What is Wet Macular Degeneration? Symptoms and Treatments

How the Eye Works

Wet AMD affects the macula, a small but essential area in the center of the retina at the back of the eye. Although it takes up only a small part of the retinal surface, the macula is responsible for central vision and fine detail. You depend on it to read, drive, recognize faces, and see objects clearly in front of you.

The macula is densely packed with photoreceptor cells that detect light and color and help you see sharp detail. When light enters the eye, it is focused onto the retina and the macula. The photoreceptor cells then convert that light into electrical signals that travel through the optic nerve to the brain, where they are processed into the images you see. Any condition that damages the macula, such as wet AMD, can interfere with these signals and reduce clarity in the center of your vision.

Understanding Wet Macular Degeneration

Wet macular degeneration, sometimes called neovascular age-related macular degeneration, is a chronic eye condition that causes blurred central vision or a blind spot. It is one of the two main forms of age-related macular degeneration, the other being dry AMD. Wet AMD occurs when new, fragile blood vessels grow beneath the retina and macula. These vessels tend to leak fluid or blood, which can cause the macula to swell, lift, or become scarred. As a result, central vision can decline quickly, making it harder to read, drive, see faces clearly, or perform other tasks that require detail.

Dry AMD, the more common type, involves gradual thinning and aging of the macula, along with the buildup of yellow deposits under the retina. Dry AMD usually progresses more slowly and causes gradual vision changes. Wet AMD, in contrast, can appear suddenly and cause more substantial vision loss in a shorter period of time. Dry AMD can progress to wet AMD, which is why regular monitoring and follow-up exams are so important for people who have already been diagnosed with macular changes.

Although wet AMD accounts for a smaller percentage of overall AMD cases, it is responsible for the majority of severe vision loss from macular degeneration. The condition primarily affects older adults and is most often diagnosed in people over the age of 50.

What are the Symptoms of Wet Macular Degeneration?

Early symptoms of wet macular degeneration can be subtle and may be mistaken for normal age-related changes in vision. Paying attention to these warning signs and seeking care early can make a meaningful difference in outcomes:

• Distorted Vision

• Blurred Central Vision

• Dark or Empty Areas in Vision

As wet macular degeneration progresses, these symptoms often become more pronounced. People may experience faster vision loss, colors that seem washed out, and increasing difficulty with everyday activities such as reading, driving, or recognizing people across the room. Because wet AMD can progress quickly, any sudden change in central vision should be evaluated by an eye doctor at EyeCare Associates as soon as possible. Early diagnosis and treatment offer the best chance to preserve the vision you still have.

What Causes Wet AMD?

Understanding the factors that contribute to macular degeneration can help with early detection and risk reduction. Although the exact cause of wet AMD is not completely understood, research has identified a combination of genetic, environmental, and health-related factors that can increase the likelihood of developing the condition.

Genetics

Family history plays a meaningful role in AMD. If a close relative has macular degeneration, your own risk is higher. Certain inherited changes in genes, especially those related to the body’s immune and complement systems, have been linked to a greater chance of developing AMD. While you cannot change your genetics, knowing your family history can help guide how closely your eyes are monitored over time.

Environmental and Lifestyle Factors

1. Smoking: Smoking is one of the strongest modifiable risk factors for advanced AMD. It reduces blood flow to the retina and increases oxidative stress, which can damage the macula. Quitting smoking is one of the most important steps you can take to help protect your vision.

2. Diet: Diets low in antioxidants and omega-3 fatty acids may raise AMD risk. Eating more leafy green vegetables, colorful fruits, and fish can provide nutrients that support retinal health and help protect the macula from oxidative damage.

3. Sun Exposure: Long-term exposure to ultraviolet (UV) light can contribute to retinal damage. Wearing sunglasses that block UVA and UVB rays, along with a brimmed hat outdoors, can help shield your eyes.

Age-Related Factors

Age is the single biggest risk factor for wet macular degeneration. The condition is most common in people over 50, and risk increases with each decade of life. Some amount of macular change is part of the aging process, but in certain individuals, these changes progress more quickly and can lead to AMD. Regular eye exams become more important as you get older so that any changes can be caught early.

Additional Health Conditions

Some medical conditions are also associated with a higher risk of wet AMD, including:

• High Blood Pressure (Hypertension): Elevated blood pressure can damage the delicate blood vessels in the retina, increasing the likelihood of abnormal vessel growth in the macula.

