being diagnosed with GA.

What To Expect Over 5, 10, and 20 Years

While the timeline of AMD progression varies from person to person, you can get an idea of what to expect by looking at what the research says and what myAMDteam members share.

The First 5 Years

Early-stage AMD has a low risk of progressing to advanced AMD within five years. However, subclinical or early AMD may progress to the intermediate stage within five years of your diagnosis.

About 42 percent of people who have been diagnosed with wet AMD develop it in the other eye within five years.

Here’s what myAMDteam members say about their first five years after diagnosis:

“I was diagnosed five years ago but still living my life pretty much as I always have.”

“It’s been over five years since I was diagnosed and began getting shots. While I did have a setback in my right eye 20 months ago that resulted in vision change, it barely changed the way I live.”

“I have dry AMD as well, diagnosed five years ago, and it is now at an intermediate stage.”

“I was diagnosed with dry AMD about two years ago in both eyes. It recently developed into wet AMD in my right eye.”

10 Years After Diagnosis

Your AMD may progress further over 10 years, especially without lifestyle changes to slow the progression. People with early AMD have about a 15 percent chance of progressing to advanced AMD 10 years after their diagnosis.

People who are older and have more severe disease at diagnosis are at a higher risk of developing GA or wet AMD at the 10-year mark.

According to a study that followed people with AMD for 10 years, more than 48 percent of older participants with more severe AMD developed wet AMD, and 26 percent progressed to GA.

The same study found that larger drusen at diagnosis often meant faster progression. Around 71 percent of participants with medium-sized drusen developed large drusen within 10 years, and almost 14 percent progressed to advanced AMD in that time.

20 Years After Diagnosis

Another study followed people with early and intermediate AMD for 20 years after they were first diagnosed. Almost 14 percent of participants who started with early AMD progressed to advanced-stage AMD in those 20 years. Between 45 percent and 58 percent of people with intermediate AMD progressed to advanced AMD in the same time frame.

A myAMDteam member said they only recently experienced vision loss after living with AMD for over 20 years: “I’ve been treated for both wet and dry AMD for over 20 years. Two weeks ago, my doctor informed me (but I knew) I’d lost much of the sight in my right eye.”

Risk Factors That Affect AMD Progression

Several lifestyle factors are associated with a worse long-term outlook. Some risk factors can be changed, while others are out of your control. Here are some examples:

• Smoking — People who smoke are six times more likely to develop AMD than those who don’t. Your eye doctor may advise you to stop smoking to slow your AMD progression.
• Diet — A diet rich in certain nutrients, including omega-3 fatty acids, may slow AMD progression.
• Genetics — Genetics may account for around 70 percent of AMD development, which you can’t change.
• Overall health — Other medical conditions may affect the rate of AMD progression. Talk to your doctor about how your overall health may affect your eye health.

Medications called complement inhibitors are available for geographic atrophy. They slow progression by about 20 percent to 30 percent.

A specific combination of vitamins and minerals called AREDS 2 may help slow the progression of dry AMD if you have intermediate AMD. Always consult your doctor before taking any new vitamins or supplements.

If you have wet AMD, anti-vascular endothelial growth factor (anti-VEGF) medications may preserve or improve your vision. Your ophthalmologist will monitor your vision and eye health closely while you’re taking them.