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Wet vs. Dry AMD: Understanding the Differences and Protecting Your Vision
Dry AMD: What You Need to Know
Dry AMD is the more common form and tends to progress slowly over months or years. Because early symptoms can be subtle, many people do not realize they have it until it reaches a more advanced stage.
Dry AMD begins when small yellow deposits called drusen form beneath the retina. In small numbers, drusen are usually harmless. As they grow larger and accumulate, they can damage the light-sensitive cells of the macula. Over time, those cells may stop working properly or die off entirely.
In its most advanced stage, dry AMD progresses to geographic atrophy, often called GA. Geographic atrophy occurs when patches of retinal cells waste away, creating clearly defined areas of cell loss. This advanced stage can cause significant and permanent loss of central vision.
Early dry AMD often causes no symptoms at all. As the condition advances to intermediate stages, you may begin to notice changes in your day-to-day vision.
- Difficulty reading in dim or low light
- Slow adjustment when moving from bright to dark environments
- Colors that appear less vivid or washed out
- Mild distortion of straight lines
In the advanced geographic atrophy stage, a dark or blurry area may appear in the center of your vision, and distortion of straight lines may become more pronounced. These changes can affect reading, driving, and recognizing faces.
Early and intermediate dry AMD is typically managed with nutritional support and regular monitoring. Our team recommends supplements based on the AREDS 2 formula, a specific combination of vitamins and minerals studied extensively for slowing dry AMD progression. We carry Focus Select, our AREDS 2 formula supplement, for patients who may benefit.
For advanced dry AMD with geographic atrophy, Izervay (avacincaptad pegol) is a complement inhibitor (a medication that targets part of the immune system involved in cell destruction) that has been shown to slow the rate of GA progression. It is given as an intravitreal injection, meaning it is injected directly into the eye. It does not restore vision that has already been lost, but slowing progression can help preserve the vision you still have. Our Retina Specialists can help determine whether this treatment is appropriate for your situation.
Wet AMD: What You Need to Know
Wet AMD is less common than dry AMD but tends to cause vision changes more quickly. When recognized and treated promptly, there is a much better chance of preserving meaningful central vision.
The hallmark of wet AMD is macular neovascularization, also called choroidal neovascularization or CNV. This is the growth of abnormal blood vessels beneath the macula. A protein called vascular endothelial growth factor, or VEGF, drives this abnormal vessel growth. These new vessels are fragile and prone to leaking fluid or blood, which distorts the structure of the retina and damages the macula.
If leaking and bleeding continue without treatment, a disciform scar (a fibrous scar that replaces healthy retinal tissue) can form under the macula. This scarring can result in severe, lasting loss of central vision.
Wet AMD can cause vision changes that appear suddenly or develop over a short period. Unlike dry AMD, which tends to progress gradually, wet AMD can shift your vision noticeably in a matter of days.
- Sudden or rapid blurring of central vision
- Straight lines that appear wavy or bent
- Dark spots or blank areas in the center of your visual field
- Colors that look less bright than usual
If you notice any of these symptoms, especially a sudden change, contact a Retina Specialist right away. Prompt evaluation and treatment can make a significant difference in how much vision you are able to preserve.
Wet AMD is treated with anti-VEGF injections, medications injected directly into the eye that block the protein driving abnormal blood vessel growth and leaking. This class of treatment has transformed wet AMD care and gives patients today a much better chance of maintaining central vision than was possible in earlier decades.
Several anti-VEGF medications are available, including Avastin (bevacizumab), Lucentis (ranibizumab), Eylea (aflibercept), and Vabysmo (faricimab), a bispecific antibody that targets both VEGF and a second growth factor called angiopoietin-2. Our Retina Specialists will determine which medication and treatment schedule is best suited for your eye and your response to therapy. Before each injection, numbing eye drops are applied to minimize discomfort. Most patients describe the sensation as mild pressure rather than sharp pain.
Risk Factors and Who Is Most Affected
Certain factors increase the likelihood of developing AMD or experiencing faster progression. Knowing your risk can help you and your care team make informed decisions about monitoring and prevention.
The single strongest risk factor for AMD is age. The condition is uncommon before 50 and becomes significantly more prevalent with each passing decade, particularly after 80. Family history also plays a meaningful role. If a parent or sibling has been diagnosed with AMD, your own risk is higher, and it is important to share that information with your Retina Specialist.
Smoking is one of the most well-established modifiable risk factors for AMD and is associated with both developing the condition and progressing to more advanced stages more quickly. Other factors that may increase risk include obesity, high blood pressure, prolonged sun exposure without UV protection, and being of Caucasian or European descent. Women also tend to have a slightly higher overall risk than men. Reducing modifiable risk factors, especially quitting smoking, can be one of the most impactful steps a person takes for their long-term eye health.
Yes, dry AMD can convert to wet AMD at any stage and sometimes without much warning. Not everyone with dry AMD will develop the wet form, but the risk is real and ongoing. This is one of the most important reasons for staying consistent with regular monitoring appointments. Our Retina Specialists often recommend that patients with dry AMD check their vision at home each day using an Amsler grid, a simple chart with a grid of straight lines and a central dot, to help detect early distortion before it worsens.
Diagnosing AMD
Accurate diagnosis is the foundation of effective AMD management. Our team uses a combination of clinical examination and advanced imaging to understand exactly what is happening in the macula and how the condition is changing over time.
