Managing age-related macular degeneration (AMD) is a significant focus for primary care optometrists. With an early diagnosis, OD's can take potentially life-altering steps long before patients hit the intermediate stage and are forced to struggle with vision loss. The longer clinicians can keep patients from advancing to wet AMD and needing injections, the better off they will be.
In a recent study, subjects with impaired dark adaptation were twice as likely to develop clinically evident AMD and eight times as likely to advance beyond the earliest stage of AMD. Usually expressed as "night vision difficulties" impaired dark adaptation is often among the first detectable consequences of AMD and a method of identifying patients with potential sub clinical disease.
Many changes to an AMD patient's lifestyle can help avoid further central vision loss and retinal damage. Once diagnosed with early AMD, optometrists can encourage patients to take the following steps:
- More frequent examinations. Moving from a 12 to a six-month follow-up interval is useful for monitoring disease progression.
- Stay healthy. Following a healthy diet, exercising regularly and maintaining overall health are sound goals for all patients. One study found that women who followed a healthy diet, engaged in physical exercise, and avoided smoking had a substantially lower risk of early AMD compared with women who did not follow these healthy lifestyles. A Mediterranean diet is another consideration, as studies suggest those who consume a Mediterranean-style diet carry an overall lower risk of developing advanced AMD compared with those who regularly consume a traditional Western diet.
- Advocate for an active lifestyle.
- Recommend supplements and blue light-blocking lenses.
- Timely referral to a retinal specialist.
With an earlier diagnosis, optometrists can do more than let AMD run its course and eventually rob patients of their sight.
Excerpted from Dr. Jeffry Gerson, OD Review of Optometry September 2017