What is Wet Macular Degeneration? Symptoms, Causes, & Treatment

Wet macular degeneration is a serious eye condition where abnormal blood vessels grow under your retina and leak fluid or blood. This happens in the macula, the small central part of your retina that gives you sharp, detailed vision for reading and recognizing faces.

While it sounds frightening, wet macular degeneration affects only about 10-15% of people with macular degeneration. The good news is that early detection and modern treatments can significantly slow its progression and help preserve your vision.

What is Wet Macular Degeneration?

Wet macular degeneration occurs when your eye creates new, fragile blood vessels beneath the macula in a process called choroidal neovascularization. These vessels are like leaky pipes that weren't supposed to be there in the first place.

Unlike dry macular degeneration, which progresses slowly over years, wet macular degeneration can cause rapid vision changes within days or weeks. The leaked fluid and blood damage the light-sensitive cells in your macula, creating blind spots or distorted vision in your central field of view.

Your peripheral vision typically stays intact with this condition. This means you can still navigate around your home and maintain some independence, even as your central vision becomes affected.

What are the Symptoms of Wet Macular Degeneration?

The symptoms of wet macular degeneration often appear suddenly and can be quite noticeable. You might first notice that straight lines look wavy or bent, like looking through water.

Here are the key symptoms to watch for:

• Straight lines appearing wavy, curved, or distorted
• Dark or blank spots in your central vision
• Blurred or fuzzy central vision
• Colors appearing less bright or vivid
• Difficulty reading or seeing fine details
• Problems recognizing faces
• Need for brighter light when reading

Some people experience more dramatic symptoms like sudden vision loss in one eye or seeing flashing lights. These warrant immediate medical attention, as they could indicate bleeding or severe fluid buildup.

What Causes Wet Macular Degeneration?

Wet macular degeneration develops when your eye produces too much of a protein called VEGF (vascular endothelial growth factor). Think of VEGF as a signal that tells your body to grow new blood vessels.

In a healthy eye, this process stays balanced. However, when the macula becomes damaged or stressed, it releases excess VEGF as a misguided attempt to help itself. Unfortunately, these new blood vessels are poorly formed and leak easily.

Most cases of wet macular degeneration actually start as dry macular degeneration. About 10-15% of people with dry AMD eventually develop the wet form. The exact trigger for this progression isn't fully understood, but it likely involves a combination of genetic factors and environmental damage over time.

When to See a Doctor for Wet Macular Degeneration?

You should contact an eye care professional immediately if you notice sudden changes in your central vision. This is especially important if straight lines start looking wavy or if you develop new blind spots.

Consider it urgent if you experience sudden vision loss, a dramatic increase in distortion, or if you see flashing lights. These symptoms could indicate active bleeding or significant fluid accumulation that needs prompt treatment.

Even gradual changes deserve attention within a few days rather than weeks. Early treatment can make a substantial difference in preserving your remaining vision and preventing further damage.

What are the Risk Factors for Wet Macular Degeneration?

Several factors can increase your likelihood of developing wet macular degeneration. Understanding these can help you take preventive steps where possible.

The most significant risk factors include:

• Age over 60 (risk increases significantly after 75)
• Having dry macular degeneration already
• Family history of macular degeneration
• Smoking or history of smoking
• Being Caucasian (though other ethnicities can be affected)
• High blood pressure
• Heart disease
• High cholesterol levels
• Obesity
• Prolonged sun exposure without eye protection

Some less common risk factors include certain genetic variations and being female. While you can't change your age, genetics, or gender, you can address lifestyle factors like smoking, diet, and UV protection.

What are the Possible Complications of Wet Macular Degeneration?

Without treatment, wet macular degeneration can lead to significant central vision loss within months or even weeks. The most immediate concern is the progressive damage to your macula from ongoing fluid leakage.

