The Dependency Problem
Anti-VEGF injections don't rebuild macular pigment. They suppress abnormal blood vessel growth. The underlying depletion continues. Many patients on injections for years still experience progressive vision loss — because the root cause was never addressed.
The Cost Problem
Eylea: $1,000–$2,000 per injection. Administered every 4–8 weeks. Most patients require treatment indefinitely. That's $6,000–$24,000 per year — for a treatment that manages the condition but doesn't resolve the nutritional deficiency driving it.
The Anxiety Problem
A needle inserted directly into the eyeball. Every month. For years. The waiting room dread before each appointment. The recovery afterward. The knowledge that the next one is already scheduled.
One patient I followed for six years put it plainly:
"They kept switching the medication and adjusting the schedule. My vision kept getting worse. Nobody once asked me what I was eating or whether my macular pigment was being replenished. I was being managed, not treated."
The Irreversibility Problem
Photoreceptors, once dead, do not regenerate. Every month that passes with depleted macular pigment is a month of photoreceptor damage that cannot be undone. "Monitoring" a condition that is actively destroying irreplaceable tissue is a strategy that serves the monitoring schedule, not the patient.