Macular Degeneration Treatment in Jacksonville, Florida
Age-related macular degeneration damages the macula — the small central part of the retina you use to read, drive, and recognise faces. It does not cause total blindness. It takes the middle of your vision and leaves the edges, which is its own particular kind of difficulty.
An estimated 19.8 million Americans aged 40 and over are living with some degree of AMD. The large majority of that is early disease that will never threaten sight. About 1.5 million have the vision-threatening late form. It is one of the leading causes of vision loss in older adults, and the risk climbs steeply with age — from around 2 percent in the early forties to nearly half of people aged 85 and over.
Dry and wet — what the two types actually mean
Roughly 85 to 90 percent of AMD is the dry form. Deposits called drusen build up under the retina, and the light-sensing cells above them gradually thin. Most dry AMD progresses slowly, over years. Its advanced stage is geographic atrophy, in which patches of retina and the layer beneath it die off, producing blind spots that enlarge over time.
The remaining 10 to 15 percent is the wet form, also called neovascular AMD. Abnormal blood vessels grow beneath the retina and leak fluid and blood. Wet AMD can take central vision in weeks rather than years — which is why any sudden distortion or blur needs to be seen urgently rather than at the next available appointment.
Dry AMD can convert to wet AMD at any point. Having dry AMD in one eye and wet in the other is common.
Symptoms
- Straight lines appearing bent, wavy, or broken — door frames, window blinds, lines of text
- A blurred, dim, or grey patch in the centre of your vision
- Difficulty reading, or needing much brighter light than you used to
- Trouble recognising faces
- Colours looking less vivid
- Slow adjustment when moving from bright light into a dim room
Early AMD often has no symptoms at all, and because the brain fills in what one eye misses, people frequently discover a problem only when they happen to cover the good eye. Check each eye separately, one at a time. That single habit finds more wet AMD early than anything else patients do for themselves.
New distortion or a new central blur is urgent. Call us the same day.
What raises your risk
- Age — the dominant factor
- Smoking — the largest modifiable risk factor, and the one worth acting on. Quitting reduces risk at any age.
- Family history — AMD has a strong genetic component
- Cardiovascular risk factors — high blood pressure, high cholesterol, obesity
- Diet — low intake of leafy greens and fish
Dr. Elkeeb is board certified in Internal Medicine as well as Ophthalmology, and the cardiovascular side of that list gets a real conversation here rather than a leaflet.
How we examine and image the eye
Diagnosis begins with a dilated examination. We image the retina in our office on the same visit using:
- Optical coherence tomography (OCT) — cross-sectional scans that show drusen, thinning, and any fluid, often before vision changes
- OCT angiography — maps the blood vessels beneath the retina and can reveal new vessel growth without dye
- Fluorescein angiography — confirms leaking abnormal vessels
- Ultra-widefield fundus photography — documents the retina so change can be measured against a baseline rather than guessed at
More about our imaging and diagnostic testing.
Monitoring at home
The Amsler grid
A simple grid of straight lines you look at each day, one eye at a time. If the lines bend, blur, or a patch goes missing, you call. It costs nothing and it works, provided it is used consistently.
ForeseeHome
We offer ForeseeHome, an FDA-cleared home monitoring device that detects the visual distortion of new wet AMD more sensitively than an Amsler grid. It is used for a few minutes at home and transmits results to a monitoring centre, which alerts us to a significant change.
In the AREDS2-HOME study, patients whose wet AMD was picked up through home monitoring had lost a median of 4 letters of vision by the time it was detected, compared with 9 letters in those under standard care alone, and 87 percent still saw 20/40 or better versus 62 percent. Those are intent-to-treat figures, counting every patient enrolled regardless of how consistently they used the device, and they describe vision at the point the conversion was detected. It is not a treatment. It is an early-warning system, and being caught early is the single biggest predictor of how wet AMD turns out.
Medicare covers ForeseeHome for patients with intermediate dry AMD who are at risk of converting. We will check your coverage before you commit to anything.
Treatment
AREDS2 supplements — what they do and do not do
The original AREDS trial found that a specific antioxidant and zinc formulation reduced the risk of progressing to advanced AMD by about 25 percent over five years. AREDS2 then refined the formula, replacing beta-carotene with lutein and zeaxanthin — a change that both removed a lung cancer risk in smokers and former smokers and modestly improved the result.
Three things the National Eye Institute is explicit about, and that get misrepresented constantly:
- These supplements do not prevent AMD in people who do not have it.
- They show no benefit in early AMD, and do not stop early AMD becoming intermediate.
- The benefit applies to people with intermediate AMD, or late AMD in one eye.
If you have intermediate AMD, this is worth taking. If you have early AMD or a family history, the money is better spent on not smoking. We will tell you which group you are in.
