The Difference Between Wet and Dry Macular Degeneration

As we grow older, we start to notice our bodies working differently. things we used to do aren’t as easy as they were before. A big day out may leave us feeling stiff. And we can’t see quite as well as we used to.  If you’ve noticed your eyesight growing weaker, then you’re not alone.  Eyesight deteriorates with age in almost everyone because the basic structure of your eye is damaged over time through no fault of your own. Inflammation can damage the cornea. The lens ages along with the rest of your body as it becomes less clear and less pliable resulting in diseases like cataracts.

Macular degeneration is one of those eye disorders that comes as a result of aging. It’s caused by the deterioration of the macula as a result of old age.

But there’s good news.

Age impacts eyesight, but it can be treated and in some cases even restored.

Macular degeneration treatment is available for most patients. To learn more, let’s talk about the eye and the disease itself including the difference between dry and wet macular degeneration.

Start Here: A Few Important Terms

Before we dive into macular degeneration treatment, let’s go into a few key terms. These words are some that you’ll want to become familiar with before you begin your research to help you achieve a better sense of the disease and treatment options:

Retina

The retina is the layer found at the back of your eye. It’s the part of the eye holding the light-sensitive cells (photoreceptors) that are so important to vision. When light hits your eye, your retina acknowledges it and triggers the nerve impulse that sends it to the brain via the optic nerve.

Visual images – what you “see” – are then formed in your brain.

Macula

The macula is part of your retina. It’s the part of the retina featuring the concentration of cones in a small central area of the layer.  It’s in the central part of your retina and it serves as its functional center. Your macula provides the sharpest color vision as well as our ability to enjoy “20/20” vision.

Macular Degeneration

Macular degeneration is commonly known as AMD, which stands for age-related macular degeneration. Found in two strands – wet or dry – it is a medical condition caused by damage to the macula.  People with AMD experience vision loss or interruption in their central vision.

Fortunately, there is macular degeneration treatment for some forms of AMD. You’ll learn more about the types of macular degeneration treatment available later in the article.

Central Vision

Central vision is the most important kind of vision because it allows you to look straight ahead and see visual details.  AMD primarily affects your central vision either through blurriness or loss of vision altogether.

Drusen

Drusen are found under the retina and are made from lipids, which is a fatty-type protein.  While drusen are associated with AMD, they do not cause the disease. Rather, drusen are known for increasing your risk of developing AMD.

Not all drusen coincide with a higher risk of eye diseases. Hard drusen are deposits that are small and far apart in the eye. An ophthalmologist may be able to see them and want to monitor them, but the drusen won’t necessarily create problems for your vision in the near or even long-term.  Ophthalmologists look out for “soft” drusen. These ten to exist in clusters and are larger and harder to distinguish.

What Is “Dry” Macular Degeneration?

Now that you’ve had a quick refresher on the important terms associated with this disease, you’re ready to dive in.  Let’s start with “dry” macular degeneration. Why? Because it’s the most common type of the disease.  According to the American Macular Degeneration Foundation, around 90% of all people who have age-related macular degeneration have the “dry” kind.

Dry AMD may also be referred to as non-neovascular AMD or non-exudative AMD, and this best describes what happens to your eyes during the process. In “wet” macular degeneration, there is a leaking or exuding of fluid from your blood vessels.  Thus, dry AMD and non-exudative AMD don’t involve the exuding of blood or serum.

How Does Dry-Age Related Maculation Begin?

The earliest stages aren’t characterized by massive visual impairment. In fact, your vision might be minimally impacted.  Instead, you’ll experience the development of pigmentary abnormalities and large drusen that develop within your macula. Drusen are debris that builds up in your eyes: they’re acellular and amorphous.

Drusen alone don’t signal AMD; almost everyone over 50 years old has at least a single druse in their eye or even both eyes. When these drusen are small in shape or number, they don’t indicate macular degeneration. However, large drusen suggest the potential for late-age related macular degeneration.

How It Progresses

Fortunately, the “dry” form of AMD tends to progress more slowly over time than the other types of macular degeneration.  As it progresses, you may notice your central vision is blurry. It happens when parts of your macula start to die. Becuase of the role the macula plays in your retina and central vision, the death of some cells leads to blank spots in your vision.  It’s like looking at a puzzle with some of the pieces missing. It’s possible to make out shapes and colors and usually the whole picture. But there are some pieces in between that you can’t make out.

Generally, only your central vision is affected by the macula. It’s rare for peripheral vision to be damaged by the disease.  You might find it difficult to imagine what it’s like to see when your sight is affected by macular degeneration. We encourage you to watch this video provided by the American Macular Degeneration Foundation,

Will I Still Lose My Vision?

Dry AMD may still result in vision loss. However, it is more common for those who receive this diagnosis to have decent central vision (prescription 20/40 and up). But they may have functional limitations that impact their ability to use their vision.

Some functional issues may include:

  • Fluctuating vision
  • Limited vision in the dark or reduced light
  • Limited central vision area

Every experience is personal and depends on your overall eye health and the macular degeneration treatment you choose. If you are experiencing symptoms related to macula degeneration, please schedule an appointment with one of our retina specialists, today.

What Macular Degeneration Treatment Is Available?

