Wet AMD: Symptoms, Treatments and Prevention

Eye exams are the best way to find AMD before it causes vision loss. Photo Courtesy: gilaxia/iStock

Age-related macular degeneration (AMD) is an eye condition that affects millions of people worldwide. It’s most common in people ages 50 and older, and it’s one of the most common causes of vision loss. 

AMD damages the macula — the small central part of your retina at the back of your eye. The retina is a layer of light-sensitive tissue, and the macula is the part responsible for detailed central vision. Central vision is what you use when you look straight at something, as opposed to peripheral (side) vision. As you can imagine, your central vision is important in daily activities like reading, watching TV, driving and recognizing faces.

There are two different types of AMD: dry AMD and wet AMD. The good news is that there are effective treatments available for wet AMD. Learn more about the symptoms of wet AMD and how you can protect your vision.

What’s the Difference Between Wet and Dry AMD?

Dry AMD (also called atrophic AMD) happens when the light-sensitive cells that make up the macula start to break down and die. This makes your macula break down and get thinner over time (usually over several years), causing mild-to-severe central vision loss.

Wet AMD (also called advanced neovascular AMD) happens when your body grows new blood vessels under the retina to try fixing the damaged macula cells. These abnormal blood vessels can leak fluid or blood, which is why it’s called “wet”. This leaking damages the macula and leads to sudden and severe vision loss.

Dry AMD is more common than wet AMD, and has three stages — early, intermediate and late. Wet AMD is a severe type of late-stage AMD that affects about 1 in 10 people with AMD.

The symptoms of wet AMD and dry AMD are very similar. But while dry AMD develops gradually over months and years, wet AMD can develop much faster.  If you have wet AMD, you may have significant changes in your vision that happen in days or weeks.

What are the Symptoms of Wet AMD?

Common symptoms of dry and wet AMD include:

  • Blurry, dark or blind spot in your central vision
  • Colors looking less bright than they used to
  • Trouble seeing in or adjusting to low light (like when you enter a dimly lit room)
  • Trouble reading small print, even when wearing reading glasses
  • Objects looking smaller than normal
  • Trouble recognizing familiar faces
  • Seeing straight lines as wavy or crooked  

The main way to distinguish symptoms of wet AMD from the dry type is that the symptoms appear suddenly and progress rapidly (over a few days or weeks). 

Seeing straight lines as wavy or crooked is most often a sign of late stage or wet AMD. You can check this yourself by looking at surfaces in your home that are straight, like tiles or door and window frames. If what should be a straight line looks wavy to you, see your doctor right away.

There are no early warning signs of AMD, so regular eye exams are the best way to find early or intermediate AMD before it progresses.

How Will My Eye Doctor Diagnose Wet AMD?

If you notice any symptoms of wet AMD, see an eye doctor right away. To check for AMD, an eye doctor may do tests including:

  • Visual acuity test — you’ll read letters and numbers off an eye chart at different distances to check how clearly you can see.
  • Dilated eye exam — your eye doctor will give you some eye drops to dilate (widen) your pupil so they can check your eyes for signs of AMD and other problems.

If your eye doctor is concerned about AMD, they may do more tests, including:

  • Amsler grid — your doctor will ask you to look at a gridded page, like a checkerboard, and ask if any areas of the grid appear wavy, blank or blurry.
  • Fluorescein angiography — your doctor will give you a shot in your arm with a special dye, then take pictures as the dye passes through the blood vessels in your retina to check for leaks.

What Are the Treatments for Wet AMD?

While there’s currently no treatment for dry AMD, there are effective treatments available for wet AMD. You can also take steps to prevent AMD from getting worse.

If you’re diagnosed with intermediate-stage AMD in one or both of your eyes, you can take special dietary supplements called AREDS 2 to stop it from turning into late-stage AMD. Ask your doctor if AREDS 2 supplements are recommended for you.

If you’re diagnosed with wet AMD, there are two effective treatment options currently available:

  • Anti-VEGF drugs — your doctor can give you shots of these medicines in your eye every one to three months. Researchers are working on ways to space out the time between doses, so that you don’t need to get the shots as often. 
  • Photodynamic light therapy — your doctor can shine light at the back of your eyes to destroy the abnormal blood vessels that cause wet AMD.

Unfortunately, some people with wet AMD will have permanent vision loss. But vision rehabilitation services and devices (like magnifiers and assistive technologies) can help people with vision loss keep living active lives. If you’re living with vision loss from AMD, talk with your doctor about devices and services that can help.

What Causes AMD?

Experts aren’t sure exactly what causes AMD. Research suggests that a combination of factors may lead to this condition — including genetics and environmental and lifestyle factors such as smoking, poor nutrition and lack of physical activity.

Wet AMD starts out as the dry type. It happens when the body tries to fix damaged macula cells from dry AMD, by growing new blood vessels under the retina. But because these new blood vessels are abnormal, they leak and cause additional damage to the macula. And this can cause serious vision loss and other symptoms of wet AMD.

Am I at Risk?

AMD is more common in older adults, so your risk gets higher as you age. It’s most common in people ages 60 or older, but it can also affect people in their 40s or 50s. 

You may be at greater risk of wet AMD if you:

And since wet AMD is a type of late-stage AMD that starts as the dry type, your risk is higher if you’ve previously been diagnosed with dry AMD in one or both eyes.

How Can I Prevent Wet AMD?

Prevention is always better than cure, especially when it comes to your vision. So take action now, before you notice symptoms of wet AMD. There are a few general lifestyle changes you can make now to help keep yourself healthy as you get older and decrease your risk of developing AMD. Follow these tips:

  • Don’t smoke — and if you do smoke, make a plan to quit.
  • Stay physically active.
  • Eat a healthy balanced diet with lots of green leafy vegetables, fish and nuts.
  • Work with your doctor to manage other health conditions that can raise the risk of AMD, like high blood pressure and heart disease.
  • Get regular eye tests to protect your vision and find problems early.

And if you’ve been diagnosed with intermediate AMD in one or both eyes, talk with your doctor about taking AREDS 2 supplements to stop it from turning into late-stage AMD.

Remember, vision loss is not a natural part of aging — and you can take steps to protect your vision and keep seeing clearly as you get older.

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