Visual impairment is a common problem among Veterans and results in significant reduction in quality of life. Diseases commonly responsible for substantial losses in visual acuity include neovascular (“wet”) age-related macular degeneration (AMD), diabetic macular edema (DME), and central or branch retinal vein occlusion (CRVO or BRVO). While the etiologies of these diseases are complex, all are driven at least in part by vascular endothelial growth factors (VEGFs). This has led to the development of several drugs called anti-VEGF agents designed to block these factors and thus limit their damage to the eye. The most commonly used anti-VEGF agents—aflibercept, bevacizumab, and ranibizumab—have been shown to slow and even reverse the vision loss typically seen in patients with AMD, DME, BRVO, and CRVO. The comparative effectiveness, harms, and costs of these drugs are unclear.