One of the issues faced by researchers and ophthalmologists treating dry AMD is that the cause is unknown. Lack of knowledge of the origin of the disease combined with other factors mean there is not yet any macular degeneration treatment available for dry AMD.

If you’ve been diagnosed with dry AMD, your doctor and ophthalmologists often recommend the following lifestyle changes in lieu of an FDA-approved macular degeneration treatment:

  1. Eating more omega-3 rich fish
  2. Enjoying more antioxidant-rich foods
  3. Avoiding processed and artificial foods and fats
  4. Regular exercise

You’ll also be encouraged to:

  • Quit smoking
  • Lower your blood pressure
  • Achieve a healthy weight
  • Avoid exposure to UV and blue lights

These health factors have been shown to rapidly increase the progression of the disease with obesity being one of the most common predictors of vision loss due to AMD.

Will There Ever Be a Treatment for Dry AMD?

We understand that the lack of currently available macular degeneration treatments for a “dry” diagnosis is frustrating. After all, it’s the most common type of AMD.  Fortunately, work is being done to rectify this.  As of 2017, two different macular degeneration treatments (not cures) were in the earliest stages of clinical trials.

The first is the PRELUDE clinical trial. The PRELUDE trial involves a retinal surgery that aims to prevent vision loss caused by dry AMD. The second is the FILLY clinical trial, which is testing the use of intravitreal injections to treat dry AMD.  Again, these trials are still in very early stages. Even if the researchers are able to pursue them, it will take years of testing to understand how and whether they work and whether they’re safe for general use.

What Is “Wet” Macular Degeneration?

Wet macular degeneration is the less common form of AMD. It’s the result of damage done to your macula. However, it’s characterized by the leaking of blood or fluid into your macula as the result of abnormal blood vessels in your retina.  Wet macular degeneration begins in the dry form, so it’s important to monitor your vision and macula even if you’re only diagnosed with dry AMD.  If and when wet AMD sets in, you’ll notice because your symptoms will appear quickly and grow worse at an alarming rate.

Some of the symptoms found in wet AMD patients include:

  • Reductions in your central vision (one or both eyes)
  • Distorted vision (straight lines appear bent)
  • Blurring or dulling of colors
  • Blind or blurry spots that are well-defined
  • Haziness in overall central vision

Like dry AMD, the primary symptoms target your central vision. It’s rare for you to experience issues in peripheral vision. If you are experiencing these symptoms or these symptoms in combination with issues in your peripheral vision, see your doctor or ophthalmologist for an eye exam immediately.

Why Does Wet AMD Occur?

Like dry AMD, no one is certain of the exact mechanism causing wet AMD. The only known predictor is the development of dry AMD.  Out of everyone who develops age-related AMD, 10% will eventually develop wet AMD.

Here’s what we do know:

Abnormal blood vessels allow blood fluid to leak out into the macula. In some cases, these vessels are those growing from a part of your eye called the choroid into your macula. This process is called choroidal neovascularization.

The fluid does more damage than dry AMD because it builds up int he back of your eye between your retinal pigment epithelium and the choroid. Built up fluid creates a small bump within your macula. The bump causes vision loss.

Can We Treat Wet AMD?

Yes – unlike dry AMD, there is a treatment for wet AMD. It treats the issues related to the blood vessels and leakage, but of course, there’s no macular degeneration treatment for the underlying dry AMD.  The macular degeneration treatments for wet AMD are primarily pharmacological or prescription drugs.  Avastin, Lucentis, and Eylea are the three drugs used to treat AMD.

These drugs perform the process of anti-angiogenesis.  Angiogenesis is the medical term referring to the process of growing new blood vessels. These blood vessels mays sometimes become excessive or move places where they shouldn’t, such as in wet AMD.  Thus, anti-angiogenic drugs reduce the growth factors that allow this to happen.

What Is the Wet Macular Degeneration Treatment Like?

The wet macular degeneration treatment is administered through an injection into your eye.  These injections sound scary, but you’ll barely feel a thing.  Prior to the injection, your doctor or ophthalmologist will provide you with eye drops to numb your eye. Then, they’ll clean your eye to prevent any infection.

Your eyes will then be held open with an eyelid holder to ensure you don’t move at the wrong time.  The needle will go into the bottom of the white part of your eye in the lower, outer corner of your eyeball. You’ll look up, so you won’t see much coming and depending on the numbing agent used, you’ll feel a little pressure or even nothing.  In some cases, people see strange lines as the medication moves around your eye.

The wet macular degeneration treatment takes place in the office, and you’ll be able to go home right away. But you should ask someone to drive you so you can avoid getting behind the wheel.  Over the next few days, you’ll use antibiotic eye drops just in case. You might also experience some soreness or foggy vision for the first day, but it will be improved. You can also take a form of paracetamol to help ease any discomfort.

Protect Your Vision With Regular Eye Exams

Your vision will age with you, but vision loss doesn’t need to be permanent.  The best advice for protecting your vision is to keep yourself in good general health and visit your ophthalmologist or optometrist for regular eye exams. Catching AMD earlier often means you’ll be able to keep tabs on any symptoms including the transition from dry to wet AMD.

If it’s been more than a year since your last vision check-up, schedule your appointment today.

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