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Wet macular degeneration

Wet macular degeneration is a chronic eye disease that causes vision loss in the center of your field of vision. Wet macular degeneration is generally caused by abnormal blood vessels that leak fluid or blood into the region of the macula (MAK-u-luh). The macula is in the center of the retina (the layer of tissue on the inside back wall of your eyeball).

Wet macular degeneration is one of two types of age-related macular degeneration. The other type — dry macular degeneration — is more common and less severe. Wet macular degeneration almost always begins as dry macular degeneration. It's not clear what causes wet macular degeneration.

Early detection and treatment of wet macular degeneration may help reduce vision loss and, in some instances, improve vision.

Symptoms Causes Risk factors Prevention

Wet macular degeneration symptoms usually appear and progress rapidly. Symptoms may include:

  • Visual distortions, such as straight lines appearing wavy or crooked, a doorway or street sign looking lopsided, or objects appearing smaller or farther away than they really are
  • Decreased central vision
  • Decreased intensity or brightness of colors
  • Well-defined blurry spot or blind spot in your field of vision
  • Abrupt onset
  • Rapid worsening
  • Hallucinations of geometric shapes, animals or people, in cases of advanced macular degeneration

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.

It's not clear what causes wet macular degeneration. The condition almost always develops in people who have had dry macular degeneration. But doctors can't predict who will develop wet macular degeneration, which is more severe and progresses more rapidly than dry macular degeneration.

Wet macular degeneration can develop in different ways:

  • Vision loss caused by abnormal blood vessel growth. Wet macular degeneration may develop when abnormal new blood vessels grow from the choroid — the layer of blood vessels between the retina and the outer, firm coat of the eye, called the sclera — under and into the macular portion of the retina. This condition is called choroidal neovascularization.

    These abnormal vessels may leak fluid or blood between the choroid and macula. The fluid interferes with the retina's function and causes your central vision to blur. In addition, what you see when you look straight ahead becomes wavy or crooked, and blank spots block out part of your field of vision.

  • Vision loss caused by fluid buildup in the back of the eye. Wet macular degeneration sometimes may develop when fluid leaks from the choroid and collects between the choroid and a thin cell layer, called the retinal pigment epithelium (RPE). This may cause retinal pigment epithelium detachment.

    The fluid beneath the RPE causes what looks like a blister or a bump under the macula.

Factors that may increase your risk of macular degeneration include:

  • Age. Your risk of macular degeneration increases as you age, especially after age 50. Macular degeneration is most common in people older than 65.
  • Family history of macular degeneration. If someone in your family had macular degeneration, you're more likely to develop macular degeneration.
  • Race. Macular degeneration is more common in whites (Caucasians) than it is in other races.
  • Smoking. Smoking cigarettes increases your risk of macular degeneration.
  • Obesity. Being severely overweight increases the chance that early or intermediate macular degeneration will progress to the more severe form of the disease.
  • Diet. A diet that includes few fruits and vegetables may increase the risk of macular degeneration.
  • High blood pressure. Diseases that affect the circulatory system, such as high blood pressure or high cholesterol, may increase the risk of macular degeneration.
  • Inflammation. Your immune system can cause swelling of your body tissues, which may increase the risk of macular degeneration.
  • Cardiovascular disease. If you have had diseases that affected your heart and blood vessels (cardiovascular disease), you may be at higher risk of macular degeneration.

The following measures may help you avoid macular degeneration:

  • Have routine eye exams. Ask your eye doctor how often you should undergo routine eye exams. A dilated eye exam can identify macular degeneration.
  • 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.
  • Stop smoking. 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 diet rich in fruits and vegetables. Choose a healthy diet that's full of a variety of fruits and vegetables. These foods contain antioxidant vitamins that reduce your risk of developing macular degeneration.
  • Include fish in your diet. Omega-3 fatty acids, which are found in fish, may reduce the risk of macular degeneration. Nuts, such as walnuts, also contain omega-3 fatty acids.
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