Working with Your Doctors
A diagnosis of Age-related Macular Degeneration (AMD) can be a wake-up call. Initially, most people resolve to do whatever it takes in order to stay as healthy and independent as possible. But as time goes by it’s easy to slip, and along with easing up on lifestyle changes, you might be tempted to skip doctor visits. Don’t skip visits. Your doctors can spot subtle changes in your eyes and your general health that you might not notice.
When you have AMD, it’s important to work not only with your eye doctor, but also with your primary care physician and specialists involved in your overall health. That’s because some chronic diseases that are common among older Americans can have a direct impact on the progression of AMD.
10 Questions to Ask Your Eye Doctor
Knowledge is power. The more you know about your condition and your options, the more successfully you’ll be able to take charge of your life with AMD. Here are 10 questions you should consider asking your doctor at your next visit. They might not all be relevant to your condition right now—it depends on your symptoms.
- What type of AMD do I have?
- Are both my eyes affected?
- Is my AMD progressing?
- Are there specific symptoms I should note?
- Are there lifestyle changes I can make to reduce my risk of progression?
- Which medical treatments are available for me?
- Are PreserVision eye vitamins right for me? Which formula would you recommend?
- Should I see a specialist in low vision?
- Can you refer me to a visual rehabilitation clinic?
- Is it safe to drive?
Why It’s Crucial to Make—and Keep—Your Eye Doctor Appointments
The American Academy of Ophthalmology recommends an eye exam every year or two for everyone 65 or older. If you have AMD, more frequent checks may be important for three reasons:
- AMD may progress rapidly.
- Early treatment may slow AMD progression.
- Having AMD in one eye increases the risk that you’ll develop it in the other eye.
Your eye doctor will tell you how often he wants you to be checked. This could be anywhere from monthly to every 12 months, depending on your diagnosis. The important thing is to follow the schedule of visits that your doctor recommends as closely as possible.
How to stay on schedule
Make several appointments before you leave the doctor’s office and put them on your calendar right away. That way, even if you have to change an appointment, it’s on your radar. If you use a calendar on your mobile phone or computer, set an alarm to sound a week before the appointment and on the day of. Another option is to use an appointment-reminder app.
Monitoring Your Vision at Home
Changes to your central vision can happen suddenly and signal a progression to wet AMD, which must be treated promptly to avoid vision loss. A good way to spot these often subtle changes is by using an Amsler grid between doctor visits. This tool is a simple square printed with a grid of fine black lines and with a black dot in the middle. It’s been used by AMD patients successfully for more than 50 years to detect changes in vision.
In one Swiss study, some one in five people who had a positive Amsler Grid test had progressed to wet AMD.
Your doctor will give you an an Amsler grid or you can print out one yourself. Putting a magnetized grid on your refrigerator makes weekly checks super simple. You can also download Amsler grid apps for Android and Apple devices.
How to use your Amsler Grid
Always use your Amsler grid in the same place and under the same lighting conditions. Attach it to a vertical surface in a well-lit environment.
- Put on any prescription glasses that you normally use for reading.
- Stand so your face is 12 to 15 inches away from the grid.
- Cover one eye.
- Look directly at the center dot with your uncovered eye and keep your eye focused on it.
- While looking directly at the center dot, notice in your side vision how the grid lines look.
- Follow the same steps with the other eye.
Your goal is to notice any changes in how you see the grid. That’s why it’s so important to use the grid at least weekly and to use the grid in the exact same conditions each time. Signs that something has changed might be grid lines that appeared straight and clear, but now look blurry, wavy, dark or blank in places. If you think you see a change, call your doctor’s office right away. Your doctor might want you to come in for a check-up.
Click here to download an Amsler grid or join SightMatters to receive a magnetic Amsler grid
Types of Eye Care Professional
You may have been diagnosed with AMD by an optometrist or ophthalmologist. But there are other types of eye-care professional who you might see at various stages of age-related macular degeneration.
An optometrist gives vision tests and can dilate your eyes to examine your retina. He or she may also treat certain eye conditions. Most optometrists can competently monitor and advise a patient with early-stage dry AMD.
An ophthalmologist is an M.D. who may use more sophisticated tests to diagnose and monitor eye diseases. These doctors can also perform eye surgery. If your dry AMD is intermediate or advanced, or is complicated by a medical condition like diabetes, you might want to see an ophthalmologist.
A retina specialist is an ophthalmologist who has done specialized training. Retina specialists have the most sophisticated equipment and tests available to them for examining the retina and can perform injections for wet AMD.
A low-vision specialist is an ophthalmologist or optometrist who is trained to help patients manage advanced vision impairments. These specialists can teach you how to make the best use of the vision you have.
Working with Your Doctor to Manage Overall Health
Having an annual physical is as important for preserving your vision as keeping your regular eye care exams. That’s because certain chronic illnesses such as high blood pressure, arteriosclerosis, diabetes and obesity can affect your eyes and contribute to AMD progression.
In diabetes, for example, too much sugar in the blood stream damages the microscopic blood vessels of the eye, causing them to leak fluid, which makes the macula swell. If blood sugar is not controlled, further injury to the retina may occur, seriously affecting your central vision.
If you have a chronic disease that is linked to AMD, work with your PCP or specialist physician to manage it. Besides taking medications, many of the lifestyle changes that may help you guard against AMD progression can also help you control a condition like diabetes.