They've Got Their Eyes on You: Meet Your AMD Team
You do not have to navigate the world of advanced age-related macular degeneration (AMD) alone. These are the doctors and specialists who will get you through.by Rosemary Black Health Writer
Dealing with any condition that affects your vision isn’t easy, and age-related macular degeneration (AMD) certainly qualifies as one of the tougher ones. “Macular degeneration is irreversible and incurable, so once you lose your central vision, it doesn’t come back,” says David Yu-Hyon Kim, M.D., a retinal surgeon in the Montefiore Health System in New York City. This is exactly why you need to create a network of doctors and specialists who can help you preserve the vision you have, and show you how to continue living as fully as possible. Here are your people:
This medical doctor focuses on the overall treatment and management of eye diseases. An ophthalmologist is an M.D. who has completed medical school as well as a residency in eye surgery. Ideally, your ophthalmologist will be a retina specialist. “The macula is the central portion of the retina, and this is the part of the eye that’s affected by AMD,” explains Dr. Kim. “Depending on the severity of your AMD, you may see this specialist as often as once a month.”
If you have wet AMD, a more advanced form of the condition that causes blood to leak into the macula, you may also need regular injections of medicine into your eyes, explains William Schiff, M.D., a retina specialist and director of operative services at Manhattan Eye, Ear and Throat Hospital in New York City.
“It’s a scheduled type of treatment plan where you're generally injected every month for the first three months, and then we extend the therapy depending on your response,” he explains. “If caught early, patients may retain good central vision forever.”
If new problems crop up, your ophthalmologist can ensure that you’ll be treated promptly, which could have a long-term beneficial effect on your vision, Dr. Schiff says.
Optometrists help you learn how to make the most of the vision you still have, helping you lead a more independent life, explains Serena Sukhija, O.D., coordinator of Low Vision Services at The New York Eye and Ear Infirmary of Mount Sinai in New York City. “The optometrist can prescribe glasses and low-vision devices as well as help monitor the disease,” she explains.
Your optometrist is also the gatekeeper for further rehabilitation services and usually your referral source for the retina specialist, she explains. “The other specialists you will be seeing typically need a report from an eye-care specialist like the optometrist detailing what your vision and eye problems are,” she says.
Most importantly, though, low-vision specialists will work with you to help you achieve your goals, Dr. Kim explains. Low vision devices play an important role in improving the overall quality of life. If you’d like to improve your ability to read, they will show you how devices like lighted magnifiers can help. (We've got some ideas, too. Check out 15 Tools That Can Help You See.)
Mental Health Pro
Receiving a diagnosis of AMD and learning to cope with this disorder can take a toll on your emotions, says Dr. Kim. “A counselor or a social worker can help you cope with visual impairment and solve the problems it causes,” Dr. Sukhija says. And if you find that you’re really struggling as you adjust to your new normal, a psychiatrist can prescribe an appropriate medication.
This therapist helps you “develop, recover, improve, and maintain the skills needed for daily living and working,” explains Dr. Sukhija. The OT will work very closely with you on issues around day-to-day living, from assessing and modifying your home to providing guidance on which items help maximize vision, explains Robert Hutchins, M.D., a retina and vitreous surgeon at the University of Cincinnati College of Medicine and the Cincinnati Eye Institute. “An OT can help determine what will work for that particular patient to make the most of their remaining vision and to navigate their surroundings,” he says.
Internist or Nurse Practitioner
Having low vision can impact the treatment for any other conditions you may have, says Dr. Hutchins, so it’s important to make sure your primary-care provider is looped in with your eye doctors and vice versa. Plus, your internist or N.P. can be another source of support and hope. “The doctor should offer reassurance and encouragement since a visually impaired person can lead a full life with help from low-vision aids and OT. Often just knowing that he/she will retain some functional vision is what the person needs to hear,” says Dr. Hutchins. Coping with AMD requires effort, and positive reinforcement is crucial, he adds.
Rehabilitation teachers require highly specialized training and certification specifically for visual rehabilitation. This professional provides instruction and guidance in adaptive independent living skills, explains Dr. Sukhija. “This type of instruction helps you to become more confident in living independently,” she says.
Orientation and Mobility Specialist
If you’re worried about how you are going to get around, and especially if you’re no longer be driving a car, this is an essential member of your team. “This specialist teaches you how to travel safely, confidently, and independently in your environment,” Dr. Sukhija says.
Assistive Technology Specialist
You’ve got a lot of tech options that can make your life a whole lot easier, and this pro will help you figure out which ones are most appropriate for you. You’ll learn how to use them, too. In our evolving world of technology several devices are available to enhance visual function including video magnifiers, recognition apps for smartphones and tablets, talking devices, and smart glasses.