Will I go blind the way my mother did?

Many families arrive with that fear. The honest answer: AMD almost never leads to complete blindness — the outer field of vision is preserved. And unlike a generation ago, wet AMD is treatable today: with timely injection therapy, central vision can be stabilised in most people. What your parents went through is not your predetermined path.

Does the injection into the eye hurt?

The idea of it is considerably worse than the reality. The eye is thoroughly anaesthetised; most people feel only a brief pressure. The whole appointment takes about half an hour, the injection itself seconds. After the first treatments many people tell us: 'If I had known how harmless it is, I would not have spent weeks dreading it.'

How often will I need an injection?

Usually monthly to begin with, then at individually extended intervals ('treat and extend') — as rarely as possible, as often as necessary. Every check is assessed by a doctor; the interval is adjusted to your findings, not to a clinic protocol.

What is the point of the Amsler test at home?

A great deal. Once a week, cover one eye at a time and look at the grid (or at a tile joint): do straight lines appear bent or distorted, or is there a patch missing in the centre? Then call us within days — not at your next routine appointment. With wet AMD, time counts.

The risk can be reduced, not eliminated: do not smoke, keep blood pressure under control, eat green vegetables and fish, protect against UV. At certain early stages, specific vitamin preparations (the AREDS2 formula) can slow progression — whether that makes sense for you is something we tell you after the examination. Buying 'eye vitamins' as a general measure is not worth it.

Does health insurance pay for the treatment?

Yes. Diagnostics and injection therapy for AMD are covered by basic health insurance. All that falls to you is the deductible and co-payment — no hidden extra costs.

All I know is my symptom — which of your pages do I need?

Go by what you see. A sudden, complete loss of vision in one eye does not belong in the consultation but in an emergency department, immediately: call the ambulance (144). Flashes of light, many new black dots or a shadow from the side belong to the outer retina and need assessing the same day; outside consulting hours the ophthalmic emergency service applies. Distorted lines or a grey patch where you are looking: that is the macula — this page is written for it, and where they have newly appeared they need assessing within days, not at the next routine appointment. If reading becomes harder without anything being distorted, the cause more often lies at the front of the eye. And if the diagnosis is already settled, the treatment page is the right one.

Distorted lines — is that always AMD?

No. Wavy lines and a patch in the centre of the picture also occur with a macular hole and with a macular pucker, and they are treated differently. The distinction is made by the cross-sectional scan of the retina, not from the symptoms. That changes nothing about the urgency: distortion that has newly appeared needs assessing within days, not at the next routine appointment. And distorted lines are not only a sign from the macula — a sudden, painless deterioration of vision in which straight lines look skewed is on the warning list for retinal detachment as well. If flashes of light, many new black dots or a shadow from the side come with it, call the same day.

Should I call, or book an appointment online?

Call for anything that is new. The same day: flashes of light, many new black dots or a shadow from the side. Within days, and not at the next routine appointment: newly appeared distortion, a new grey patch in the centre or a marked deterioration within days. We keep short-notice slots free for that. Say straight away what you are seeing and since when — that is different information from 'an appointment with the eye doctor'. Outside consulting hours the ophthalmic emergency service applies; with a sudden, complete loss of vision in one eye, call the ambulance (144). Anything without an acute change you can arrange online.

I already have the diagnosis from elsewhere — what does an appointment here give me?

Bring your documents: earlier cross-sectional scans, medical reports and a note of which medicine you last received and when. With this disease comparability is half the diagnostics — only a series of scans says whether anything is moving. What we see we tell you, including when that means the treatment so far is right.

Can I have AMD and a cataract at the same time?

Yes, and that is the rule rather than the exception — both belong to the same stage of life. But the two sit in different places in the eye: the cataract at the lens in front, AMD at the macula behind. For you that has one consequence above all: a known cataract is no reason to put newly distorted lines down to it — distortion comes from the macula and needs assessing. Which part of the worse vision comes from where, and what a procedure would change about it, can only be said once both places have been assessed.

Macular degeneration

The diagnostic method the world uses to detect AMD was co-developed by our clinic director.

Andrea von Rückmann co-developed fundus autofluorescence — as first author of the original 1995 publication, in the setting of Moorfields Eye Hospital and the Institute of Ophthalmology in London. Today the method sits alongside OCT among the standard techniques of macular diagnostics: early detection, monitoring, and injection therapy without loss of time.

Book a macular assessment Check the warning signs How the treatment works

Where to go

What you notice — and where the answer to it is set out

Distorted lines, a grey patch, reading that has become harder: very different findings announce themselves in similar ways. This overview sorts them — and says of each sign how urgent it is.

