• One hundred three patients with neovascular maculopathy and relatively recent vision loss were surveyed to determine the most frequent symptoms and to assess the reliability of the Amsler grid in helping patients to detect early symptoms. Blurred vision and distortion, most often with near vision, were the most frequent first symptoms reported by patients. Of 49 patients who said that they were observing the Amsler grid on a regular basis, only five indicated that the Amsler grid abnormality was the first visual symptom. However, all but five of 49 patients did notice an Amsler grid abnormality during the office examination, suggesting noncompliance as the probable explanation for failure to detect an Amsler grid abnormality earlier. Patients at risk for neovascular maculopathy should be encouraged to assess a variety of visual functions—including reading vision, color saturation, and image clarity—in addition to observing the Amsler grid, in order to help them detect the earliest symptoms of submacular fluid from a potentially treatable neovascular membrane.