Disease: Macular degeneration, wet
Wet macular degeneration is a chronic eye disease that causes blurred vision or a blind spot in your visual field. It's generally caused by abnormal blood vessels that leak fluid or blood into the macula (MAK-u-luh). The macula is in the part of the retina responsible for central vision.
Wet macular degeneration is one of two types of age-related macular degeneration. The other type â dry macular degeneration â is more common and less severe. The wet type always begins as the dry type.
Early detection and treatment of wet macular degeneration may help reduce vision loss and, in some instances, recover vision.
Wet macular degeneration care at Mayo Clinic
Wet macular degeneration symptoms usually appear suddenly and worsen rapidly. They may include:
- Visual distortions, such as straight lines seeming bent
- Reduced central vision in one or both eyes
- Decreased intensity or brightness of colors
- A well-defined blurry spot or blind spot in your field of vision
- A general haziness in your overall vision
- Abrupt onset and rapid worsening of symptoms
Macular degeneration doesn't affect side (peripheral) vision, so it rarely causes total blindness.
When to see a doctor
See your eye doctor if:
- You notice changes in your central vision
- Your ability to see colors and fine detail becomes impaired
These changes may be the first indication of macular degeneration, particularly if you're older than age 50.
No one knows the exact cause of wet macular degeneration, but it develops in people who have had dry macular degeneration. Of all people with age-related macular degeneration, about 10 percent have the wet form.
Wet macular degeneration can develop in different ways:
- Vision loss caused by abnormal blood vessel growth. Sometimes abnormal new blood vessels grow from the choroid under and into the macula (choroidal neovascularization). The choroid is the layer of blood vessels between the retina and the outer, firm coat of the eye (sclera). These abnormal blood vessels may leak fluid or blood, interfering with the retina's function.
- Vision loss caused by fluid buildup in the back of the eye. When fluid leaks from the choroid, it can collect between the choroid and a thin cell layer called the retinal pigment epithelium. This may cause a bump in the macula, resulting in vision loss.
Your doctor will review your medical and family history and conduct a complete eye exam. To confirm a diagnosis of macular degeneration, he or she may do several other tests, including:
- Examination of the back of your eye. Your eye doctor will put drops in your eyes to dilate them and use a special instrument to examine the back of your eye. He or she will look for fluid or blood or a mottled appearance that's caused by drusen. People with macular degeneration often have many drusen â yellow deposits that form under the retina.
- Test for defects in the center of your vision. During an eye exam, your eye doctor may use an Amsler grid to test for defects in your central vision. If you have macular degeneration, some of the straight lines in the grid will look faded, broken or distorted.
- Fluorescein angiography. During this test, your doctor injects a colored dye into a vein in your arm. The dye travels to and highlights the blood vessels in your eye. A special camera takes pictures as the dye travels through the blood vessels. The images will show if you have abnormal blood vessels or retinal changes.
- Indocyanine green angiography. Like fluorescein angiography, this test uses an injected dye. It may be used to confirm the findings of a fluorescein angiography or to identify specific types of macular degeneration.
- Optical coherence tomography. This noninvasive imaging test displays detailed cross-sections of the retina. It identifies areas of thinning, thickening or swelling. This test is also used to help monitor how the retina responds to macular degeneration treatments.
People whose wet macular degeneration has progressed to central vision loss may experience depression or visual hallucinations (Charles Bonnet syndrome).
The following measures may help reduce your risk of developing wet macular degeneration:
- Have routine eye exams. Ask your eye doctor how often you need to undergo routine eye exams. A dilated eye exam can identify macular degeneration. In between checkups, you can do a self-assessment of your vision using an Amsler grid.
- Manage your other medical conditions. For example, if you have cardiovascular disease or high blood pressure, take your medication and follow your doctor's instructions for controlling the condition.
- Don't smoke. Smokers are more likely to develop macular degeneration than are nonsmokers. Ask your doctor for help to stop smoking.
- Maintain a healthy weight and exercise regularly. If you need to lose weight, reduce the number of calories you eat and increase the amount of exercise you get each day. Maintain a healthy weight by exercising regularly and controlling your diet.
- Choose a healthy diet. Include fruits, leafy greens, nuts and fish high in omega-3 fatty acids, such as salmon.
- Take certain nutritional supplements.If you have intermediate or advanced macular degeneration, taking supplements with high levels of vitamins C and E, zinc and copper may reduce the risk of vision loss, the American Academy of Ophthalmology says. Ask your doctor if taking supplements is right for you.
Coping and support
Vision loss from macular degeneration can affect your ability to do things such as read, recognize faces and drive. These tips may help you cope with your changing vision:
- Ask your eye doctor to check your eyeglasses. If you wear contacts or glasses, be sure your prescription is up to date.
- Use magnifiers. A variety of magnifying devices can help you with reading and other close-up work, such as sewing. Such devices include hand-held magnifying lenses or magnifying lenses you wear like glasses. You may also use a closed-circuit television system that uses a video camera to magnify reading material and project it on a video screen.
- Change your computer display and add audio systems. Adjust the font size in your computer's settings. And adjust your monitor to show more contrast. You may also add speech-output systems or other technologies to your computer.
- Use electronic reading aids and voice interface. Try large-print books, tablet computers and audio books. Some tablet and smartphone apps are designed to help people with low vision. And many of these devices now come with a voice recognition feature.
- Select special appliances made for low vision. Some clocks, radios, telephones and other appliances have extra-large numbers. You may find it easier to watch a television with a larger high definition screen, or you may want to sit closer to the screen.
- Use brighter lights in your home. Better lighting helps with reading and other daily activities, and it may also reduce the risk of falling.
- Consider your transportation options. If you drive, check with your doctor to see if it's safe to continue doing so. Be extra cautious in certain situations, such as driving at night, in heavy traffic or in bad weather. Use public transportation or ask a friend or family member to help, especially with night driving. Make arrangements to use local van or shuttle services, volunteer driving networks, or rideshares.
- Get support. Having macular degeneration can be difficult, and you may need to make changes in your life. You may go through many emotions as you adjust. Consider talking to a counselor or joining a support group. Spend time with supportive family members and friends.
Factors that may increase your risk of macular degeneration include:
- Age. This disease is most common in people over 65.
- Family history. This disease has a hereditary component. Researchers have identified several genes related to developing the condition.
- Smoking. Smoking cigarettes or being regularly exposed to smoke significantly increases your risk of macular degeneration.
- Obesity. Research indicates that being obese increases the chance that early or intermediate macular degeneration will progress to a more severe form of the disease.
- Cardiovascular disease. If you have diseases that affect your heart and blood vessels, you may be at higher risk of macular degeneration.
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