Scheie Eye Institute, University of Pennsylvania
Preparing ahead of time for your visit to the eye doctor can help you manage your vision health. This article lists the top 10 questions that you should ask your eye doctor if you have a diagnosis of macular degeneration.
Visits to the doctor can sometimes feel rushed and stressful. It’s not always easy to know or remember what questions to ask. To get the information you need, it’s helpful to have a family member or friend accompany you to help ask questions and remind you of what the doctor said during the visit.
Below is a list of commonly asked questions. Depending on your stage of age-related macular degeneration (AMD)—and whether it is the "dry" or "wet" form of the disease—some questions will be more relevant than others. Since a very long list of questions could be difficult for you and the doctor to discuss fully in the time available, you might want to pick your top four or five questions for each visit.
When is the best time to ask questions? After your examination and tests, such as retina photographs, your doctor will share the results and any recommendations. This is an optimal time to ask questions.
Many patients with early AMD, with drusen (little white spots under the retina visible to the ophthalmologist) have an excellent chance of keeping reading vision for the next 5 years and beyond. The risk can be estimated based on the number and size of drusen, the presence of other pigment abnormalities in the retina (view an illustration of eye anatomy ), and the status of the other eye. Even patients with wet AMD, if treated within a few days to weeks after the onset of symptoms, have a good chance of keeping reading vision if treated with injections.
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Sometimes a cataract, a clouding of the lens in inside the eye, can interfere with vision. In a patient with AMD, it is not so easy to determine whether a cataract or the macular disease is responsible for reduced vision. Often, both conditions contribute. The key question is how much better the vision could be after cataract surgery.
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Patients with AMD can often benefit from new glasses, especially for reading small print. These glasses will magnify letters, making them easier to read. It is critical that eyeglass prescriptions are as good as possible. Special reading glasses with built in prisms provide a high level of magnification and sometimes yellow-tinted lenses can help increase contrast.
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If visual tasks remain a problem after the visit to the ophthalmologist, you may want to see an optometrist who specializes in low vision, who might find the optimal glasses magnification, and may recommend special devices like optical or digital magnifiers. A professional known as a low vision therapist can help your remain as independent as possible by advising you on safety-proofing your home, and on the latest devices and tips for living with low vision.
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This is a time of rapid advances in AMD research. There are several drugs in clinical trials for both wet and advanced dry (geographic atrophy) AMD. If you are eligible, participating in clinical trials could help your vision in the short or long term, and could help make new treatments available for others in the future.
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Depending on the number and size of your drusen, it may be helpful to take AREDS2 vitamins. For people with any form of AMD, it is helpful to eat a diet rich in vegetables, as well as some fruits and fish.
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Some patients with wet AMD require an injection every 4 weeks to maintain their best possible vision. Others can do almost as well with less frequent injections. This is a trade-off to discuss with your doctor based on your specific situation and the doctor’s experience and judgment.
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Some patients with AMD, unfortunately, get into accidents because of their visual impairment. It is difficult to give up the independence that driving provides. However, it is not worth the risk of injuring yourself and others. Adjustments to lifestyle should be made.
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Siblings and children of AMD patients have, on average, approximately twice the risk of developing AMD. To reduce their risk, they can avoid or quit smoking, eat a veggie rich diet with some fruits and fish, and wear sunglasses and a hat when outside in bright light.
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Your doctor will ask you to check your vision at home to help detect any new onset of wet AMD. You should do this by covering one eye at a time (the “good” eye will compensate so you might not notice any change in the diseased eye) and looking at some reading material or a graph like an Amsler grid every few days. If you notice a change like blurry, wavy, or missing lines or letters, give your eye doctor a call. There may be additional concerning symptoms that your doctor will tell you about, depending on your situation.
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Joshua Dunaief, MD, received his BA magna cum laude in Biology from Harvard (1987), MD/PhD from Columbia College of Physicians and Surgeons (1996), completed ophthalmology residency at the Wilmer Eye Institute, Johns Hopkins in 2000, and medical retina fellowship at Scheie Eye Institute, University of Pennsylvania in 2004.
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