This page is the overview: it describes how you notice a change in the centre of the retina, how the dry and the wet form differ, and with what diagnostics we assess both. How a treatment then works is set out on the page AMD treatment: injections, intervals and side effects.

A single distinction orders everything else: dry or wet. It decides whether there is a treatment at all or whether monitoring is the treatment — and it cannot be made from the symptoms, only from the examination. That is why this page begins with the signs that should prompt an appointment: those you notice at home, the classification you do not.

None of these signs hurts — and that is exactly where the danger lies, because symptoms without pain get postponed. What you see therefore decides how urgent it is, before it is settled what it is. The sections below stand in that order: the most urgent first.

Sudden, complete loss of vision in one eye

That does not belong in our consultation but in an emergency department, immediately: call the ambulance (144). It applies in particular together with headache, pain on chewing, or difficulty with language and speech and signs of paralysis. Behind it there can be a vascular occlusion or an inflammation of the vessels, where minutes and hours count.

Flashes of light, a shower of floaters or a shadow from the side

These three do not belong to the centre of the retina but to its outer parts — and they are the urgent finding. New flashes of light, a new shower of floaters, or a shadow moving in from the outside into your field of vision belong in an examination the same day. Call us: +41 44 500 69 00. Outside consulting hours the ophthalmic emergency service applies — contact it, or go directly to the emergency department of an eye hospital.

In what order these signs appear is described on the page about the four warning signals of a retinal detachment and the route to emergency assessment. If many new black dots suddenly appear on their own, posterior vitreous detachment with its drifting shadows can be behind them — usually without consequence, sometimes with a tear. From the outside the two cannot be told apart; with the pupil dilated they can. So the same day applies here too.

Distorted lines or a grey patch in the centre

That is what this page is written for: straight lines ripple, a grey patch sits where you are looking, letters go missing in the middle of a word. If such changes appear newly, call within days — not at the next routine appointment; behind the same signs there can be wet AMD, and there the time to the first treatment helps decide the outcome. If flashes of light, a shower of floaters or a shadow come with them, or if one eye suddenly and painlessly becomes rapidly blurred, the section above applies: the same day.

Reading gets harder, but nothing is distorted

Then the cause more often lies at the front of the eye. If the eye needs more distance and more light to read, without lines bending, presbyopia is what comes first: why near vision becomes more of an effort from about forty, and what helps. If the picture becomes duller overall and glare bothers you more, that fits better with a cataract, which slowly clouds the lens of the eye. Either can exist alongside an AMD — and either is a reason for a regular appointment, not an urgent one.

The diagnosis is already settled

Then the question is no longer what it is but what happens now. The treatment page sets out how injection therapy works, how the intervals are set and where its limits lie. If you have no diagnosis yet, the framework for these checks is under eye screening, which looks for retinal findings before they cause symptoms.

Warning signs: when the centre of the picture is no longer right

The macula is the small centre of the retina you read with, recognise faces with and drive with. Age-related macular degeneration (AMD) often begins unobtrusively — and that is exactly what makes it dangerous:

Straight lines — window frames, tile joints, lines of text — appear bent or distorted.
A blurred or grey patch appears in the centre of your field of view; faces become harder to recognise.
Reading needs more light, letters 'blur' in the middle of the line.

Important:If changes like these appear newly — within days or weeks — do not wait for your next routine appointment. Call us: +41 44 500 69 00. With wet AMD, the time until the first treatment is part of what decides the outcome.

Dry and wet AMD — the difference that counts

Dry AMD is the more common and slower form: metabolic deposits weaken the centre of the retina over years. It calls for regular, precise monitoring — and a trained eye for when it turns into the second form. If you do not yet have a diagnosis, the framework for monitoring of this kind is set out under eye screening, which looks for AMD before it causes symptoms.

Wet AMD is the emergency among the forms it takes: leaking, newly formed vessels allow fluid into the retina. Untreated, central vision can decline sharply within weeks to months. Treated — with injection therapy — it can be stabilised in most people, often for many years. Where the macula sits within the retina, and which other findings originate there, is described in the overview of Retina and vitreous — structure, warning signs and diagnostics.

Diagnostics with one of the method's own developers

We examine your macula with high-resolution OCT imaging and — where useful — with fundus autofluorescence (FAF): the method Andrea von Rückmann co-developed, as first author of the original 1995 publication (Moorfields Eye Hospital). FAF makes the retina's metabolism visible before damage becomes irreversible. When the first medicines for dry AMD were approved, the US Food and Drug Administration accepted in 2023 the growth of the atrophic area — measured with fundus autofluorescence — as the primary efficacy endpoint.

