For people over 50, age-related macular degeneration (AMD) is a leading cause of blindness. Caught early, it is treatable; unfortunately, warning signs come late. In its early stages, it is usually asymptomatic. The disease attacks the macula, the central and most sensitive area of the retina. The development of drusen, small deposits of cellular debris that accumulate under the retina, mildly impair vision in early and intermediate AMD. With the onset of late AMD, vision loss due to drusen is compounded by damage to the macula, which presents as a hole in the center of the field of vision (see below).
There are two types of late AMD: “dry” and “wet.” In dry AMD, which is more common, loss of vision is gradual, while wet AMD, in some cases, progresses rapidly.
Here are four things your facility can do to help residents cope with AMD:
- Preventing AMD
The best way to help residents cope with the disease, of course, is to prevent it in the first place. Fortunately, the damage from AMD can be significantly slowed or even stopped in its early stages, but unfortunately, a common eye myth is that eye exams are necessary only for people experiencing a problem. Those over the age of 50, especially if they have diabetes, need regular – usually annual – comprehensive eye exams with dilation conducted by an ophthalmologist. An exam is often the only way an individual will learn they have early or even intermediate AMD.
Age is the most influential risk factor for the disease, but conditions like high blood pressure and vitamin D deficiency – along with smoking – can further increase an individual’s chances of contracting AMD.
Lifestyle adjustments can help. “Regular exercise, quitting smoking, and eating a nutritious diet rich in green, leafy vegetables are good not only for your eyes but for your overall health status,” explains Dr. Jeffrey Heier, clinical instructor in ophthalmology at the Massachusetts Eye and Ear Infirmary and director of the Retina Service at Ophthalmic Consultants of Boston.
- Treatment of AMD
There is no cure for AMD, but the disease can be treated. “The good news,” said Vincent Hau, MD, Ph.D., and board-certified ophthalmologist, “is that there are now new treatments that can help slow or stabilize the disease in some individuals. For example, the availability of intravitreal anti-VEGF injections for neovascular (wet) AMD may be able to help patients retain some of their central vision.” In dry AMD, progression can be slowed by protecting vision by wearing sunglasses and following the AREDS2 diet, which is a specific regimen known to support eye health.
Additional treatments include:
- Photodynamic laser therapy uses a combination of a light-sensitive drug injection with high energy laser light to destroy abnormal blood cells present in AMD.
- Anti-angiogenic drugs, which stop the formation of new blood vessels in wet AMD. These abnormal vessels can leak, which further impairs vision loss in this form of the disease.
- Implantable miniature telescope is Medicare-eligible and approved by the Food and Drug Administration for patients over 65 with advanced AMD in both eyes. The implant magnifies objects in view by approximately 2.7x and projects those images to undamaged sections of the retina.
- Support for Residents Challenged with an AMD Diagnosis
Dr. Hau points out perhaps the most destructive aspects of AMD: It “dramatically impacts quality of life, manifesting in greater social dependence and challenges to maintaining independence.” Ultimately, these losses often lead to increased incidence of stress, anxiety, and depression.
A variety of therapists and specialists can help AMD patients adjust to their condition, make the most of their remaining sight, and retain as much independence as possible. Helpful services include training on using peripheral vision, how to adapt living space, and exploring options like glasses, magnifiers, and other vision assistance devices.
- Onsite Vision Services for Residents Can Help
Aria Care Partner’s optometrists are skilled in working with residents who have trouble communicating. Our clinical staff serves as an extension of the facility care team, answering questions and providing ongoing education for staff, residents, and families.
Aria handles all appointments, paperwork, compliance, and billing. We want to make it easier for skilled nursing facilities to support maintenance of residents’ good eye health year-round to help them see well for a lifetime.