Abstract: Objective To evaluate changes in higher-order aberrations of eyes in patients with unilateral neovascular age-related macular degeneration (nAMD). Methods Thirty two patients with unilateral nAMD were recruited for this study. Biocular higher-order wavefront aberrations for a 6-mm pupil were measured with ZywaveⅡaberrometer (Bausch & Lomb,Zyoptix, USA). The root mean square (RMS) of Zernike coefficients were compared between the eyes with nAMD and the fellow eyes. Relation ship between RMS values and LogMAR vision of the nAMD were analysed. Results The total higher-order aberrations (HOAs), third order aberrations (RMS3), sphere aberration (SA), coma, coma along x axis, and horizontal trefoil in the eyes with nAMD were all significantly greater than those in the fellow eyes (P<0.05). Increases of vertical trefoil and coma were found to be associated with increased LogMAR values (r_s=0.377, P=0.034; r_s=0.416, P=0.018). Conclusion Higher-order aberrations in nAMD are greater than normal eyes, which may have effects on distant corrected visual acuity. Examinations of higher-order aberrations should be added into visual function evaluations of nAMD.