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Dry versus wet macular degeneration

Macular disease is the biggest cause of sight loss in the UK and age-related macular degeneration (AMD) is the most common form, usually affecting people over the age of 50[i],[ii]. There are two types of AMD, known as ‘dry’ and ‘wet’, and understanding the difference between the two can sometimes be confusing.

The macula is part of the retina at the back of the eye, and is responsible for our central vision, most of our colour vision and the fine detail of what we see[iii]. Dry AMD is a gradual deterioration of the macula, as the retinal cells die off and are not renewed. The term ‘dry’ does not mean the person has dry eyes in terms of their tear production, just that the condition is not defined as wet AMD. Around 10-15% of people with dry AMD also go on to develop wet AMD[iv].

Approximately 40,000 people develop wet AMD in the UK each year[v]. Wet AMD develops when abnormal blood vessels grow into the macula. These leak blood or fluid which leads to scarring of the macula and rapid loss of central vision[vi]. It can develop quickly and worsen over time, leading to difficulty in everyday activities, such as reading and recognising faces[ii]. That’s why it’s important to monitor for changes in vision to catch and treat wet AMD early.

For more information on understanding macular degeneration, click here.

Elderly woman cutting vegetables in kitchen

Recognising symptoms

AMD can affect different people in different ways, and symptoms can also change over time.

Symptoms of dry and wet AMD can often be similar (e.g. distorted or blurry vision, finding bright light glaring, incorrect perception of colour[iv], but there are some key differences to look out for:

  • Dark spot in the centre of vision. In wet AMD, a small black dot or gap may appear in the centre of your vision due to blood vessels leaking fluid underneath the retina. This black dot can gradually get larger, covering your central vision[vi].
  • More severe and rapid changes in vision. Wet AMD can progress very quickly, with vision sometimes getting worse in just days or weeks[vii].
  • Fluid build-up, detected by an optical coherence tomography (OCT) scan during your eye appointment. Retinal fluid build-up is a sign that your macular degeneration has progressed to wet AMD. This fluid is caused by the growth of abnormal, leaky blood vessels[viii].

Monitoring your symptoms and vision at home is vital, as it allows you to catch any changes quickly so you can alert your eye specialist as soon as possible.

For more information on risk factors and symptoms, click here.

Taking action

To better manage disease progression, it is important to speak to your eye specialist as soon as you notice any changes in your vision and understand the treatment options available to you.

"If you haven’t been diagnosed with AMD but are experiencing any of the above symptoms, get in touch with your local opticians as soon as possible. If your optometrist suspects wet AMD, you should be referred to a retinal specialist at the hospital directly[v]."

If you have been diagnosed with wet AMD, or if you’re caring for someone with wet AMD, it is important to make the most of the time you get with your eye care team, so take this quick questionnaire and download your appointment guide.

Although there is currently no cure for wet AMD[ix], it is important to be proactive in managing the disease to slow down its progression. Consistent treatment and regular monitoring of fluid and blood in the back of the eye could help slow down the progression of wet AMD[x]. This, along with lifestyle modifications, could allow people living with the disease to remain independent for longer[vi].

Hospitals and eye clinics across the country are continuing to follow a range of safety measures to prevent the spread of COVID-19 and keep you safe during your appointment. From social distancing to reducing the number of people visiting a clinic at any one time, measures are in place to give you confidence that you’ll receive treatment in a safe environment.

For more information on staying safe when attending appointments, click here.

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[i] Quartilho, A et al. Leading causes of certifiable visual loss in England and Wales during the year ending 31 March 2013. Eye vol. 30(4), 602-607. 2016.

[ii]  NHS. What is AMD? Available at: https://www.nhs.uk/conditions/age-related-macular-degeneration-amd/. Last accessed November 2021.

[iii] Macular Society. What is the macula? Available at: https://www.macularsociety.org/macular-disease/macula/. Last accessed November 2021.

[iv] Macular Society. Dry age-related macular degeneration. Available at: https://www.macularsociety.org/macular-disease/macular-conditions/dry-age-related-macular-degeneration/. Last accessed November 2021.

[v] Owen CG, Jarrar Z, Wormald R, et al. The estimated prevalence and incidence of late stage age related macular degeneration in the UK. Br J Ophthalmol 2012;96:752-756.

[vi] Macular Society. Wet age-related macular degeneration. Available at: https://www.macularsociety.org/macular-disease/macular-conditions/wet-age-related-macular-degeneration/. Last accessed November 2021.

[vii] Royal College of Ophthalmologists. Understanding age-related macular degeneration. Available at: https://www.rcophth.ac.uk/wp-content/uploads/2021/06/Understanding_AMD_NV.pdf. Last accessed November 2021.

[viii] Ambati J, Fowler BJ. Mechanisms of age-related macular degeneration. Neuron. 2012;75(1):26-39.

[ix] All About Vision. Macular degeneration: Prevention and risk factor reduction. Available at: https://www.allaboutvision.com/en-gb/conditions/amd-prevention/. Last accessed November 2021.

[x] NHS Hull University Hospitals. Treatments for Patients with Wet Age-Related Macular Degeneration. Available at: https://www.hey.nhs.uk/patient-leaflet/treatments-patients-wet-age-related-macular-degeneration/. Last accessed November 2021.

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