At present, the diagnosis of new nvAMD, especially for the first affected eye, still very much relies on self-recognition of visual symptoms by patient themselves. This is, however, problematic as those affected in only one eye tend not to be aware of the visual change and may therefore remain ‘asymptomatic’ for a considerable length of time.28 Indeed, this seemed to be case in our study in which nearly all patients presented with nvAMD affecting the first eye.