Demographic/Environmental Factors

Age (years)	-Select-
Family history of AMD in parent or sibling	Yes No
Current cigarette smoker	Yes No

Retinal Examination

Simple scale score	-Select- 0 1 2 3 4
Very large drusen (>250 microns) in either eye	Yes No
Advanced AMD present in either eye	Yes No
If advanced AMD is present, geographic atrophy (GA) or neovascular AMD (NV)	-Select- GA NV

Risk Calculation

Risk of developing advanced AMD within

-Select- 2 3 4 5 6 7 8 9 10  years

Risk of advanced AMD	%
Risk of GA	%
Risk of NV	%