ENAge-related macular degeneration does not take away all sight, only its middle: faces become hard to recognise, a line of print breaks apart, a straight door frame looks bent. Side vision stays, so people long tell themselves they “just need new glasses”.
This page explains macular degeneration treatment in Germany: how the dry and wet forms differ, what a German clinic does at the first appointment, how eye injections work and why success depends not on one trip but on keeping treatment going. Wet-form injections are a regimen lasting years. General overview: eye clinics in Germany.
Dry and wet form: a difference of pace
The difference is pace: the dry form takes years, the wet form far less. The macula, the pinhead-sized centre of the retina, handles reading, faces and fine work. In the dry form, deposits called drusen build up and the cells thin out: a slow process of years, sometimes decades.
In the wet form, fragile new vessels grow under the retina and leak fluid and blood, and central vision can worsen within weeks. That is why bent straight lines or a sudden central spot call for an urgent eye examination, not for waiting until the holidays.
The dry form can turn into the wet one, and the wet form always develops in an already changed macula: not two diseases but two states of one. In their current joint statement (in German), Germany’s ophthalmological societies call the wet form a chronic, progressive disease usually needing monitoring, and if necessary treatment, for many years. Macular swelling in diabetes or retinal vein occlusion is a different diagnosis with its own approach; see retina treatment in Germany.
What a German clinic does at the first appointment
At the first appointment, diagnosis rests on images of the retinal layers, not on visual acuity. The basis is optical coherence tomography (OCT), a contact-free scan showing the macula in cross-section and any fluid under the retina; later scans track the response to treatment.
OCT angiography is added and, if the wet form is suspected, at least before the first injection, fluorescein angiography: a dye injected into a vein shows the new vessels themselves. In the dry form, separate autofluorescence images measure the areas of atrophy, where retinal cells have died.
For visitors, scans and reports from home are reviewed and compared, but the OCT is almost always repeated: later checks need a fresh image from the same device. The appointment is with an ophthalmologist specialising in retinal disease, not any eye doctor; see the ophthalmologist in Germany page.
Anti-VEGF injections: how it actually works
For the wet form, the main treatment is an intravitreal injection: a drug injected into the eye. These drugs block VEGF, the growth factor that makes new vessels grow and leak; the fluid clears, and vision improves in some patients and stops worsening in others. No guarantees are given.
The injection is given under sterile conditions in an operating room after anaesthetic drops and takes minutes; patients usually describe pressure, not pain. It starts with several injections, usually three, about a month apart; then the doctor gradually extends the intervals guided by OCT, the treat-and-extend principle.
Crucially for patients from abroad: this is not one procedure but a regimen lasting years. Missed months usually cannot be made up, so agree from the start where the next injections will be given and who will read the OCT at home; a written plan with the drug name and intervals is needed straight away. Macular disease is managed in the retina departments of German eye clinics. Among AlenMed’s partners, the University Eye Hospital in Tuebingen is headed by Prof. Karl Ulrich Bartz-Schmidt, with vitreoretinal surgery led by Prof. Spyridon Dimopoulos; at the Herzog Carl Theodor Eye Clinic in Munich, senior physician Prof. Christos Haritoglou works on macular disease and intravitreal therapy.
What is done in the dry form and what depends on the patient
Anti-VEGF injections are not used in the dry form; here the work is monitoring and protecting what is left: regular OCT, self-checks on an Amsler grid (a simple grid on which patients spot bent lines themselves) and giving up smoking, the one reliably proven modifiable risk factor. New drugs exist for geographic atrophy, the late stage of the dry form, but none is currently authorised in the EU, so availability and indications are a question for the clinic.
The practical part helps more than patients expect: choosing magnifying aids and lighting, reading techniques and, if needed, a low-vision consultation. Many patients also have a cataract, and the order of procedures is decided by the doctor, not the patient; see cataract treatment in Germany.
Frequently asked questions
Can macular degeneration be cured?
Not completely, but its course can be held back. In the wet form, injections clear fluid under the retina; vision improves in some patients and stops worsening in others. In the dry form, regular OCT, Amsler grid checks and not smoking protect what is left. No doctor can promise a result.
Can all injections be done in one trip?
No. In the wet form, injections are a regimen lasting years: several about a month apart, then longer intervals set by OCT, and nobody can say in advance how many will be needed. Treatment can start in Germany and continue at home under a written plan.
What if vision worsens between injections?
See an ophthalmologist wherever you are as soon as possible, without waiting for the planned visit: bent straight lines or a new central spot need an urgent examination. Between visits, check each eye on an Amsler grid and keep your latest OCT scans and treatment plan to hand for the local doctor.
How AlenMed arranges treatment for macular degeneration
AlenMed sends an eye clinic the OCT and angiography files, the ophthalmologist’s reports and a record of which drugs have been injected and how often. The doctor answers which tests must be repeated, how many injections are planned for this trip and how to continue. Then come a written estimate, a visa invitation, an interpreter at appointments and an escort: after an injection, someone must take the patient back to their accommodation.
Plan ahead: bring all previous images, not just the latest report; leave a few days between the injection and the flight home for a check-up; ask for a written plan with dates and the drug name, translated for your home ophthalmologist.
This material is for information only and is not an offer. The indication and injection schedule are decided by a doctor in person.
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