Dry and wet macular degeneration: What is the difference?

Age-related macular degeneration (AMD) is one of the most common causes of vision loss in older adults. In Austria, hundreds of thousands of people are affected — many of them without even knowing it. But what exactly is this condition, and what distinguishes the dry form from the wet form?

What Is the Macula?

The macula is the central area of the retina and is responsible for sharp, detailed vision. It allows us to recognise faces, read, and perceive fine details. When this area is damaged, central vision is affected first — peripheral (side) vision, however, usually remains intact.

Dry AMD — the More Common Form

Approximately 85–90% of all AMD cases are dry AMD. It develops through a gradual ageing process and the slow deterioration of retinal cells in the macular area. A characteristic feature is the formation of drusen — small deposits beneath the retina — that accumulate over time.

Typical symptoms:

• Blurred or reduced sharpness in the centre of the visual field

• Colours appear duller or less vivid

• Difficulty reading, especially in poor lighting

Dry AMD generally progresses slowly — over months or years. In advanced stages, it can lead to so-called geographic atrophy, where larger areas of the retina deteriorate irreversibly.

There is currently no curative treatment for early-stage dry AMD. For the advanced form (geographic atrophy), however, newly approved medications are now available that can slow its progression. Certain dietary supplements (known as AREDS vitamins) can also reduce the risk of deterioration in intermediate AMD.

Wet AMD — the More Aggressive Form

Wet AMD is less common but significantly more aggressive. In this form, abnormal new blood vessels grow beneath the retina. These vessels are fragile and leaky — they can release fluid or blood into the retina, leading rapidly to severe vision loss.

Typical symptoms:

• Sudden or rapidly worsening blurred vision

• Distorted vision (straight lines appear wavy or bent — known as metamorphopsia)

• A dark or grey spot in the centre of the visual field

Wet AMD is an ophthalmic emergency: if you notice sudden distortion of vision, you should see a specialist without delay, as every day counts.

How Is Wet AMD Treated?

The good news: wet AMD can be treated effectively today. The most important therapy is intravitreal injections — known as IVOM — in which medication is injected directly into the vitreous body of the eye. These so-called anti-VEGF agents inhibit the growth of abnormal blood vessels and can, in many cases, not only halt progression but also improve vision.

The injections may sound daunting, but in practice they are well tolerated and virtually painless — they are performed under sterile conditions with local anaesthesia.

When Should You See a Doctor?

As a general rule: the earlier AMD is detected, the better the treatment options. The following warning signs should be taken seriously and assessed promptly:

• Blurred or distorted vision

• Straight lines appear wavy (e.g. door frames, tiles)

• A dark spot in the central visual field

A simple self-test is the Amsler grid — a checked pattern that allows you to monitor your central visual field on a daily basis. Ask your eye doctor about it.

If you have any questions about macular degeneration or notice any of the symptoms described above, we are happy to see you at our practice. An early examination can make all the difference.