Dry vs. Wet Macular Degeneration: Key Differences Explained

When patients are told they have macular degeneration, the immediate question is which type. The distinction shapes everything that follows.

Dry AMD

Roughly 85 to 90 percent of cases are dry. Yellow deposits called drusen accumulate under the retina, and over years the light-sensing cells and their supporting layer thin and die.

• Progression is slow, often over many years
• Early and intermediate stages may cause no symptoms
• Advanced dry AMD, called geographic atrophy, produces well-defined blind areas in central vision
• Treatment focuses on AREDS2 supplements for appropriate stages, smoking cessation, cardiovascular health, UV protection, and monitoring. Newer complement-inhibiting injections can slow the growth of geographic atrophy in selected patients.

Wet AMD

About 10 to 15 percent of cases, but responsible for the majority of severe vision loss. Abnormal blood vessels grow beneath the retina and leak fluid and blood.

• Progression can be measured in days to weeks
• Symptoms typically appear suddenly: distortion of straight lines, a dark central spot, rapid blurring
• Treated with anti-VEGF injections, which stop the leakage and frequently recover vision when started early

Conversion: The Thing to Watch For

Dry AMD can convert to wet at any time, and the risk rises with more advanced dry disease and with wet AMD already present in the other eye. Conversion is why we insist on daily Amsler grid testing and prompt reporting of changes. The difference between calling in three days and calling in three months is often the difference between reading and not reading.

Warning Signs to Report Immediately

• New or increased waviness in straight lines
• A new dark or gray spot in central vision
• Sudden blurring in one eye
• Objects appearing different in size between the two eyes

Diagnosis and Monitoring

OCT shows fluid, drusen, and atrophy in cross-section. OCT angiography and fluorescein angiography map abnormal vessels. Fundus autofluorescence tracks geographic atrophy over time. These are painless and fast, and comparing images across visits is what allows early intervention.

What Both Forms Share

Neither causes total blindness — peripheral vision is preserved, so patients continue to walk, move around, and remain independent. Both are strongly linked to smoking, age, family history, and cardiovascular health. And for both, early detection is the strongest predictor of a good outcome.

If you have been diagnosed with AMD and want a second look with advanced imaging, call (954) 633-8202.