OBJECTIVES: The Visual Function Questionnaire Utility Index (VFQ-UI) is a vision-specific preference measure developed from the National Eye Institute Visual Function Questionnaire 25 (NEI VFQ-25). The objective of this analysis was to assess the validity and reliability of the VFQ-UI in individuals with age-related macular degeneration (AMD). METHODS: Post-hoc analysis using data collected from a multicenter, randomized controlled trial of 138 individuals with AMD. The NEI VFQ-25, HUI, and EQ-5D were administered at baseline and day 1 visits. The NEI VFQ-25 dataset was used to calculate utility values using the VFQ-UI algorithm. Validity was assessed using convergent validity with HUI2, HUI3 and visual acuity and discriminant validity with the EQ-5D and known groups of visual acuity. Reliability was assessed using Cronbach’s alpha and intra-class correlation. RESULTS: The mean age was 76.3 (8.9) years, majority of the subjects were female (55.1%), residing in the United States (77.5%) and Caucasian (92.8%). The mean utility value calculated with the VFQ-UI was 0.68 (0.11), compared to the EQ-5D: 0.88 (0.12), HUI2: 0.81 (0.13), and HUI3: 0.73 (0.22). The VFQ-UI is associated with HUI2 (r = 0.22, p<0.05) but not significantly associated with the EQ-5D or the HUI3. There was no significance in the correlation between VFQ-UI and visual acuity in the study eye. The VFQ-UI varied by known groups using a combination of study and fellow eye visual acuity; the more impaired visual acuity the lower the utility value (more disability in visual functioning). Internal consistency reliability for the VFQ-UI was 0.76 and the intra-class correlation was 0.84. CONCLUSIONS: Utility values calculated from the VFQ-UI demonstrated greater visual functioning impairment compared to the HUI and EQ-5D. The VFQ-UI showed good convergent validity with the HUI2, good discriminant validity with visual acuity known groups and good internal consistency and test-retest reliability in individuals with AMD.