The study analyzed 147,406 patients with newly diagnosed exudative age-related macular degeneration (AMD) in Korea from 2009–2023. The prevalence of visual impairment in 2023 was 4.82% and the overall incidence rate was 12.18 per 1,000 person-years. At 8 years, the cumulative probability of monocular visual impairment was 4.8% (95% CI, 4.6–5.1) and binocular 4.4% (95% CI, 4.1–4.7). The average duration from diagnosis to visual impairment was 3.3 ± 2.6 years. The risk increased with older age (HR 1.38; 95% CI 1.35–1.42), lower income (HR 1.06; 95% CI 1.05–1.08), female gender (HR 1.41; 95% CI 1.35–1.47), diabetic retinopathy (HR 1.16; 95% CI 1.08–1.25), glaucoma requiring vitrectomy (HR 1.10; 95% CI 1.05–1.15) and severe AMD (HR 3.14; 95% CI 2.63–3.75). In patients with a recent diagnosis, the incidence of visual impairment decreased by 0.25% per year (p < 0.001). The conclusion emphasizes the need for better adherence to anti-VEGF treatment and equitable access to care.