What is the difference between Dry and Wet AMD?

Macular degeneration (known as AMD) is a disease common in people aged 65+ that causes damage to the retina and to central vision and it comes in two forms, dry and wet. Dry AMD is much more common and mild but it can turn into the wet type of macular degeneration and cause more damage to your vision.

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Dry Macular Degeneration

Around 90% of all AMD cases are dry which rarely leads to legal blindness. In this type of macular degeneration, the macula ages and thins out, resulting in clusters of small pieces of protein and fat collecting under the retina called drusen. Dry AMD usually starts in just one eye but is likely to also develop in the other eye over time. In the early stages, a person with dry AMD usually does not notice any change in his or her vision because the effects of dry AMD are very gradual and usually the unaffected eye can compensate for the eye with AMD. It is therefore so crucial to be checked by an eye doctor who can detect the early stages of this disease and help slow down its progression.

Wet Macular Degeneration

Most legal blindness resulting from macular degeneration occurs in 10% of cases which fall under the wet AMD category. The wet type of macular degeneration gets its name from the fact that it damages the eye due to the leakage of fluid and blood under the retina. This results from unstable new blood vessels that form on the retina.

Wet Macular Degeneration
Symptoms

Symptoms

Dry AMD

The symptoms for this more mild form of macular degeneration start gradually and without pain, making it hard for the person with this condition to notice it for the first while as they could be asymptomatic for months or years. A person with dry AMD may notice very subtly over time that their vision starts to decrease and could fluctuate, but is usually best in bright light. Since dry AMD can go undetected at the beginning, it is so important to schedule an appointment with your eye doctor who can start to see early changes in your retina. If dry AMD is diagnosed early, certain precautions can be taken to prevent it from turning into the more serious type of wet AMD which can cause serious vision loss.

Wet AMD

In contrast to the gradual symptoms of dry AMD, in wet AMD, the onset of symptoms could be sudden with a rapid progression.

If you have wet AMD, you may notice certain differences in your vision, such as:

  • Straight lines looking more curvy and distorted - as if you’re looking in a mirror that’s bent out of shape
  • You no longer see as clearly with your glasses like you used to
  • Recognizing faces may be more challenging
  • Difficulty adapting to dim lights
Symptoms

Diagnosis

Various tests are performed by your eye doctor in order to conclusively diagnose this condition. You will be asked to share your medical history, any symptoms or changes in your vision and if any of your first degree relatives have macular degeneration. The eye doctor will use eye drops to dilate your pupils which enables a non-invasive examination of the retina where the doctor can check for characteristic signs of macular degeneration, such as yellow spots called drusen or abnormal blood cells.

 

In addition, there are various other diagnostic tools available which can display damage to the retina. One such method, Ocular Coherence Tomography (OCT) is a special machine used for imaging of the retina in which any changes, such as those that are seen in AMD, can be clearly detected. Another option is fluorescein angiography where dye is injected into the vein of the arm and this dye travels to the eye. A picture of the retina is taken to show the dye which highlights any leakage or retinal changes resulting from AMD. 

 

The eye doctor will also check your vision to detect any changes and will use the Amsler grid for this purpose. This tool is a small black and white grid that the patient simply looks at and can determine if any of the lines look distorted or have disappeared which can help identify any visual changes such as a blind spot. You will likely be given an Amsler grid to use at home in order to screen for any changes or progression of AMD. There are many effective tools we have today to ensure a proper diagnosis of macular degeneration.

