During the course of age-related macular degeneration, the visual prognosis is abruptly changed when the presence of a subretinal neovascular membrane (SRNVM) is established by intravenous fluorescein angiography (IVFA). Patients who have been alerted to this condition may notice distortion on the Amsler grid and report within days of the onset of symptoms. Unfortunately most patients either do not notice the early changes in central vision or incorrectly attribute these symptoms to the development of cataracts and defer proper retinal evaluation for several months. We reviewed our records to determine the natural history of those SRNVMs which on initial IVFA either originated or extended into the foveal portion of the macula. Our results clearly indicate that treatment must be undertaken early in the course of this disease to maintain useful visual function for as long as possible.