AMD or age related macular degeneration is a polygenic disease. This means that a variety of genes are involved. We also know that it is largely influenced by dietary factors. Specifically, numerous well controlled studies have revealed that patients with highest risk of AMD are those with low levels of antioxidants in their diets. The best general advice for patients concerned about AMD is to include a variety of antioxidant rich foods in their diets. This means dark green leafy vegetables on a regular basis since foods such as spinach, kale, collard greens, swiss chards, mustard greens all are rich in pigments that concentrate in the retina and protect from oxidative damage. While many doctors routinely advise use of supplements such as the AREDS 2 formula, we emphasize that it is superior to obtain these nutrients from food. Two reasons for this are 1- bioavailabilty of micronutrients is superior in food, and 2- pharmacologic production of isolated micronutrients can and has been associated with several side effects such as increased risk of cancer, anemia, urinary tract infection and more. So eat your spinach! (It has more antioxidant than carrots). There are two subtypes of macular degeneration. One is wet AMD. This represents about 10% of cases and can result in rapid progressive loss of central vision. Fortunately, it can be treated with injections and stabilize and even improve vision that has declined. Examples of medicaions that we employ to manage wet AMD include Eylea, Vabysmo, Avastin and more. All of these medications work in a similar fashion and are effective for managing wet AMD. The second typle of AMD is called "Geographic Atrophy". This is a more slowly progressive type of macular degeneation that results in visual loss without bleeding like wet AMD. Currently, there are two medications available as injections that have been shown in studies to slow the progression of this condition. Unfortunately, none of the medicaitons, Syfovre or Izervay, can reverse the disease. Use of these medications is limited to those patients with the subtype of AMD called geographic atrophy and only with certain other accompanying criteria. New therapies are in continuous development as AMD is a significant cause of visual loss in the US and the world. One interesting therapy employs the use of certain wavelengths of light in the red and near infrared range that are thought to act on cellular components resulting in renewal of reduction of damage. These are under active investigation.