Wet vs. Dry Age-Related Macular Degeneration: What To Know

If you or someone you know has been diagnosed with macular degeneration, you know there are a lot of terms thrown around. Even the names of the conditions are long and complex. Not to mention the implications on your life when you’re told you’re living with macular degeneration. It’s not surprising that you may feel confused, nervous and full of questions.

“It can be scary to be diagnosed with macular degeneration,” explains ophthalmologist and retina specialist Aleksandra Rachitskaya, MD. “A lot of people know someone who’s lost their vision from it, but it’s important to know that macular degeneration exists on a spectrum, and in many cases, we have treatments available to try to preserve your sight.”

But what exactly is age-related macular degeneration? What are the differences between the “wet” kind and the “dry” kind? And what does it all mean for your vision? Dr. Rachitskaya explains.

Wet vs. dry age-related macular degeneration

We know it’s a mouthful to say, so let’s start by breaking down what is meant by “age-related macular degeneration.”

Age-related means that your condition is related to aging — as opposed to other causes, like diabetes, injuries or infections. Typically, age-related macular degeneration is a condition that develops after age 50. Dr. Rachitskaya says it’s more common in people ages 70+.

Macular refers to your macula, a specific part of your eye. Your macula is an area in the center of your retina, which is the very back layer of your eyeball. Your macula is responsible for your central vision — that’s to say, your retina allows you to see figures and shapes that are right in front of you. Your macula allows you to see details in your central vision — things like letters on a page or the color of someone’s shirt. Central vision allows us to do things like see faces, read, work on the computer, knit and drive.

Degeneration means there’s damage to your macula. That damage doesn’t necessarily affect both of your eyes the same. One eye may not be affected or may be affected less than the other.

Macular degeneration comes in one of two forms: wet and dry.

Can dry age-related macular degeneration change to wet?

Yes. Some people may begin by having dry age-related macular degeneration that progresses into the wet kind. Dry macular degeneration can also progress to geographic atrophy.

Let’s take a closer look.

Dry age-related macular degeneration

Dry age-related macular degeneration is the more common form of age-related macular degeneration. About 90% of people with age-related macular degeneration have the dry kind. Geographic atrophy is the advanced stage of dry age-related macular degeneration.

The dry condition develops when tiny protein deposits, called drusen, form in your macula.

Dry age-related macular degeneration develops in stages. In the early stage, your eye care provider will see changes to your macula, but you won’t experience any vision changes. In the intermediate stage, your vision may become slightly blurry. If your condition progresses to the advanced stage, the macula becomes thinned and you can lose your central vision altogether.

But not everyone with dry age-related macular degeneration will experience that progression.

“Some people can stay in an early stage of dry macular degeneration and not have significant vision changes. They may stay stable, even without getting treatment,” Dr. Rachitskaya explains.

There are steps your eye specialist may recommend to slow down the progression of dry age-related macular degeneration. That includes things like:

• Taking AREDS II vitamins (a specific eye health multivitamin that contains vitamin C, vitamin E, copper, zinc, lutein and zeaxanthin).
• Following a diet focused on whole foods and healthy fats, specifically the Mediterranean diet.
• Wearing sunglasses to protect your eyes from UVA and UVB light.
• Avoiding tobacco smoke, including secondhand smoke.

Wet age-related macular degeneration

Wet age-related macular degeneration (also called exudative macular degeneration) is much less common than the dry type.

It happens when your body creates abnormal blood vessels under your retina in the macular region. Those blood vessels cause fluid accumulation and bleeding in the macula.

While dry age-related macular degeneration happens more gradually and in stages, wet age-related macular degeneration is always considered to be an advanced stage.

Although wet age-related macular degeneration is an advanced condition, there is hope. Dr. Rachitskaya says that anti-vascular endothelial growth factor (anti-VEGF) injections can control the growth of new blood vessels in your eyes. They’re not an all-out cure, but they’ve proven to be an effective treatment.

“Particularly when we catch the disease early, continued and consistent treatment can not only preserve vision, but in some cases can improve the vision of people with wet age-related macular degeneration,” she continues. “We have a lot of data showing that with treatment we’re often able to preserve vision and provide good vision and independence to our patients.”

As you age, it’s important to recognize any changes in your vision and to seek prompt medical care. But because macular degeneration can begin before you notice any issues, regular eye care is important.

“The earlier we can intervene, the better the chances are that we can catch eye conditions in their early stages when they are most treatable. So, it’s important to visit your eye provider every year and to make an appointment if you experience any new visual symptoms,” Dr. Rachitskaya advises.