OBJECTIVES: To determine if the quality-of-life of AMD patients with monocular visual dysfunction differs from that of those with bilateral visual dysfunction. METHODS: A cross-sectional study (n = 168) determined if there was a statistically significant difference in patient-reported health related quality-of-life (HRQoL) of AMD patients with monocular versus bilateral visual dysfunction. Subjects underwent a series of interviewer-administered techniques to ascertain their HRQoL, including the Visual Function Index (VF-14) and patient preferences elicited through both the time tradeoff (TTO) and standard reference gamble (SRG). Visual acuity obtained from a subject's better- and worse-seeing eye was categorized as 20/20 to 20/40, 20/40-20/70, 20/80-20/200, and worse than 20/200. Based on the various combinations of these 4 visual acuity groupings in the better-seeing (BSE) and worse-seeing eyes (WSE), subjects were classified into one of 10 subgroups. Multivariate linear regression determined if an association existed between various clinical variables and HRQoL. RESULTS: The mean age was 72 years; 63% were females. Mean scores were: VF-14, 66.1; TTO, 0.86; SRG, 0.89. Subjects with binocular visual dysfunction reported a lower HRQoL compared to those with monocular dysfunction (p <0.001); mean differences in the TTO, SRG, and VF-14 were 0.19 (SE = 0.04), 0.14 (SE = 0.04), and 59.2 (SE = 3.9), respectively. Multivariate models demonstrated that only visual acuity subgrouping, a function of acuity in both the BSE and WSE, was associated with HRQoL score (overall eta2 = 34.8%, p <0.01, and partial eta2 equal to 22% [TTO], 20% [SRG] and 60% [VF-14]). Models including both BSE and WSE visual acuity explained an additional 10% in HRQoL variability compared to models with only BSE visual acuity. CONCLUSIONS: Subjects with binocular visual dysfunction reported a significantly lower HRQoL as compared to those with monocular dysfunction. These results suggest that binocular vision is a better predictor of HRQoL in AMD than only visual acuity in the BSE.