Potential complications include:

• Severe central vision loss or legal blindness
• Formation of scar tissue under the macula
• Hemorrhaging (bleeding) under the retina
• Retinal detachment in rare cases
• Development of choroidal neovascular membranes
• Geographic atrophy (areas of dead retinal tissue)

The emotional impact shouldn't be overlooked either. Many people experience anxiety, depression, or fear about losing independence. However, with modern treatments, the outlook is much more hopeful than it was even a decade ago.

How is Wet Macular Degeneration Diagnosed?

Your eye doctor will use several tests to diagnose wet macular degeneration and determine how advanced it is. The process typically starts with a comprehensive eye exam and your description of symptoms.

A key tool is the Amsler grid, a simple chart with straight lines that helps detect vision distortion. Your doctor will also dilate your pupils to examine the back of your eye with special instruments.

More detailed tests include fluorescein angiography, where a dye is injected into your arm to highlight blood vessels in your eye. Optical coherence tomography (OCT) creates detailed cross-sectional images of your retina, showing fluid accumulation and tissue thickness with remarkable precision.

These tests help your doctor determine the exact location and extent of abnormal blood vessels, which guides treatment decisions. The entire diagnostic process usually takes about an hour and is generally comfortable.

What is the Treatment for Wet Macular Degeneration?

The primary treatment for wet macular degeneration involves anti-VEGF injections directly into your eye. These medications block the protein that causes abnormal blood vessel growth and leakage.

Common anti-VEGF drugs include ranibizumab (Lucentis), aflibercept (Eylea), and brolucizumab (Beovu). Your doctor will inject these medications into your eye using a very fine needle after numbing the area with drops.

Treatment typically starts with monthly injections for the first few months, then the frequency may be reduced based on your response. Many people need ongoing treatments every 6-12 weeks to maintain their vision improvements.

In some cases, your doctor might recommendations photodynamic therapy, which uses a light-activated drug to close abnormal blood vessels. Laser therapy is less commonly used today but might be appropriate in specific situations.

How to Take Care at Home During Wet Macular Degeneration Treatment?

Supporting your eye health at home can complement your medical treatment and potentially slow progression. Focus on protecting your eyes and maintaining overall health.

Nutrition plays a crucial role in eye health. Consider taking AREDS2 vitamins, which contain specific amounts of vitamins C and E, zinc, copper, lutein, and zeaxanthin. These supplements have been shown to slow progression in some people with macular degeneration.

Eat plenty of leafy green vegetables like spinach and kale, which are rich in lutein and zeaxanthin. Omega-3 fatty acids from fish can also support retinal health. If you smoke, quitting is one of the most important steps you can take.

Protect your eyes from UV light with quality sunglasses when outdoors. Use good lighting when reading, and consider magnifying devices or large-print materials to reduce eye strain.

How Should You Prepare for Your Doctor Appointment?

Preparing for your appointment can help you make the most of your time with the doctor and ensure you get all the information you need. Start by writing down all your symptoms, including when they started and how they've changed.

Bring a list of all medications you're taking, including over-the-counter supplements. Your medical history, especially any family history of eye problems, will be helpful for your doctor to know.

Consider bringing a family member or friend to help you remember information and provide support. After eye dilation, your vision may be blurry for several hours, so you'll need someone to drive you home.

Prepare questions about your treatment options, what to expect from injections, and how often you'll need follow-up visits. Don't hesitate to ask about financial assistance programs if cost is a concern.

What's the Key Takeaway About Wet Macular Degeneration?

Wet macular degeneration is a serious condition, but it's no longer the hopeless diagnosis it once was. With prompt treatment, many people can stabilize their vision and some even experience improvement.

The most important thing to remember is that time matters. The sooner treatment begins, the better your chances of preserving vision. Regular eye exams and monitoring any changes in your vision can make a significant difference in your outcomes.

While living with wet macular degeneration requires adjustments, many people continue to lead fulfilling, independent lives. Low vision aids, support groups, and rehabilitation services can help you adapt and maintain your quality of life.