Age-related macular degeneration (AMD) is a chronic disease of the macula, the central part of the retina responsible for fine vision. The main causes of AMD and certain risk factors promote its onset or accelerate its progression. Julien Gozlan, M.D., ophthalmic surgeon in Paris 16, provides an overview of the causes of AMD and simple measures to better protect your vision.
Overview: what is AMD?
AMD affects the macula, the area that enables reading, recognizing faces, seeing details, and driving. It manifests as blurred central vision, distortions (wavy lines), or a central dark spot. Peripheral vision is generally preserved, but the functional impairment can be significant. Simple self-monitoring at home using the Amsler grid can help detect these distortions earlier.
A distinction is made between a so-called dry (atrophic) form, which progresses slowly, and an exudative (wet) form, which is more rapid and related to abnormal blood vessels beneath the retina. Understanding the causes of AMD enables early action and appropriate follow-up planning.
Non-modifiable risk factors and causes of AMD
Age
The primary cause of AMD is simply age. The disease is rare before age 55, then its frequency increases with the aging of retinal tissues. After age 70, a significant proportion of the population shows early or more advanced signs of AMD.
Family history
Having a family member with AMD (father, mother, brother, sister) increases your own risk. Genetic variants influence the macula's sensitivity to oxidative stress and inflammation and are among the non-modifiable causes of AMD. Genetics cannot be changed, but such a family history warrants regular ophthalmological monitoring from a certain age onward.
Skin type and eye color
Individuals with fair skin and light-colored eyes appear to be somewhat more susceptible. Less pigmentation filters light and UV rays less effectively. This risk factor does not act in isolation, but it is often cited among the suspected causes of AMD and reinforces the importance of good sun protection (quality sunglasses, hat, etc.).
Modifiable causes of AMD
Smoking
Smoking is one of the leading causes of AMD. It greatly increases the likelihood of developing the disease and of seeing it progress more rapidly. Tobacco reduces oxygen supply to the retina and promotes oxidative stress.
Quitting smoking is a major preventive measure. Even after many years, smoking cessation remains beneficial for the retina and for overall cardiovascular health. If needed, you can seek support from Tabac Info Service.
Hypertension, cholesterol, and diabetes
Poorly controlled high blood pressure, excess cholesterol, or certain cardiovascular disorders damage the small blood vessels that nourish the retina. These vascular abnormalities are also among the causes of AMD, particularly in patients already weakened by age or a family history. In diabetic patients, these factors also increase the risk of retinal damage such as diabetic retinopathy.
Regular follow-up with your primary care physician, proper adherence to treatments, and a healthy lifestyle are essential to limit these risks.
Diet and excess weight
A diet low in fruits, vegetables, and oily fish, and high in saturated fats or refined sugars, promotes oxidative stress and inflammation in the macula. Conversely, certain nutrients play a protective role and can counteract some lifestyle-related causes of AMD.
A varied diet is recommended, rich in:
- green and colorful vegetables (lutein, zeaxanthin);
- oily fish (omega-3 fatty acids);
- fruits rich in antioxidants.
Significant excess weight or a sedentary lifestyle are among the causes of AMD and cardiovascular diseases: regular physical activity and dietary adjustments help protect the retina.
Light exposure
Chronic and intense exposure to sunlight without protection may contribute to macular damage in some patients. This exposure is often mentioned among the possible causes of AMD. Wearing UV-filtering sunglasses and a hat outdoors is a common-sense measure, especially when other risk factors are present.
How to reduce your risk of AMD?
Age cannot be eliminated nor genetics altered, but it is possible to reduce several lifestyle-related causes of AMD in practice:
- smoking cessation with support if needed;
- control of blood pressure, cholesterol, and diabetes;
- a diet rich in green vegetables, fruits, and oily fish;
- regular physical activity adapted to your health status;
- ocular sun protection with quality sunglasses.
In patients with early-stage AMD, specific dietary supplements may be recommended on a case-by-case basis, following an ophthalmological examination.
FAQ: frequently asked questions about the causes of AMD
If one of my parents has AMD, at what age should I start being monitored?
If there is a family history of AMD (father, mother, brother, or sister), it is reasonable to begin regular ophthalmological monitoring from age 50–55, or earlier if you notice decreased vision or distorted lines. This monitoring does not necessarily involve extensive testing at every visit, but includes a fundus examination, supplemented if needed by a macular OCT. Your ophthalmologist will adjust the frequency based on your overall risk profile (smoking, blood pressure, cholesterol, diabetes, eye color, etc.).
