10 Questions to Ask Your Eye Doctor About Wet AMDby Lambeth Hochwald Health Writer
Even if you've been dealing with age-related macular degeneration (AMD) for a while, learning your condition has advanced to the "wet" form can be distressing. It means abnormal blood vessels are leaking fluid or blood into the macula, a part of the retina at the back of the eye, and without treatment it can lead to blindness. The first step to managing the fear? Getting answers to your questions. We've got 10 important ones to discuss with your ophthalmologist.
How Will I Know I Have Wet AMD?
Some of the biggest clues that you have wet AMD: experiencing a sudden distortion or decrease in your vision, or developing a clouding, especially in the center of your eye. “If you’re experiencing this, see your doctor right away as this can mean there is bleeding in the eye,” says Raj Maturi, M.D., a clinical spokesperson for the American Academy of Ophthalmology. “Treatment should be started right away.”
What Will Treatment Be Like?
Expect to have regular injections of drugs that block the growth of new blood vessels, such as Beovu (Brolucizumab), Eylea (aflibercept), Lucentis (ranibizumab), Macugen (pegaptanib sodium), or Avastin (bevacizumab), a cancer-therapy injection that’s used off label for wet AMD. Most are given monthly, though Beovu was just approved by the FDA for use every 12 weeks. Yes, all of these drugs require an injection directly into your eye, but experts say there's minimal discomfort. “There is a sensation of pressure, of something in the eye, two to four hours afterwards,” Dr. Maturi says. “If you ever feel anything that makes you uncomfortable, we can always make that go away by doing a numbing shot before the injection.”
Why Do I Need Regular Eye Exams With Wet AMD?
“Once you’re diagnosed with wet AMD, you will be seen regularly to make sure your wet AMD is stable and to find anything else that may have developed since your last appointment,” says Dr. Maturi. In fact, the American Academy of Ophthalmology recommends that all adults have an eye examination at age 40 to preserve their vision, because this is the age when early signs of disease or changes in vision may appear. “It’s important to find eye diseases early,” says Dr. Maturi, so you can get the maximum benefit from treatment.
Will I Go Completely Blind?
“Over the last 10 years, we’ve found that if wet AMD is caught early, we can stop the growth of blood vessels with regular treatment and follow up,” says. Dr. Maturi. But it is important to act fast because wet AMD can cause significant loss of central vision, including the ability to see faces, signs, or fine print. We know that's scary, but your doctor will be your partner in making sure you preserve as much of your sight as possible.
Can You Tell Me About Vitamin Therapy?
While treatment options vary, taking a high-dose combination of antioxidant vitamins and minerals can help delay the progression of wet AMD, says Christopher Walton, M.D., an ophthalmologist in Mobile, AL. “The AREDS II (Age-Related Eye Disease Study II) identified supplementing with vitamins C and E, as well as minerals like zinc and copper, in order to diminish the progression of wet AMD,” Dr. Walton says. “However, you should always check with your doctor before taking any supplements.”
Will I Be Able to Drive, Read, or Watch TV?
It all depends on how advanced your wet AMD is. And, while driving, reading, or watching TV can be challenging with this condition, low-vision aids such as magnifiers and high-powered reading classes can be helpful. “Again, this is why early treatment and intervention is so important,” says Ming Wang, M.D., Ph.D., an ophthalmologist at Wang Vision 3D Cataract & LASIK Center in Nashville. “It offers the very best chance of helping to keep your vision at the best possible level.”
What Is Photodynamic Therapy?
The goal of this type of laser therapy is to control the abnormal growth of blood vessels in the macula, but it only works for certain cases, usually those in which vision loss develops slowly, according to Johns Hopkins Medicine. “Some wet AMD patients do see positive results from photodynamic therapy, which uses targeted laser light to eliminate faulty blood vessels in the retina,” Dr. Walton says. The treatment may be used in conjunction with medication since its benefits tend to be short-term.
Will I Always Be in Treatment?
One of the biggest challenges of wet AMD is the chronic nature of the condition and its treatments. “Patients need to see a specialist for injections as frequently as every four weeks,” Dr. Wang explains. “The treatments can eventually be spaced out, but often need to continue indefinitely. It’s great that we now have treatments for wet AMD that are very effective, but the frequency of these treatments can place a big burden on patients, their families, doctors, and the healthcare system in general.”
Is Wet AMD Genetic?
While environment and lifestyle play a role in the development of wet AMD, your risk for developing it is at least three times higher if you have a family member with AMD than if you don’t. “This is why we want people to get tested as soon as possible, especially if this runs in your family,” Dr. Maturi says. “Early screenings can make all the difference.”
Are There Any New Treatments in Development?
Right now, researchers are focusing on everything from retinal-cell transplants to radiation therapy to prevent new blood-vessel growth under the macula. They’re also zeroing in on more injections that will last for several months versus several weeks. “These are very exciting areas of research,” says Dr. Wang. “If you can get treatments less frequently, it will significantly improve your quality of life. I think there’s a good chance we will see new longer-lasting treatments in the not-too-distant future.”