For you that means your images are not merely 'taken' but assessed by a doctor who has worked with this diagnostic method, scientifically and clinically, for three decades — and who explains to you, in terms you can follow, what she sees. For this you can book an appointment for a macular assessment online; if distortions appear newly, it is better to call us.

Treatment: consistent, personal — by findings rather than by protocol

We treat wet AMD with anti-VEGF injections — tiny quantities of medicine that stop the growth of blood vessels. The procedure is done as an outpatient, under careful anaesthesia, in a few minutes. Usually monthly to begin with, then at intervals extended individually. How a treatment day runs, how the intervals are set and what is discussed about side effects is set out on the page of its own about how AMD treatment works: injections, intervals and side effects.

What sets us apart from conveyor-belt injections: every check is assessed by a doctor, every adjustment is discussed with you — and you always know which medicine you are receiving and why. With dry AMD we monitor the course closely and tell you honestly what vitamin preparations can do — and what they cannot.

Further reading: How AMD treatment works, in detail · Patient information (PDF)

Telling them apart

Distorted vision is a symptom, not a diagnosis

Wavy lines and a patch in the centre of the picture occur with several changes of the macula. Which of them is present is decided by the cross-sectional scan.

'Straight lines are crooked' is a very precise symptom for the place and a very unspecific one for the cause. Three findings produce this picture and are treated quite differently; telling them apart is done on the cross-sectional scan (OCT), not from the symptoms.

AMD — the tissue of the macula itself

With AMD the tissue of the macula itself suffers: in the wet form through fluid from newly formed vessels, in the dry form through deposits over years. It is the only one of the three for which injections into the eye come into question.

Macular pucker — a membrane on the retina

Here the problem lies not in but on the retina: a wafer-thin membrane grows onto the macula and draws it into folds — the picture does not become darker but skewed. Many findings stay stable for years; what a macular pucker is and when an operation even comes up is set out on a page of its own.

Macular hole — a defect in the centre itself

If the macula tears under the same traction, a piece is missing in the centre: people describe not a distorted but an absent middle of the picture. What happens then is on the page about it: how a macular hole develops, what stages it passes through and why timing counts. All three sit at the same interface between retina and vitreous; the overview shows where macula, retina and vitreous connect inside the eye.

The Amsler grid between appointments

Between two appointments you are the only person who can notice a change — that is what the Amsler grid is for. What matters here is less the technique than the consequence: test each eye separately. Otherwise, in everyday seeing, the better eye covers what the other one loses, and a marked deterioration can go unnoticed for months.

A grid with instructions is part of what we offer online: the Amsler grid in the free eye and eyelid check. It is expressly non-diagnostic and does not replace an examination; conversely, an unremarkable grid is no all-clear. If it looks newly distorted or a piece is missing, call within days — not at the next routine appointment.

The first appointment

What happens at a macular assessment here

An assessment should produce an answer in a single appointment: what is there, how urgent it is and what happens next.

It begins with the examination, not with a conversation about treatments: visual acuity, the slit lamp, a cross-sectional scan of the retina, and where the question calls for it fundus autofluorescence as well. What an eye examination checks in detail and how such an appointment runs is set out on the overview page about them.

Both eyes are assessed, even when only one of them is causing symptoms: both forms can be at different stages in the two eyes.

If the back of the eye is to be assessed, the pupil is dilated with drops; they go on working for several hours, you see blurred close up and are sensitive to light. Come to an appointment like that without a car. Whether your appointment calls for dilation depends on the question being asked — ask on the phone if you have to plan the day.

Bring what already exists: earlier cross-sectional scans and medical reports, including ones from another practice. A single scan says where you stand today; only the series says whether anything is moving.

What you go home with

At the end there is one of three answers, and we tell you which it is: no change that needs treatment — then we set the interval for the next check; a dry AMD — then monitoring is the actual treatment; or an active wet AMD, and then we begin without delay.

If you notice new distortion, call rather than looking online for one of the next regular appointments: we keep short-notice slots free for that. For anything without an acute change, an appointment for a retinal and macular check can be requested online.

If you already bring the diagnosis with you

A second opinion is a reasonable thing to want. If you are unsure about an ongoing injection schedule, bring your documents: we tell you what we see — including when that means the treatment so far is right.

Costs & health insurance

What does the insurer pay for — and what not?

AMD diagnostics and treatment are covered by basic health insurance. Nobody should have to forgo treatment of their retina out of fear of the cost.

