OBJECTIVE: To assess the impact of best and worst eye visual acuity (VA) on vision-specific health-related quality of life (HRQol) and utility in patients with wet Age-Related Macular Degeneration (AMD) METHODS: A cross-sectional study was carried out in three European countries: France, Germany, Italy. Patients were enrolled when they visited a participating retina specialist. VA at diagnosis and at inclusion were collected. Two HRQoL instruments were administered at the visit day: the National Eye Institute Visual Function Questionnaire – 25 items (NEI-VFQ-25), and the Health Utility index (HUI). Patients were stratified into four groups of severity using two VA thresholds, 20/40 for the best eye (BE) and 20/200 for the worst eye (WE). Analysis of variance was performed on QoL and utility scores to estimate the impact of each eye adjusted on age, gender and country. RESULTS: 360 patients were included, mainly females (60%). Mean age and time since AMD diagnosis were respectively 77 years and 2.3 years. At inclusion, mean VA was 0.49 LogMar for BE and 1.0 LogMar for WE. HUIs mean scores decreased with severity from 0.62 to 0.39 for HUI3 and from 0.76 to 0.63 for HUI2. For both utility indexes, scores were mainly linked to BE VA. The NEI-VFQ-25 scale also exhibits a decreasing trend in the global score as VA decreases. Mean global score varied from 67.0 for the less severe group to 47.0 for the more severe one. Global NEI-VFQ-25 score was significantly affected by BE and WE VA (BE p<.0001; WE p=0.0306). This contribution was also observed for the General vision, distance vision, driving, and mental health subscales. CONCLUSION: HRQoL and utility scores decreased with the deterioration of VA. BE VA and WE VA are two independent factors of vision-related QoL. Vision preservation in both eyes should maintain QoL for AMD patients.