Vision loss among the elderly is a major healthcare issue: about one in three people have some vision-reducing disease by the age of 65. Age-related macular degeneration (AMD) is the most common cause of blindness in the developed world. In Europe, approximately 25% of those 60 and older have AMD. The dry form is relatively common among people over 65, and usually causes only mild sight loss. However, about 15% of patients with dry AMD go on to develop a more serious form of the disease exudative AMD, or exAMD which can result in rapid and permanent loss of sight. Fortunately, there are treatments that can slow further vision loss. Although there are no preventative therapies available at present, these are being explored in clinical trials. The period before the development of exAMD may therefore represent a critical window to target for therapeutic innovations: can we predict which patients will progress to exAMD, and help prevent sight loss before it even occurs?