TL;DR
Some risk factors for AMD are entirely beyond your control. But the encouraging news? There are several factors you can influence to help protect your vision. Understanding the difference between the two can empower you to take meaningful steps towards preserving your eye health.
Risk factors you can’t control
Whilst these factors are unchangeable, being aware of them helps you understand your personal risk profile and emphasises the importance of regular eye examinations.
Age
Age is the single biggest risk factor for AMD, which is why it’s called age-related macular degeneration. The condition predominantly affects people over 50, with risk increasing significantly as you get older.
After age 60, the likelihood of developing AMD rises considerably. By age 75, roughly one in five people will show some signs of macular degeneration. This happens because the delicate cells in the macula naturally deteriorate over time, and the body’s repair mechanisms become less efficient with age.
💡 What you can do: Whilst you can’t stop ageing, you can prioritise regular eye tests. The NHS recommends eye examinations every two years, or more frequently if advised by your optometrist. Early detection is crucial for managing AMD effectively.
Genetics and family history
Your genes play a substantial role in determining your AMD risk. If a close relative – such as a parent or sibling – has been diagnosed with macular degeneration, your own risk increases significantly.
Research has identified several genes associated with AMD, including variations in the complement factor H (CFH) gene and the age-related maculopathy susceptibility 2 (ARMS2) gene. People who inherit certain genetic variations can be up to three times more likely to develop the condition.
💡 What you can do: Inform your optometrist about your family history of AMD. This information allows them to monitor your eye health more closely and recommend preventive measures tailored to your risk level.
Ethnicity
Studies consistently show that AMD is more prevalent among people of white European descent compared to those of African, Caribbean, or Asian heritage. The reasons for this disparity aren’t entirely understood, but genetic factors likely contribute to the difference in risk.
Whilst ethnicity itself cannot be changed, understanding that certain populations are at higher risk helps healthcare providers offer more targeted screening and preventive advice.
Gender
Women face a higher risk of developing AMD than men. This increased risk may be partly explained by the fact that women typically live longer than men, giving AMD more time to develop. However, hormonal factors may also play a role, though research in this area is ongoing.
Postmenopausal women, in particular, should be vigilant about regular eye examinations, as oestrogen levels decline during this period and may influence macular health.
Risk factors you can control
The modifiable risk factors for AMD offer genuine opportunities to reduce your risk and potentially slow the progression of the disease. Taking action in these areas can make a meaningful difference.
Smoking
Smoking is the most significant controllable risk factor for AMD. Studies show that smokers are two to three times more likely to develop the condition than non-smokers. Smoking introduces harmful toxins into the bloodstream, reducing oxygen supply to the retina and increasing oxidative stress – both of which damage the delicate cells in the macula.
The good news is that quitting smoking reduces your risk, even if you’ve smoked for years. Within a few years of stopping, your risk begins to decrease towards that of someone who has never smoked.
💡 What you can do: If you smoke, seek support to quit. The NHS offers free stop smoking services, including counselling, nicotine replacement therapy, and prescription medications. Your GP can refer you to local services that can help you succeed.
Diet and nutrition
What you eat has a direct impact on your macular health. A diet rich in antioxidants, particularly lutein and zeaxanthin, can help protect the macula from oxidative damage. These nutrients are found in abundance in leafy green vegetables like spinach, kale, and collard greens.
Omega-3 fatty acids, found in oily fish such as salmon, mackerel, and sardines, also support eye health by reducing inflammation and promoting healthy blood flow to the retina.
💡 What you can do: Aim to include leafy greens and oily fish in your diet several times a week. If you struggle to get these nutrients through food alone, consider discussing supplements with your healthcare provider. The AREDS2 study has shown that specific vitamin and mineral combinations can slow AMD progression in certain individuals.
Cardiovascular health
High blood pressure, high cholesterol, and obesity are all linked to an increased risk of AMD. These conditions affect blood flow to the eyes, depriving the retina of essential oxygen and nutrients. They also contribute to inflammation and oxidative stress throughout the body, including in the delicate tissues of the macula.
Managing your cardiovascular health through regular exercise, a balanced diet, and appropriate medication when needed can therefore benefit your vision as well as your heart.
💡 What you can do: Schedule regular check-ups with your GP to monitor your blood pressure and cholesterol levels.
Aim for at least 150 minutes of moderate physical activity each week, such as brisk walking or cycling. Even small improvements in cardiovascular fitness can positively impact your eye health.
Sun exposure
Prolonged exposure to ultraviolet (UV) light from the sun can damage the retina over time and may increase AMD risk. The cumulative effect of UV exposure throughout your lifetime can contribute to oxidative stress in the macula.
💡 What you can do: Protect your eyes by wearing sunglasses that block 100% of UVA and UVB rays whenever you’re outdoors, even on cloudy days. Wide-brimmed hats provide additional protection. Look for sunglasses with the CE mark or British Standard BS EN ISO 12312-1:2013 to ensure adequate UV protection.
Taking control of your eye health
Whilst you cannot change your age, genetics, ethnicity, or gender, understanding these non-modifiable risk factors helps you appreciate the importance of what you can control. By addressing lifestyle factors – quitting smoking, eating a nutrient-rich diet, managing cardiovascular health, and protecting your eyes from UV light – you can significantly reduce your AMD risk or slow its progression.
Regular eye examinations remain your most powerful tool for early detection. If you notice any changes in your vision, such as difficulty reading, distorted straight lines, or dark spots in your central vision, contact your optometrist promptly.
Expert opinion
AMD doesn’t have to define your future. With the right knowledge and proactive steps, you can take meaningful action to protect your sight and maintain your quality of life for years to come.
