Age-related gut dysbiosis directly contributes to macular degeneration by disrupting immune responses and metabolic homeostasis. Beneficial bacteria like Lactobacillus casei, Bifidobacterium longum, and Faecalibacterium prausnitzii protect retinal health, while pathogenic species including Escherichia coli and Prevotella accelerate disease progression through enhanced gut permeability and pro-inflammatory cascades. This gut-retina axis represents a paradigm shift in understanding age-related macular degeneration beyond traditional genetic and oxidative factors. The connection opens promising therapeutic avenues through microbiome modulation—probiotics, synbiotics, and even fecal transplantation could potentially preserve vision in aging populations. However, this review synthesizes existing knowledge rather than presenting novel clinical data, and the field still lacks robust human trials demonstrating causation versus correlation. The practical implications remain largely theoretical until controlled studies establish optimal probiotic strains, dosages, and treatment protocols. While mechanistically compelling, translating these microbiome insights into effective ARMD prevention strategies requires substantial clinical validation to move beyond the preclinical promise described here.