Wet age-related macular degeneration: symptoms and eye injection treatment

The macula is the central part of the retina that gives the sharp detailed vision used for reading, driving and recognising faces. The Macular Society explains that in wet AMD abnormal blood vessels grow into the macula and leak blood or fluid, causing scarring and rapid loss of central vision.

The NHS says AMD does not cause total blindness but can make reading and recognising faces difficult. Without treatment, vision may deteriorate gradually over several years and then worsen quickly over weeks or months.

Early AMD may not cause any symptoms. As it progresses, the Macular Society lists the following changes.

• Blurry or fuzzy central vision.

• Straight lines looking wavy or distorted.

• Difficulty recognising faces.

• Trouble seeing in low light.

• Dark or empty spots in the centre of vision.

• Difficulty with reading, driving or close-up work.

AMD usually first affects people in their 50s, according to the NHS, and the Macular Society describes it as the biggest cause of sight loss in the UK. The exact cause is unknown, but links are recorded with age, smoking, high blood pressure, being overweight and family history. NICE lists the same group of risk factors and adds a diet low in omega 3 and 6, vitamins and minerals, a diet high in fat, lack of exercise, and AMD already present in the other eye.

The Macular Society says smokers are up to four times more likely to develop AMD than non-smokers, and that stopping smoking after diagnosis can help reduce the chance of the eye condition worsening.

Diagnosis begins with a comprehensive eye examination including a dilated retinal check. The Macular Society lists the tests that help determine the type and stage of AMD.

There is no cure, but the NHS says treatments can help slow down changes in vision. For wet AMD these are injections of anti-VEGF medicine given directly into the eye, and light treatment to destroy the vessels causing the problem. The Macular Society names Lucentis, Eylea, Beovu and Vabysmo as examples of anti-VEGF drugs, which stop abnormal blood vessel growth.

NICE sets out the timing: eyes with confirmed active wet AMD for which treatment is recommended should be treated as soon as possible, within 14 days of referral to the macular service. The referral itself should normally be made within 1 working day but does not require an emergency referral. Treatment is delivered by a team that may include an optometrist and an ophthalmologist, with regular check-ups so that treatment can be adapted.

Practical help includes magnifiers, large-print materials, screen readers, better lighting, contrast adjustments, vision rehabilitation services and emotional support. NICE also notes that some people with AMD develop visual hallucinations associated with retinal dysfunction, known as Charles Bonnet syndrome, and that registration as sight impaired or severely sight impaired can unlock benefits and entitlements.

On driving, the Macular Society says many people with early or dry AMD can drive safely, but you must declare to the DVLA if AMD affects both eyes or your vision is below driving standards.

Because timing matters, anyone with new central distortion should seek an urgent optometrist or eye casualty assessment rather than waiting for a routine appointment. Anti-VEGF injections are available on the NHS for eligible patients, and some private providers offer assessment, scans and injections. The Macular Society notes that OCT scans on the high street may carry an additional fee. Ask any private provider about the number of visits and who will manage ongoing monitoring.