Is quitting smoking really beneficial if I have been smoking for a long time?
Yes. Smoking is one of the main modifiable factors among the causes of AMD. Even after several decades of smoking, quitting reduces oxidative stress in the retina and lowers the risk of progression to a more severe form. The benefit is not immediate, but it is real for ocular, cardiovascular, and general health. Support (nicotine substitutes, dedicated apps, help from a smoking cessation specialist) increases your chances of success and is an integral part of AMD prevention when other risk factors are present.
Are screens and blue light a cause of AMD?
To date, the direct role of screens among the causes of AMD has not been demonstrated to the same extent as smoking, age, or cardiovascular factors. The light intensity emitted by a computer or smartphone remains far lower than that of the sun. However, prolonged exposure at close range without breaks can increase visual fatigue and dry eye. In practice, it is advisable to limit excessive exposure in the evening, increase viewing distance, take regular breaks (the 20-20-20 rule), and prioritize effective sun protection measures outdoors, which are more relevant for the macula than "blue light filtering" glasses alone.
Can dietary supplements prevent AMD?
Dietary supplements for the macula (lutein, zeaxanthin, zinc, antioxidant vitamins, omega-3 fatty acids) do not replace a healthy lifestyle, but they may be recommended at certain early stages of AMD or in already vulnerable patients, following an ophthalmological examination. They do not eliminate the causes of AMD, but can help slow progression in well-defined profiles. Self-medicating at random is not advised: the formulation must be tailored to your case, especially if you smoke or have a cardiovascular history. The most important factor remains a varied diet rich in green vegetables, fruits, and oily fish, which these supplements may complement.
Does a Mediterranean diet truly protect the macula?
A Mediterranean-style diet, rich in green and colorful vegetables, fruits, oily fish (omega-3 fatty acids), quality vegetable oils, and low in refined sugars and saturated fats, is associated with a lower risk of AMD in several studies. It addresses multiple lifestyle-related causes of AMD: reduction of oxidative stress, better cardiovascular health, and more stable weight. While not an "absolute shield," this type of diet provides a reasonable foundation for protecting the retina, alongside other measures (smoking cessation, blood pressure and cholesterol control, regular physical activity).
How can I protect myself from the sun if I have risk factors for AMD?
Intense sunlight is regularly cited among the environmental factors that may contribute to the causes of AMD, especially in individuals with fair skin and light eyes. The goal is not to eliminate all exposure, but to make it safer: wear sunglasses that filter 100% of UV rays (category 3 or 4 depending on conditions), with prescription lenses if needed, and a wide-brimmed hat during prolonged exposure. Avoid looking directly at the sun or very intense reflections (snow, sea) without protection. These simple measures are part of an overall macular protection strategy, alongside regular medical monitoring and correction of other risk factors.
What should I tell my children or siblings if I have AMD?
Having AMD does not mean that all your relatives will develop the disease, but their risk is somewhat higher than that of the general population. The main message is preventive: do not smoke, protect your eyes from the sun, monitor blood pressure and cholesterol, and in case of diabetes, aim for good control. From the age of fifty onward (earlier if visual concerns arise), it is advisable to have a regular ophthalmological examination with fundus examination and, if needed, OCT. Explaining the value of a balanced diet and the Amsler grid for self-monitoring enables them to take an active role in their visual health, without excessive anxiety but with appropriate vigilance.
When to consult Julien Gozlan, M.D.?
If you have a family history of AMD, prolonged smoking history, cardiovascular disorders, or if you notice blurred central vision, distortions, or a spot in the center of your vision, it is important to schedule a consultation.
Julien Gozlan, M.D., ophthalmologist in Paris 16, performs a comprehensive macular examination (fundus examination, macular OCT) and establishes a personalized follow-up plan based on the various causes of AMD identified in your case.
📍 Consultation at Paris – Auteuil Ophthalmology Practice
Julien Gozlan, M.D. sees patients at the Paris – Auteuil Ophthalmology Practice for screening, follow-up, and management of the various causes of AMD as well as early or advanced forms of the disease.
Book an AppointmentFurther reading
- Age-related macular degeneration (AMD): understanding symptoms and treatments.
- Macular OCT: the key examination for analyzing the macula.
- Amsler grid: a simple self-monitoring tool for use at home.
- Intravitreal injections: management of exudative forms of AMD.