Which Is Better—Dry or Wet Macular Degeneration?

Neither wet nor dry AMD is better, per se. But wet AMD is the more serious and dangerous type. It can quickly lead to vision loss, which is often permanent. Wet AMD develops by and large from dry AMD, so it’s important to stay on top of your eye health and monitor possible signs of dry AMD.

How Does Dry AMD Become Wet AMD?

Most cases of dry AMD don’t become wet AMD. But most wet AMD cases begin with dry AMD. Dry AMD at any stage can suddenly turn into wet AMD. So, even an early stage of dry AMD without symptoms has the potential to quickly morph into wet AMD. Because wet AMD can devastate vision and quality of life, early detection of dry AMD is important.

Can You Fix Central Vision Loss From AMD?

Central vision loss from AMD, either wet or dry, cannot generally be restored. Prevention is paramount. At your annual eye exam, your eye doctor checks for underlying conditions and signs of disease, including AMD. So, be sure to schedule a comprehensive eye exam every year and whenever you notice changes in your eyesight.

Does Macular Degeneration Cause Blindness?

Macular degeneration doesn’t usually lead to total blindness. That’s because AMD mostly only affects central vision, leaving your peripheral vision intact. That said, any permanent loss of your central vision hinders your eyesight as a whole. If the damage to your macula is bad enough to significantly impair your central vision, you may even meet the criteria for being legally blind.

What Is Low-Vision Rehabilitation?

People with AMD often have low vision, which is when eyesight is considerably diminished but not completely gone. AMD can harm your central vision severely but spare your peripheral vision. If you have pronounced vision loss from AMD, your eye doctor may recommend low-vision rehabilitation to make the most of your remaining eyesight. Brighter lighting, switching to anti-reflective glasses, and using assistive devices like magnifiers and high-contrast displays can all help.

Wet vs. Dry Macular Degeneration: Symptoms and Treatment

Macular degeneration is an eye disease that is one of the most common causes of adult vision loss, affecting around 20 million people in the U.S. “Wet” and “dry” are the two main types of macular degeneration, also known as age-related macular degeneration or AMD.

AMD starts as the dry form, which has the potential to develop into wet AMD—the “worse” and more advanced form. But either wet or dry AMD can significantly impact your eyesight and quality of life. No cure exists for AMD, so early detection is important.

We’re here to explain the similarities and differences between wet and dry macular degeneration. First, we’ll give an overview of macular degeneration. Then, we’ll discuss what happens with wet AMD versus dry AMD, how the dry form can become the wet form, and treatment options.

What Is Macular Degeneration (AMD)?

The macula is the part of your eye responsible for sharp central vision (what you see looking straight ahead) and much of your color vision. In someone with macular degeneration, the macula becomes damaged, often causing central vision loss. Central vision is essential for daily activities like reading, driving, and recognizing people’s faces.

There are two main forms of AMD: wet and dry. (There’s also a rare form of macular degeneration called Stargardt disease, which most often affects children.) You can think of wet and dry AMD as stages of the same disease (AMD) or points on a continuum that progresses from dry AMD to wet AMD.

What Does Macular Degeneration Look Like?

It’s common not to notice wet/dry AMD symptoms (which can occur gradually) until the disease is at an advanced stage. Often, if early signs of AMD are present, your eye doctor is the one who detects them—at your comprehensive eye exam. (We can’t stress enough the importance of scheduling an annual comprehensive eye exam.)

Typically, macular damage worsens as AMD progresses, making more and more of your central vision distorted or obscured. Symptoms may include:

Blurry vision
Distorted vision (Straight lines may look wavy, for instance.)
Problems seeing details or recognizing people’s faces
Floaters
Dark or blind spots where vision is partially or completely obscured
Colors looking less bright or faded
Objects appearing smaller than they are
Difficulty seeing in low light or adapting from bright light to a darker environment

Here’s how the progression of AMD might go for someone who has it:

Risk Factors

As you would expect, age-related macular degeneration (AMD) is frequently associated with aging—it most often happens in people age 55 or older. But in addition to age, other risk factors exist. These include high blood pressure, high cholesterol, smoking, and a family history of AMD.

Wet vs. Dry AMD: How They’re Different

Several major differences exist between wet and dry AMD. Let’s take a glance:

What Is Wet AMD?

Wet AMD is the rarer and more serious form of the disease. It’s sometimes referred to as neovascular AMD (nAMD) or exudative AMD because it involves new blood vessels that exude (leak) fluid.

Wet AMD can progress rapidly and cause sudden vision loss. Most cases of wet AMD begin with dry AMD, meaning dry AMD has the potential to advance into wet AMD. Wet AMD is always considered late- or advanced-stage AMD.

What Happens With Wet Macular Degeneration?

In someone with wet AMD, new blood vessels appear under the macula and retina. Those weak blood vessels bleed or leak fluid, deforming and damaging the macula. Scarring, which is common in wet AMD, further damages the macula.

This macular damage causes central vision distortion or loss, which can be extreme and permanent. The process can happen quickly—within days or weeks.

Wet AMD Is an Emergency

Because of the rapid development and potential severity of the outcome, wet AMD is considered a medical emergency requiring immediate treatment.

