Dry AMD is the more common form. It can progress gradually as retinal cells in the macula become damaged. In advanced dry AMD, areas of retinal tissue can deteriorate in a process known as geographic atrophy.
Wet AMD is less common but can cause faster and more severe changes. It occurs when abnormal blood vessels grow beneath or within the retina and leak blood or fluid, damaging the macula.
Both forms can result in significant loss of central vision.
The National Eye Institute emphasizes that AMD usually does not cause complete blindness. Instead, the condition can severely damage the central vision required for reading, recognizing faces and seeing fine details.
That distinction is particularly important when discussing Dench's condition.
Her experience should not automatically be interpreted as total blindness. Rather, her comments describe extremely severe impairment of the central vision that she once relied upon for acting and everyday activities.
Dench has experienced different forms of AMD
When Dench first revealed her diagnosis in 2012, she explained that she had wet AMD in one eye and dry AMD in the other and had undergone treatment intended to slow further damage.
That earlier treatment is consistent with what is known about wet AMD.
Today, anti-VEGF injections are a major treatment for neovascular or wet AMD. These medications target vascular endothelial growth factor, a protein involved in the growth and leakage of abnormal blood vessels in the retina.
According to the National Eye Institute, anti-VEGF injections can slow or stop vision loss associated with wet AMD, although they often need to be administered repeatedly. Photodynamic therapy is another treatment that may be used in certain cases.
Treatment, however, is not the same as a cure.
AMD can continue to progress despite medical intervention, and the options available depend heavily on the type and stage of the disease.
For advanced dry AMD, particularly geographic atrophy, treatment has historically been much more limited. The National Eye Institute notes that there is currently no treatment that reverses late dry AMD, although research continues and new therapies have emerged for certain forms of advanced disease.
This is part of the reason Dench's recent description of her eyes being beyond treatment should be understood in the context of the specific stage and type of disease she has been experiencing.
Medical advances have changed the outlook for AMD
There is an important historical dimension to Dench's story.
When she was first diagnosed in 2012, treatment for wet AMD had already improved dramatically compared with previous decades. Anti-VEGF drugs had transformed the management of neovascular AMD by slowing abnormal blood vessel growth and, in many cases, preserving or improving vision.
The National Eye Institute describes anti-VEGF therapy as a major development in the treatment of wet AMD.
But medicine still cannot simply restore all vision once advanced retinal damage has occurred.
This is why early detection remains so important.
The National Eye Institute recommends comprehensive eye examinations, particularly for people at increased risk of AMD. Early disease may produce few or no noticeable symptoms, meaning that someone can have retinal changes before realizing that their vision is being affected.
Once central vision begins to deteriorate, however, symptoms may include blurred or distorted areas in the center of vision, difficulty seeing in low light, changes in color perception and trouble recognizing faces.
For some people, straight lines may appear wavy or distorted — an important warning sign that should prompt an eye examination.
A career built around sight and observation
Dench's condition has particular resonance because acting is fundamentally visual.
Actors need to know where they are, where other performers are positioned, where cameras are located and where to direct their gaze. On a film set, small visual cues can determine whether a performance works.
Stage acting can be even more demanding.
An actor may need to navigate a set in front of hundreds or thousands of people, react to fellow performers and move safely around scenery, props and lighting equipment.
As Dench's vision worsened, these demands became increasingly difficult.
In 2024, she acknowledged that her sight loss had effectively made traditional acting extremely difficult and that she needed assistance when moving around in public. Later deterioration has only increased those challenges.
Her decision to step away from conventional acting therefore cannot simply be described as a lack of desire to work.
The physical demands of the profession change dramatically when a performer can no longer reliably see faces, scripts, television screens or surroundings.
Shakespeare remains a bridge to her past
Despite these limitations, Dench has not abandoned performance or Shakespeare.
Her connection with Shakespeare goes back decades and has become one of the clearest examples of how she has adapted her work.
Even when she can no longer rely on printed scripts, she can still access the words through memory and through other people reading aloud.