Service	Coverage	What this means for you
Macular assessment (OCT, FAF, examination)	Basic insurance (OKP)	Fully covered diagnostics where there is a medical indication.
Anti-VEGF injection therapy	Basic insurance (OKP)	Medicine and procedure covered; you pay the deductible and co-payment.
Monitoring	Basic insurance (OKP)	Closely, according to your treatment plan.
AREDS2 vitamin preparations (where sensible)	Self-pay	We tell you honestly whether they will do anything at your stage.

Our promise:Before any treatment you receive a complete, itemised cost breakdown in writing — before you decide. Nothing is added to it afterwards.

Related conditions

Retina & vitreous Cataract

Medically reviewed by PD Dr. med. Andrea von Rückmann

Your ophthalmologistPD Dr. med. Andrea von RückmannView profile

Frequently asked questions

: Many families arrive with that fear. The honest answer: AMD almost never leads to complete blindness — the outer field of vision is preserved. And unlike a generation ago, wet AMD is treatable today: with timely injection therapy, central vision can be stabilised in most people. What your parents went through is not your predetermined path.
: The idea of it is considerably worse than the reality. The eye is thoroughly anaesthetised; most people feel only a brief pressure. The whole appointment takes about half an hour, the injection itself seconds. After the first treatments many people tell us: 'If I had known how harmless it is, I would not have spent weeks dreading it.'
: Usually monthly to begin with, then at individually extended intervals ('treat and extend') — as rarely as possible, as often as necessary. Every check is assessed by a doctor; the interval is adjusted to your findings, not to a clinic protocol.
: A great deal. Once a week, cover one eye at a time and look at the grid (or at a tile joint): do straight lines appear bent or distorted, or is there a patch missing in the centre? Then call us within days — not at your next routine appointment. With wet AMD, time counts.
: The risk can be reduced, not eliminated: do not smoke, keep blood pressure under control, eat green vegetables and fish, protect against UV. At certain early stages, specific vitamin preparations (the AREDS2 formula) can slow progression — whether that makes sense for you is something we tell you after the examination. Buying 'eye vitamins' as a general measure is not worth it.
: Yes. Diagnostics and injection therapy for AMD are covered by basic health insurance. All that falls to you is the deductible and co-payment — no hidden extra costs.
: Go by what you see. A sudden, complete loss of vision in one eye does not belong in the consultation but in an emergency department, immediately: call the ambulance (144). Flashes of light, many new black dots or a shadow from the side belong to the outer retina and need assessing the same day; outside consulting hours the ophthalmic emergency service applies. Distorted lines or a grey patch where you are looking: that is the macula — this page is written for it, and where they have newly appeared they need assessing within days, not at the next routine appointment. If reading becomes harder without anything being distorted, the cause more often lies at the front of the eye. And if the diagnosis is already settled, the treatment page is the right one.
: No. Wavy lines and a patch in the centre of the picture also occur with a macular hole and with a macular pucker, and they are treated differently. The distinction is made by the cross-sectional scan of the retina, not from the symptoms. That changes nothing about the urgency: distortion that has newly appeared needs assessing within days, not at the next routine appointment. And distorted lines are not only a sign from the macula — a sudden, painless deterioration of vision in which straight lines look skewed is on the warning list for retinal detachment as well. If flashes of light, many new black dots or a shadow from the side come with it, call the same day.
: Call for anything that is new. The same day: flashes of light, many new black dots or a shadow from the side. Within days, and not at the next routine appointment: newly appeared distortion, a new grey patch in the centre or a marked deterioration within days. We keep short-notice slots free for that. Say straight away what you are seeing and since when — that is different information from 'an appointment with the eye doctor'. Outside consulting hours the ophthalmic emergency service applies; with a sudden, complete loss of vision in one eye, call the ambulance (144). Anything without an acute change you can arrange online.
: Bring your documents: earlier cross-sectional scans, medical reports and a note of which medicine you last received and when. With this disease comparability is half the diagnostics — only a series of scans says whether anything is moving. What we see we tell you, including when that means the treatment so far is right.
: Yes, and that is the rule rather than the exception — both belong to the same stage of life. But the two sit in different places in the eye: the cataract at the lens in front, AMD at the macula behind. For you that has one consequence above all: a known cataract is no reason to put newly distorted lines down to it — distortion comes from the macula and needs assessing. Which part of the worse vision comes from where, and what a procedure would change about it, can only be said once both places have been assessed.

Distorted lines? Do not wait.

A macular assessment brings clarity in a single appointment. If treatment is needed we begin without delay — and if it is not, you have that in black and white.

Book a macular assessment

Or call us: +41 44 500 69 00 — Mon–Fri 08:00–12:00 / 13:00–17:30