If you experience sudden changes in your vision, contact an eye care specialist or seek medical assistance right away. If wet AMD is diagnosed, it’s important to see a retinal specialist within two weeks.

Wet Macular Degeneration Treatment

Early treatment of wet AMD is vital. Any loss of eyesight that’s already occurred is irreversible. So, the focus of wet AMD treatment is staving off further macular damage and harm to your vision. Your doctor may recommend one or more of the following treatments:

Anti-VEGF (anti-vascular endothelial growth factor) drugs: Injected into the eye on a regular schedule to halt or slow the growth of new blood vessels that could leak and cause additional retinal damage

Radiation: A radiation treatment to help reduce the formation of new blood vessels and lessen scarring and inflammation

Gene therapy: New gene therapy drugs, delivered via surgery or a single injection, to stimulate the eye to manufacture its own anti-VEGF treatment

Photodynamic therapy: A type of laser surgery meant to reduce blood vessel leakage

Low-vision rehabilitation: Specialized devices or changes in your environment to enhance the vision you still have

What Is Dry Macular Degeneration?

Dry AMD happens when yellow waste deposits called drusen form in the retina. What causes dry macular degeneration is the growing and multiplying of the drusen, which thin and dry out the macula. This damages the macula, causing central vision loss.

The disease usually emerges gradually. Early signs of dry AMD, such as a small number of drusen, can go unnoticed.

Dry AMD is also known as atrophic AMD. That’s because, as it progresses, retinal cells die (atrophy). Other terms for dry AMD are non-neovascular AMD and nonexudative AMD. These terms distinguish it from wet AMD since dry AMD doesn’t involve the formation of new blood vessels that exude (leak) fluids.

What Happens When You Have Dry AMD?

The evolution of dry AMD can be separated into three stages: early, intermediate, and advanced. Any stage of dry AMD can become wet AMD.

Here’s a breakdown of the stages:

Stage 1 (early): In the early stage of dry AMD, drusen appear in the retina. Dry AMD often stops developing at this stage, and most people over age 50 have at least one druse (singular of drusen). People with dry AMD at this stage often can’t tell that anything is amiss. Any vision loss at this stage is generally minimal.
Stage 2 (intermediate): Here, drusen grow and accumulate. Changes in central vision may occur slowly. At this stage, people still might not notice any signs of dry AMD.
Stage 3 (advanced or late): In this dry AMD stage—also called geographic atrophy—an abundance of drusen thins the retina, and patches of dead retinal cells form. The result is central vision distortion or loss. Roughly one-third of late-stage dry AMD cases are this type.

Dry Macular Degeneration Treatment

Treatment options for dry AMD attempt to manage the disease and slow its progress. Based on your case and the stage, your eye doctor may suggest:

Medications: Management medications targeting the immune system, injected into the eye on a monthly or bimonthly schedule

Supplements: AREDs 2, a group of antioxidant dietary supplements

Low-Vision Rehabilitation: Specialized devices or changes in your environment to enhance the vision you still have

Implant surgery: A telescopic lens that an eye doctor implants into the eye to magnify close-up and far-away vision

Cell-transplant surgery: An emerging treatment that replaces dead retinal cells with stem cells

How Is AMD Diagnosed?

At your comprehensive eye exam, the doctor looks for evidence of age-related macular degeneration. This screening may include the components discussed below.

Visual Acuity Test

During a visual acuity test, your eye doctor checks your eyesight sharpness and whether it’s changed since your last visit. The test commonly involves covering one eye and, from 20 feet away, reading a Snellen chart—a wall chart containing rows of letters that decrease in size from top to bottom.

Retinal Exam

In a retinal exam, your eye doctor looks into your eye to detect early signs of AMD. These include irregular blood vessels and numerous or large drusen. The exam involves traditional pupil dilation (also known as ophthalmoscopy), retinal imaging, or both. During the retinal exam, the doctor can also screen for other eye disorders and diseases.

Amsler Grid Test

An Amsler grid looks like a piece of graph paper with a small dot in the center. This test checks for irregularities when you look at the grid. Irregularities may include a blind spot or wavy lines instead of straight ones. Both a blind spot and wavy lines are symptoms of AMD.

Optical Coherence Tomography

During an optical coherence tomography (OCT), your eye doctor uses light waves to take pictures of the retina. The pictures help with detection of abnormal or leaky blood vessels.

Preventing Wet and Dry AMD

By far, the best way to prevent AMD is detecting its early signs. A comprehensive eye exam every year lets your eye doctor examine your eye for any indications of AMD.

In addition, certain healthy practices may lower your risk of AMD and otherwise improve your eye health. These practices include:

Keeping your blood pressure and cholesterol under control
Maintaining a healthy diet
Taking AREDs 2 supplements—if your doctor recommends it
Giving up (or not starting) smoking
Wearing sunglasses outdoors (Blue light from the sun may contribute to the risk of AMD.)

H2: Your Eye Health Is Important

AMD is a serious eye disease that can alter your sight and life forever. Dry AMD can develop without symptoms and has the potential to ravage your eyesight with or without becoming wet AMD. We cannot overstate the importance of early detection and being aware of any wet/dry AMD symptoms. Be sure to undergo a comprehensive eye exam every year.

Wet vs. Dry Macular Degeneration: What’s the Difference?