OBJECTIVE: To evaluate the vision-related quality of life (QoL) consequences of the best and the worst eye, respectively, in patients suffering from age related macular degeneration (AMD). METHODS: One hundred fourteen patients with a diagnosis of exudative AMD and a primary or recurrent subfoveal neovascular membrane (<5400 µm in its greater dimension; > 50% choroidal neovascularization representing >1 mm2) were included. ETDRS visual acuity (VA in LogMAR) was measured in both eyes separately. Vision-related QoL was assessed using the NEI-VFQ-39 (13 scores from 0 to 100). An analysis of variance was performed on the QoL scores, including best eye (VA > 0.3), worst eye (VA > 1), and their interaction. RESULTS: Best eye VA was 0.34 on average and 43.0% had a VA > 0.3. Worst eye VA was 0.85 on average and 32.5% had a VA > 1. VA was not linked to general health and ocular pain scores. General vision, near activities, distance vision, driving, mental health, role difficulties, dependency, peripheral vision and the global scores were affected both by best eye VA (-10.2 to -47.4) and by worst eye VA (-6.9 to -20.0). An interaction was found on social functioning score: QoL loss was most important when worst eye VA was higher than 1 (-1.1 versus -18.5). Worst eye contributed from 19.9% to 47.4% of the total QoL loss. CONCLUSION: Worst and best eye VA contributed independently to vision-related QoL. Under isotropic hypothesis, preserving VA on the worst eye should contribute to maintain vision-related QoL on the long term.