• High Cholesterol: Excess cholesterol can contribute to deposits in blood vessels and may affect circulation to the retina.

• Cardiovascular Disease: Heart and blood vessel conditions can impact blood flow throughout the body, including the retina, and may raise the risk of macular degeneration.

Managing these conditions with the help of your primary care provider and following your treatment plan can support both overall health and long-term eye health.

How is Wet Macular Degeneration Diagnosed?

Wet macular degeneration is usually diagnosed through a comprehensive, dilated eye exam along with specialized imaging tests. These evaluations help your EyeCare Associates doctor look for fluid, bleeding, and abnormal blood vessels beneath the macula. Because wet AMD can change quickly, it is important to schedule an exam promptly if you notice new distortion, a dark spot, or other sudden changes in your central vision.

A wet AMD evaluation often includes:

• Vision Testing: Checks how clearly you see letters and how your central vision is functioning.

• Dilated Retinal Exam: Dilating drops widen the pupil so the doctor can examine the retina and macula for signs of macular degeneration and related changes.

• Optical Coherence Tomography (OCT): A quick, painless scan that helps detect swelling or fluid under or within the retina.

• Retinal Imaging: Documents the appearance of the retina to track changes over time.

• Fluorescein Angiography (When Needed): Uses a dye and a special camera to help identify abnormal blood vessels and leakage patterns. Not everyone needs this test; your eye doctor will recommend it based on your symptoms and OCT findings.

Treatment Options for Wet AMD

Although there is no cure for wet macular degeneration, several effective treatments can slow the disease and, in some cases, improve vision. The main goal of treatment is to stop or reduce leakage from abnormal blood vessels, protect the macula from further damage, and help you maintain the highest possible quality of life.

Anti-VEGF Injections

Anti-vascular endothelial growth factor (VEGF) injections are the primary treatment for most people with wet AMD. VEGF is a protein that encourages new blood vessel growth. In wet AMD, excess VEGF can lead to fragile, leaky vessels under the macula. Anti-VEGF medications block this signal, helping reduce leakage, bleeding, and swelling and often stabilizing or improving central vision.

Many patients are surprised at how quickly the injection visit is completed. In general:

• The eye is numbed with anesthetic drops (and sometimes a numbing gel).

• The surface of the eye is cleaned to lower the risk of infection.

• The medication is gently injected into the eye in just a few seconds.

• Vision may be temporarily blurry afterward, and mild irritation or a scratchy feeling is common for a day or two.

Photodynamic Therapy

Photodynamic therapy (PDT) is a two-step treatment that combines a light-sensitive medication with a special laser. The medication is injected into a vein and circulates through the body. Once it reaches the abnormal blood vessels in the eye, a low-power laser is used to activate the drug. This helps close off the abnormal vessels while minimizing damage to the surrounding retinal tissue.

PDT is used less frequently than anti-VEGF injections but can be helpful in specific situations, such as certain patterns of abnormal blood vessels or when additional treatment is needed alongside injections. It is typically performed as an outpatient procedure. Because the medication is activated by light, you may be advised to avoid bright sunlight or intense indoor lighting for a period of time afterward.

Laser Surgery

Laser surgery, also called laser photocoagulation, uses a concentrated beam of light to seal abnormal blood vessels and stop them from leaking. This option is only considered when the problematic vessels are located away from the very center of the macula. Treating vessels directly under the central macula with a traditional laser could damage the area needed for sharp central vision, which is why this approach is now used in select cases and much less often than injections.

The procedure is generally done in an office or outpatient setting. Numbing drops are placed in the eye, and the laser is applied in short bursts to the targeted area. Follow-up exams and imaging help your doctor see whether leakage has stopped and monitor for any recurrence.

Lifestyle Changes and Supportive Therapies

In addition to medical treatments, certain lifestyle choices and supportive tools can play a helpful role in managing macular degeneration:

• Eating a diet rich in leafy greens, brightly colored fruits, and fish to support overall eye health

• Exercising regularly and maintaining a healthy weight to support good circulation

• Quitting smoking to reduce further damage to the retina

• Using low-vision aids such as magnifiers, special reading lenses, and electronic devices to make daily tasks easier

For some patients with age-related macular degeneration, AREDS2-based vitamin supplements may be recommended to support macular health. Your EyeCare Associates doctor will discuss whether these are appropriate in your specific situation.