Wet age-related macular degeneration (wet AMD) is an advanced form of macular degeneration in which abnormal blood vessels grow beneath the retina, leak fluid and blood, and damage the central vision you rely on for reading, driving, and recognizing faces. It accounts for a smaller share of all AMD cases than the dry form, but it is more immediately threatening to sight. Unlike dry AMD, which can progress slowly over years and sometimes never affects vision at all, wet AMD always impacts central vision and can cause noticeable changes within days or weeks.
How Wet AMD Develops
The retina sits at the back of your eye and converts light into the signals your brain reads as images. Beneath the retina is a thin layer of support cells called the retinal pigment epithelium (RPE), which sits on top of a membrane that separates it from the blood supply underneath. As you age, waste products accumulate on that membrane, thickening it and reducing blood flow to the retina. The tissue becomes starved of oxygen.
In response, your body ramps up production of a protein called vascular endothelial growth factor, or VEGF. VEGF’s normal job is to stimulate new blood vessel growth, but the vessels it creates in the macula (the small, detail-rich center of your retina) are fragile and poorly formed. They leak plasma, blood, and proteins into and under the retina, warping its structure and destroying the photoreceptor cells responsible for sharp central vision. This process, called choroidal neovascularization, is what distinguishes wet AMD from dry AMD.
Risk Factors
Age is the strongest predictor. Compared to people aged 55 to 69, those between 70 and 79 have roughly 4 to 9 times the risk, and people aged 80 to 86 face an 18- to 32-fold increase. Smoking is the second most consistent risk factor: current smokers have a 2- to 4-fold higher risk of AMD than people who have never smoked.
Genetics also play a significant role. Variants in genes involved in the immune complement system, particularly complement factor H (CFH), are strongly linked to AMD risk. Family history matters: if a parent or sibling has AMD, your own odds go up substantially. Other risk factors include high blood pressure, obesity, and a diet low in leafy greens and fish.
What It Looks Like From the Inside
The hallmark symptom is distorted central vision, a phenomenon called metamorphopsia. Straight lines, like door frames or text on a page, appear wavy or bent. Objects may look bigger, smaller, or slightly misshapen, as if you’re looking through someone else’s glasses. Some people notice a blurry or dark patch near the center of their field of view that makes it hard to see fine details or read.
These distortions are more severe in wet AMD than in most other eye conditions because the damage is concentrated in the macula, the area responsible for color perception and high-resolution detail. Peripheral vision typically remains intact, so you can still navigate a room, but the central blind spot makes tasks like reading, cooking, or watching television increasingly difficult. Symptoms often appear in one eye first, which can make them easy to miss since the other eye compensates.
How It’s Diagnosed
An ophthalmologist can detect wet AMD during a dilated eye exam, but the diagnosis is confirmed with imaging. Optical coherence tomography (OCT) uses light waves to create a cross-sectional picture of your retina, revealing even tiny pockets of fluid beneath or within the retinal layers, thickening of the tissue, or detachment of the RPE layer. These are the earliest and most reliable signs of active disease.
In some cases, a fluorescein angiography is also performed. A dye is injected into a vein in your arm, and a special camera photographs the dye as it travels through the blood vessels in your retina. Leaking vessels glow brightly, pinpointing the location and extent of the abnormal growth. Together, these two tests give your doctor a detailed map of the disease and guide treatment decisions.
Treatment With Eye Injections
The standard treatment is a series of injections directly into the eye that block VEGF and slow or stop the growth of abnormal blood vessels. The three most established medications are ranibizumab (Lucentis), aflibercept (Eylea), and bevacizumab (Avastin). All work by binding to VEGF so it can no longer trigger new vessel formation or increase leakage from existing vessels.
Treatment typically begins with a loading phase of three monthly injections. After that, your doctor monitors your retina with OCT scans and adjusts the schedule based on how your eye responds. Many patients move to a “treat and extend” approach, where the interval between injections is gradually lengthened as long as the disease stays quiet.
Newer options are extending the time between visits. Eylea HD, a higher-dose version of aflibercept, was recently FDA-approved and can last 3 to 4 months between injections. Faricimab (Vabysmo) targets both VEGF and a second protein called angiopoietin-2 that contributes to vessel instability. Most patients on Vabysmo can also go 3 to 4 months between treatments. For people who found monthly injections burdensome, these longer-lasting options represent a meaningful quality-of-life improvement.
What to Expect During Injections
The idea of a needle in the eye sounds alarming, but the procedure is quick and largely painless. Your eye is numbed with anesthetic drops, the surface is cleaned, and the injection itself takes only a few seconds. Most people feel pressure rather than pain. You may have mild soreness, redness, or floaters afterward, but these usually resolve within a day or two. The entire appointment, including prep time, typically takes about 15 to 30 minutes.
Monitoring Your Vision at Home
Between appointments, an Amsler grid is one of the simplest tools for catching changes early. It’s a square grid of evenly spaced lines with a dot in the center, and you can print one or view it on a screen. To use it, wear your normal reading glasses, hold the grid 12 to 15 inches from your face in good light, cover one eye, and focus on the center dot. Without moving your eye from that dot, notice whether any of the surrounding lines look wavy, blurry, dark, or blank. Repeat with the other eye.
Do this once a day. If you notice any new distortion, darkness, or blank spots that weren’t there before, contact your ophthalmologist right away. Early detection of a flare-up means earlier treatment, which gives you the best chance of preserving the vision you still have.
Living With Wet AMD
Wet AMD is a chronic condition. Treatment can stabilize vision and, in many cases, recover some of what was lost, but it requires ongoing monitoring and injections for years. Stopping treatment typically allows the disease to reactivate. The good news is that with consistent anti-VEGF therapy, many people maintain functional central vision well into their later years.
Low-vision aids, including magnifying readers, large-print devices, and screen magnification software, can help bridge the gap for tasks that become difficult. Bright, direct lighting when reading and high-contrast settings on phones and computers make a noticeable difference. Quitting smoking, eating a diet rich in dark leafy greens, and managing blood pressure won’t reverse existing damage, but they reduce the stress on your retina and may slow progression in the other eye if it hasn’t yet been affected.