Anti-VEGF injections for wet AMD
Injections into the eye that block the signal driving abnormal vessel growth. They are the standard of care for wet AMD and they changed its outlook completely — before 2006 this was a diagnosis that usually ended in central vision loss.
We use aflibercept (Eylea and Eylea HD), bevacizumab (Avastin), faricimab (Vabysmo), and approved biosimilars. Which one we start with depends in part on your insurance, and we will tell you plainly what that means for you.
The treatment burden has come down considerably. Aflibercept 8 mg was approved in April 2026 for dosing intervals of up to 20 weeks in patients who respond well, and faricimab can be extended to every four months in some patients. Many people still begin with monthly injections while the retina dries, and some continue to need them — the interval is set by your OCT scan, not by a calendar.
Starting quickly matters more than which drug is used. Vision that has already been lost to wet AMD is difficult to recover; vision that has not yet been lost is very often protected.
Geographic atrophy
Until recently there was nothing to offer for advanced dry AMD. There now are two FDA-approved complement inhibitor injections — Syfovre (pegcetacoplan) and Izervay (avacincaptad pegol) — and we offer treatment for geographic atrophy — but it is worth being precise about what these drugs do, because the marketing around them has not always been.
They slow the rate at which atrophy spreads, by roughly 14 to 20 percent in the pivotal trials. Neither has been shown to improve vision, and neither demonstrated a statistically significant benefit on the trials' vision-related secondary endpoints. They also carry real risks: an increased rate of converting to wet AMD, intraocular inflammation, and a small number of reported cases of severe occlusive retinal vasculitis with serious vision loss. European regulators reviewed the same data and were not persuaded that the benefit was meaningful enough to patients' daily function; neither drug is authorised in the EU.
None of that makes them worthless. Slowing the spread of atrophy toward the centre of vision can be worth a great deal to the right patient. It makes them a decision to take carefully, with the numbers in front of you, and that is how we will have the conversation.
Low vision rehabilitation
Magnifiers, electronic readers, task lighting, and training in using the healthy peripheral retina can restore a great deal of practical function. This is chronically under-referred. If AMD has cost you reading vision, ask us about it — there is more available than most patients realise.
When to call us urgently
- New or worsening distortion of straight lines
- A new grey, dark, or blank patch in central vision
- A sudden drop in vision in one eye
- A change picked up on your Amsler grid or a ForeseeHome alert
We see urgent cases within 24 hours. In wet AMD, days matter.
Questions patients ask
Will I go blind from macular degeneration?
AMD does not cause total blindness. It affects central vision and spares the periphery, so people with even advanced disease retain the ability to move around independently. What it can take is reading, driving, and face recognition — which is why treatment and monitoring are aimed squarely at protecting the centre.
Is macular degeneration hereditary?
There is a strong genetic component, and having a parent or sibling with AMD raises your risk substantially. That is a reason to be examined, not a reason to assume the outcome. Genetic testing is not currently recommended for routine clinical use, because it does not change what we would do.
Should I be taking AREDS2 vitamins?
Only if you have intermediate AMD, or late AMD in one eye. They have not been shown to help people with early AMD or to prevent AMD in people who do not have it. Tell us if you smoke or used to — that determines which formulation is safe for you.
Can dry AMD turn into wet AMD?
Yes, at any stage, and often without warning. That is the reason for home monitoring and for scheduled follow-up even when nothing has changed.
Do the injections hurt?
The eye is numbed first. Most patients describe pressure rather than pain, and the injection takes a few seconds. Grittiness or a red spot on the white of the eye afterwards is normal and settles in a few days.
How long will I need injections?
Wet AMD is usually a long-term condition, but the interval between treatments often lengthens once the retina is dry — in some patients out to four or five months. Some people can eventually stop. The schedule follows the OCT scan.
Getting seen
We accept urgent referrals and see urgent cases within 24 hours. Call (904) 666-5050. We see patients at 3627 University Blvd S, Suite 605, Jacksonville, FL 32216, and our staff speak English, Arabic, and French.
Referring physicians and optometrists: our referral information is here.
Sources: Centers for Disease Control and Prevention, Vision and Eye Health Surveillance System, and Rein DB et al., JAMA Ophthalmol 2022; National Eye Institute, Age-Related Macular Degeneration and AREDS/AREDS2 resources; American Academy of Ophthalmology; AREDS Report No. 8, Arch Ophthalmol 2001, and AREDS2 Research Group, JAMA 2013; AREDS2-HOME Study Research Group, Ophthalmology 2014; FDA prescribing information for pegcetacoplan and avacincaptad pegol; American Society of Retina Specialists Research and Safety in Therapeutics Committee report, January 2024; European Medicines Agency CHMP opinions, 2024.
This page is general information about a medical condition and is not a substitute for examination and advice from your own physician. Do not start, stop, or change any medication or supplement based on what you read here.