Both types of AMD are identified during a comprehensive dilated eye exam. Dilating eye drops are used to widen the pupil so the Retina Specialist can examine the macula closely for signs of drusen, atrophy, fluid, or bleeding. This examination is the starting point for any AMD diagnosis and an essential part of every follow-up visit.
Optical coherence tomography, or OCT, is a non-invasive imaging test that produces detailed cross-sectional images of the retina. It can reveal fluid beneath or within the retina, thinning of the macula, and areas of geographic atrophy that might not yet be visible during a standard exam. OCT angiography (OCT-A) can map retinal blood flow without dye. Our practice also uses wide-field imaging, fundus photography, and autofluorescence imaging to build a complete picture of your retinal health. Serial retinal photo comparisons at each visit allow our team to track changes in your macula over time with precision.
When wet AMD is suspected, our team may perform fluorescein angiography. A safe dye is injected into a vein in the arm, and photographs are taken as the dye travels through the blood vessels of the retina. This test reveals whether abnormal vessels are leaking, which confirms the presence of wet AMD and helps guide treatment planning. Indocyanine green angiography is another dye-based imaging option that can provide additional detail about deeper blood vessel layers.
Living with AMD and What to Expect
AMD is a long-term condition that requires ongoing care, monitoring, and, in many cases, regular treatment. Understanding what to expect can help you stay engaged in your care and protect your vision over time.
For patients with wet AMD, regular visits to your Retina Specialist for monitoring and injections are essential. Treatment frequency varies depending on the medication used and how your eye responds. Some patients need injections every four weeks, while others may be extended to every 12 or 16 weeks. Skipping appointments or delaying injections can allow leaking to resume and vision to decline. Consistency with your treatment schedule is one of the most important things you can do for your eyes.
Because AMD affects central vision, tasks like reading, driving, and recognizing faces can become more challenging even with treatment. Low-vision aids such as magnifying lenses, large-print materials, and specialized lighting can help maintain daily independence. Many communities offer low-vision rehabilitation services that teach practical strategies for adapting to vision changes, and these programs can make a meaningful difference in quality of life.
Some symptoms require urgent evaluation, not a scheduled appointment. Contact our office right away or go to an emergency room if you experience any of the following.
- A sudden increase in floaters (small specks or spots in your vision)
- New flashes of light in one or both eyes
- A dark curtain or shadow moving across your field of vision
- Sudden blurring or loss of vision
- Rapid onset of new distortion of straight lines
These symptoms can signal that dry AMD has converted to wet AMD, or that wet AMD is actively worsening. Rapid treatment can preserve vision that would otherwise be lost.
Frequently Asked Questions
These answers address questions our patients commonly ask about AMD that go beyond the basics covered above.
The monitoring schedule depends on the severity of your drusen and whether any other risk factors are present. Patients with early dry AMD may need only one to two visits per year, while those with intermediate dry AMD or other concerning features may need to be seen more frequently. Your Retina Specialist will set a schedule based on the specific details of your condition. Between visits, daily Amsler grid monitoring at home adds an important layer of early detection.
Yes, AMD is typically a bilateral condition, meaning it can affect both eyes, though it often develops at different rates in each eye. Having advanced AMD in one eye increases the risk of progression in the other eye. Your Retina Specialist monitors both eyes at every visit and will adjust your treatment plan based on what is happening in each eye individually.
Anti-VEGF injections control wet AMD but do not eliminate it. The underlying tendency of the eye to grow abnormal blood vessels remains, which is why ongoing treatment and monitoring are necessary. Stopping injections without your Retina Specialist's guidance can allow leaking to return and vision to decline. Some patients are able to extend the time between injections as their disease stabilizes, but this is determined on a case-by-case basis.
AREDS 2 supplements were studied for their ability to reduce the risk of progression from intermediate dry AMD to advanced AMD. They are most beneficial for patients at intermediate stages. They have not been shown to reverse damage that has already occurred or to treat wet AMD. If you are unsure whether supplements are appropriate for your stage of disease, your Retina Specialist can review your imaging and advise you directly.
These are two different drug classes treating two different disease processes. Anti-VEGF injections are used for wet AMD and block a protein that drives abnormal blood vessel growth. Izervay (avacincaptad pegol) is a complement inhibitor used for geographic atrophy in advanced dry AMD. It targets a part of the immune system involved in cell destruction and is designed to slow the rate at which GA spreads. The two types of medication are not interchangeable, and each is matched to a specific condition.
Yes. AMD often causes no noticeable symptoms in its early stages, which means it can be present and progressing before you are aware of any vision changes. Adults over 50, and especially those with a family history of AMD or other risk factors like smoking or high blood pressure, should have a comprehensive dilated eye exam to establish a baseline. Detecting AMD early gives your care team the best opportunity to monitor it closely and intervene before significant vision is lost.
Schedule Your AMD Evaluation at Atlantic Retina Center
At Atlantic Retina Center, we exclusively treat the retina, vitreous, and macula, which means every member of our team is focused entirely on conditions like AMD. Our fellowship-trained, board-certified Retina Specialists serve patients throughout the Eastern Shore of Maryland and central and southern Delaware, bringing specialized vitreoretinal care close to home. If you have been diagnosed with AMD, have risk factors, or are experiencing any changes in your central vision, we encourage you to schedule an evaluation with our team so we can help you understand your condition and protect the vision you have.