Common Questions

How do I know how to distinguish if I have dry or wet AMD? The best way to figure it out is to go see your eye doctor who will be able to take a look at your retina and based on different findings a clear diagnosis can be established. The main sign of dry AMD are yellow spots on the retina called drusen which is present in patients with macular degeneration. If this condition progresses then dry AMD becomes wet AMD. In wet macular degeneration, the eye doctor will see signs of atypical blood vessels forming on the retina, known medically as neovascularization. In addition to these findings, the eye doctor will discuss with you your symptoms and will check to see if there is a decrease in your visual abilities. The eye doctor will use various diagnostic testing methods to figure out whether you have macular degeneration and if it falls under the dry or wet category.
For dry AMD, the main goal is early detection and preventing it from turning into wet AMD. The dry category does not cause significant damage to our vision but it’s a warning that the retina is at high risk for developing unstable blood vessels which can cause wet macular degeneration. If you have dry AMD, your eye doctor will recommend an effective vitamin supplement in order to prevent vision loss. The supplement contains vitamins C and E, lutein, zeaxanthin, zinc and copper. In addition, your eye doctor will recommend that you do a quick and easy at home screening test with a small black and white card called an Amsler grid to make sure that your condition is not turning into wet AMD. You take a look at this grid with one eye at a time and you’re asked to pay attention if any of the lines appear to be curvy or distorted or if any of the lines disappear which could attest to a blind spot. If there are any unusual changes in the appearance of the grid then you should consult your eye doctor who can check if there are any changes in your retina that could lead to wet AMD. In wet AMD, the visual damage is caused by abnormal new blood vessels that form in the retina. There is an effective treatment for this using injections that are called anti-VEGF which can stop vision loss and even reverse the damage caused by AMD.
What is the difference between Dry and Wet AMD?
Dr. Ikeda cartoon

Summary

Macular degeneration is a common eye disease in people aged 65+ and thankfully there are wonderful ways your eye doctor can detect this condition early in order to prevent visual damage. There is also very effective treatment available for those who are experiencing changes in their vision. It is important to understand the difference between the more mild dry AMD as opposed to wet AMD so that the proper precautions can be taken to avoid serious vision loss.  It is very highly recommended for people aged sixty or over to be monitored for macular degeneration. If you are in this age group, or have a family history of macular degeneration or any suspicion that you might be experiencing changes in your vision, please schedule an appointment at our office. The eye doctor will check for AMD and will guide you with the necessary precautions and measures you can take to preserve the health of your eyes.

Testimonials


  • I haven't actually used the optometrist side, so my review is limited to the vision therapy offered.  This office was recommended by my occupational therapist for the treatment of my double vision following a stroke.


    Claire A.

  • Love this location. I had a brain injury accident from day one one. All the team make you feel you still important and hope in the horizon after when the medical system fell you miserably. Dr. Ikeda very professional and very understanding about your issue. Two tombs up.


    Jim K.

  • My husband and I were immediately impressed with Dr Ikeda. I was hit by a car while cycling which caused broken bones and three brain injuries. The brain injuries caused double vision. Dr. Ikeda examined my eyes and got me started on vision therapy with his occupational therapist who specializes in vision therapy.  She (Chris) is absolutely great.  I am impressed with the array of tools used to help recover my binocular vision.  I am doing things I never thought were possible (balance boards etc).  Chris pushes me and keeps me motivated. I really enjoy my sessions with her.  The office staff is always friendly and they have a wonderful appointment reminder tool that makes it easy to keep my calendar up to date. I am happy the rehab center at Little Co. of Mary recommended them!!


    Teresa S.

  • The Vision Therapy is handled in a separate office through a different door from the shared waiting room. Chris, the vision therapist, has a wide and varied assortment of tools, equipment and resources to best evaluate and treat most vision issues. After just a few visits, my double vision became easier to control, using exercises developed during the therapy process. It was time well-spent.


    Joe M.

  • I have been coming here since I can remember. I love it here. The staff is so amazing and nice. They explain everything they gonna do and never make you feel rushed. Dr. Ikeda has always been my doctor and I would never want another one. He is the doctor for my whole family and is always asking how everyone is doing. I am also so crazy about picking out my frames and have to try so many and each person who helps me take the time and lets me try them all on. I would never want to go anywhere else! I definitely would recommend this office to anyone looking for a great eye doctor.


    Kayla W.

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