When the macula is in its normal configuration (i.e., when it has its normal curve in the back of the eye), images that are seen by the macula are transmitted to the brain and recognized as being straight. When wet macular degeneration occurs, leakage and bleeding underneath the macula distort the normal architecture of the macula.
Instead of having its normal curves,there will be areas that are elevated and irregular. An image that is now projected onto the macula is interpreted by the brain as being bumpy or irregular because the brain is not capable of differentiating an irregular or bumpy image from an irregular or bumpy macula. Therefore, the brain perceives any abnormality in the macula contour as an irregular or bumpy image.
Another common complaint is that images in the affected eye seem smaller than in the unaffected eye. This distortion is due to the photoreceptor cells, the cells in the macula that sense light and send an impulse to the brain, being distorted or swollen in such a way that fewer of them occupy a given space.
For instance, if it normally took five cells to cover a certain area and, because of blood and fluid in and around the cells, only three are now able to occupy the same space, then the brain will interpret an image covering that same space as only being three cells big instead of five.
The image is the same size, but the brain will think it is smaller because it only is touching three cells rather than five. Often, this distortion improves with successful treatment of wet macular degeneration; however, it rarely improves back to normal. Usually there is some mild persistent abnormality.