Foveal visual function was compared with fundus appearance for 41 eyes that had good acuity but whose fellow eye had exudative age-related macular degeneration (AMD). The visual functions tested were among those reported to be compromised by AMD. They included: (1) dark adaptation, (2) absolute sensitivity, (3) S cone-mediated sensitivity, and (4) color matching. The fundus features used to evaluate the risk of developing exudative AMD included: (1) drusen confluence, (2) drusen size, and (3) focal hyperpigmentation. For the group of eyes defined by the presence of one or more high-risk fundus characteristics, all visual functions were compromised significantly. In particular, all 21 eyes with abnormally slow rates of dark adaptation had high-risk fundi, and all 16 eyes with abnormal color matching (ie, a small effect of test area on the color match or rejection of all potential color matches) had high-risk fundi. Conversely, 30 of the 32 eyes with high-risk fundi had abnormally slow rates of dark adaptation or abnormal color matching. In addition, reduced acuity in the fellow exudative eye was associated significantly with a high-risk fundus in the nonexudative eye.