How to Identify and Treat Wet Macular Degeneration

Understanding the Eye's Structure

Wet AMD affects the macula, a small but crucial area located in the center of the retina at the back of the eye. Although it occupies only a small portion of the retinal surface, the macula provides detailed central vision. You depend on it for everyday tasks that require clarity and precision, such as reading, driving, recognizing faces, and seeing objects clearly straight ahead.

The macula is packed with photoreceptor cells that detect light and color and allow you to see fine detail. When light enters the eye, it is focused onto the retina and the macula. The photoreceptors convert this light into electrical signals, which travel along the optic nerve to the brain. There, those signals are processed into the images you see. When the macula is damaged by conditions like wet AMD, this visual pathway is disrupted and the center of your vision may become blurred, distorted, or dark.

What is Wet Macular Degeneration?

Wet macular degeneration, also known as neovascular age-related macular degeneration, is a long-term eye disease that can cause blurry central vision or a central blind spot. It is one of the two primary forms of AMD, the other being dry macular degeneration. Wet AMD occurs when new, fragile blood vessels grow underneath the retina and macula. These abnormal vessels are prone to leaking fluid or blood, which can cause the macula to swell, lift, or scar. As this damage progresses, central vision can decline quickly, making it more difficult to read, drive, recognize faces, or complete tasks that rely on sharp 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. It usually progresses more slowly and leads to more gradual changes in vision. Wet AMD, in contrast, may appear more suddenly and often causes more significant vision loss over a shorter period of time. Because dry AMD can progress into wet AMD, regular eye exams and follow-up appointments are especially important if you have already been told you have macular changes.

Although wet AMD makes up a smaller share of total AMD diagnoses, it accounts for most of the severe vision loss linked to macular degeneration. The condition primarily affects older adults and is most commonly diagnosed in people over the age of 50.

The Symptoms of Wet Macular Degeneration

Early symptoms of wet macular degeneration can be subtle, and it is easy to assume they are simply part of getting older. Paying close attention to any changes in your vision and seeking care early can make a meaningful difference in protecting your sight. Common warning signs include:

• Distorted Vision

• Blurred Central Vision

• Dark or Empty Areas in Vision

As wet AMD progresses, these symptoms often become more noticeable. People may experience faster vision loss, colors that appear faded or washed out, and increasing difficulty with routine activities such as reading, driving, cooking, or recognizing people across a room. Because wet AMD can worsen quickly, any sudden change in central vision should be evaluated by an eye doctor at Grene Vision Group as soon as possible. Early diagnosis and treatment give you the best chance to preserve the vision you still have.

What Can Cause Wet AMD?

Understanding what may contribute to macular degeneration can make it easier to recognize changes early and make informed decisions about your risk. While the exact cause of wet AMD is not completely known, research suggests that a combination of inherited traits, lifestyle choices, and overall health factors can increase the likelihood of developing this condition.

Genetics

Family history is an important part of the AMD story. If a parent, sibling, or other close relative has been diagnosed with age-related macular degeneration, your own risk is higher than average. Certain gene variations, including those linked to the body’s immune and complement systems, have been associated with a greater chance of developing AMD. You cannot change your genetics, but talking openly about your family history allows your Grene Vision Group eye doctor to decide how closely your eyes should be monitored over time.

Environmental and Lifestyle Factors

1. Smoking: Smoking is one of the most significant controllable risk factors for advanced AMD. It decreases blood flow to the retina and increases oxidative stress, which can damage delicate macular tissue. Quitting smoking, at any age, is one of the most powerful steps you can take to help protect your vision.

2. Diet: Diets that are low in antioxidants and omega-3 fatty acids may raise the risk of AMD. Choosing more leafy green vegetables, colorful fruits, and fish can provide nutrients that support the retina and help guard the macula against oxidative damage.

3. Sun Exposure: Long-term exposure to ultraviolet (UV) light can contribute to retinal stress. Wearing sunglasses that block UVA and UVB rays, along with a brimmed hat outdoors, adds an extra layer of protection for your eyes.

Age-Related Factors

Age is the strongest overall risk factor for wet macular degeneration. The condition is most commonly diagnosed after age 50, and the likelihood rises with each decade of life. Some age-related changes in the macula are expected, but in some individuals those changes progress more quickly and can lead to AMD. As you get older, comprehensive eye exams become even more important so that subtle changes can be detected and tracked over time.

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.

Working closely with your primary care provider to manage these conditions, take medications as directed, and maintain a heart-healthy lifestyle can support both your general health and long-term eye health.

How is Wet Macular Degeneration Diagnosed?

Wet macular degeneration is usually identified during a comprehensive, dilated eye exam and may require additional imaging tests. These evaluations help your Grene Vision Group doctor look for fluid, bleeding, and abnormal blood vessels beneath the macula. Because wet AMD can worsen quickly, it is important to schedule an eye exam promptly if you notice new distortion, a dark spot, or any sudden change 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 wet macular degeneration cannot be cured, several effective treatments can slow the disease and, in some cases, improve vision. The main goals of treatment are to limit leakage from abnormal blood vessels, protect the macula from further damage, and help you maintain as much central vision and independence as possible.

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 promotes new blood vessel growth. In wet AMD, too much VEGF encourages fragile, leaky vessels to form beneath the macula. Anti-VEGF medications block this signal, which can reduce leakage, bleeding, and swelling and often stabilize or even improve central vision.

Many patients are surprised by how quick and straightforward an injection visit is. Typically:

• 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 throughout the body. Once it reaches the abnormal blood vessels in the eye, a low-power laser is used to activate the drug. This process helps close off the abnormal vessels while limiting damage to the surrounding retinal tissue.

PDT is used less often today than anti-VEGF injections but can be helpful in specific situations, such as certain patterns of abnormal blood vessels or when additional therapy is needed alongside injections. It is usually performed as an outpatient procedure. Because the medication is activated by light, patients are often advised to avoid bright sunlight or very bright indoor lighting for a period of time after treatment.

Laser Surgery

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

The procedure is typically performed in an office or outpatient setting. Numbing drops are placed in the eye, and the laser is applied in brief pulses to the targeted area. Follow-up visits and imaging allow your doctor to confirm whether leakage has stopped and to monitor for any signs that new abnormal vessels are forming.

Lifestyle Changes and Supportive Therapies

Medical treatments are only one part of managing wet AMD. Everyday choices and supportive tools can also play a meaningful role in protecting vision and maintaining independence:

• 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 people with age-related macular degeneration, AREDS2-based vitamin supplements may be recommended to support macular health. Your Grene Vision Group eye doctor will review your diagnosis, stage of disease, and overall health to determine whether these supplements are appropriate for you.