MANAGING PATIENTS WITH AMD
This section covers some point on managing patients with AMD, including:
Vision rehabilitation
Research by Lighthouse International in 1995 showed that 94% of adults reporting vision problems did not take advantage of any vision rehabilitation services.
Studies have shown that referral to low vision or psychological/psychiatric services, or to vision rehabilitation services, occupational therapy or support groups may improve patient functional status and quality of life. It is preferable to refer patients early in disease progression so that relationships and skills are developed.
Low vision rehabilitation services include prescription of low vision optical and non-optical devices, absorptive lenses, and electronic assistive devices, as well as training in independent and safe travel and modifying the home and work environment.
Certified vision rehabilitation teachers train patients in new ways to accomplish everyday tasks and alternative methods for navigating safely while moving through their everyday lives, thereby increasing patient satisfaction and quality of life.
Monitoring
Monitoring patients with AMD is important. Eligible lesions should be considered for treatment when they are first observed; lesions need to be monitored regularly because disease progression may result in growth of lesions or conversion from treatable to untreatable lesions or from untreatable to treatable lesions.In addition, treating ophthalmologists can play a key role in referring appropriate patients for low vision rehabilitation services, psychological services, etc. and in this way impact a patient's quality of life.
Useful field of vision
Patients can be taught eccentric viewing techniques to compensate for central scotomas.
Knowledge of the scotoma position relative to fixation can help in predicting difficulties faced, for example in returning to the left hand margin on a page when reading (scotoma to the left of the PRL) or hand-eye coordination (large central scotoma).
Additional magnification or illumination can also be useful for certain patients.
Measure to minimize loss of vision
Patients can monitor the health of their eyes and help to minimize visual loss by:
- scheduling routine eye examinations
- eating dark green leafy and orange vegetables
- protecting eyes from the sun
- not smoking
- controlling blood pressure and serum cholesterol levels
If strictly applied over several years, vitamin supplements could reduce the visual loss of over 250,000 Americans who are at high risk of developing advanced AMD.The Age-Related Eye Disease Study (AREDS) has found that selected patients with AMD treated with high doses of antioxidants and zinc have a 27% lower relative risk at 5 years of developing advanced AMD and moderate visual loss compared with a placebo group.
