ARTICLES / Caregiver / 5 Tips on AMD Caregiving /
By: Samuel Masket MD
Despite recent projections estimating the number
of individuals in the U.S. with age-related macular
degeneration (AMD) will reach 20 million in 2020,
new survey results reveal that nearly 75 percent of
Americans still don’t know AMD – the loss of one’s
central vision - is the leading cause of legal
blindness in older adults.
The top choice selected was, incorrectly, glaucoma.
The survey also found that 43% of Americans age 65
years or older (equivalent to nearly 20 million
Americans) have or know someone with AMD and find
themselves assisting those individuals frequently,
despite not being familiar with this debilitating
form of blindness.
What is Age-Related Macular Degeneration?
The signs of AMD are subtle at first. Straight
lines, like mailbox posts, may appear bent or
crooked, or vision might be slightly blurred. It
isn’t until AMD progresses that caregivers may find
that their parents need more help paying bills,
running errands, and recognizing friends they meet
on the street. As central, “straight-ahead” vision
deteriorates, an older adult sacrifices their
independence and it’s very common for these patients
to experience increased stress or depression as a
Today, more than 15 million Americans are affected
by some form of macular degeneration and
approximately 2 million Americans have the advanced
(End-stage) form with associated vision loss, which
is the leading cause of irreversible vision loss and
legal blindness in individuals over the age of 60.
AMD does not cause complete blindness, but at its
most aggressive, it can completely damage the
macula, which is the region of the retina
responsible for central, detailed vision. Although
peripheral vision remains unaffected by AMD, the
developing “blind spot” in central vision is not
something people can see around using natural eye
Despite the availability of new drug treatments that
slow, but not stop, the progression of AMD, the
number of people with the advanced form of the
disease is expected to double by the year 2050.
Only a comprehensive dilated eye exam, usually given
by an ophthalmologist, can detect macular
degeneration. It’s important that caregivers ensure
that their loved ones see their eye doctor at least
once a year, or more frequently if AMD is
progressing, to be assessed for treatment. The more
common form of AMD is called dry (atrophic) AMD,
which is a slower progressing form of AMD compared
to wet (neovascular) AMD, which is caused by
abnormal blood vessels that leak fluid or blood and
damage the macula. Wet AMD is only diagnosed in 10
percent of all patients.
Caring for the AMD Patient
Do you know how to care for someone living with AMD?
Studies find that people living with advanced AMD
may need assistance nearly four hours per day, five
days per week. Spouses or adult children provide 72
percent of that care.
Notably, the above referenced survey found that more
than 1 in 3 (35%) Americans who know someone with
AMD assist them frequently. But, also, that despite
the high prevalence of AMD, the majority of
respondents -- 66 percent -- report that they are
unconfident in their ability to care for their loved
one should a family member develop AMD. Learning
about AMD and different strategies to identify
symptoms, treat and manage the condition benefits
both the patient and their caregiver.
How can you help your loved one manage AMD? Here are
some quick tips that you may find useful:
- Start a
conversation – Work with your loved one to identify
the questions that are important to address with a
doctor about the specific diagnosis and available
- Commit to a
healthy life - Quitting smoking, losing weight and
watching your blood pressure can help reduce the
risk of AMD progression; simple changes like
adjusting lighting and purchasing an e-reader (that
allows for larger print) can make daily life easier.
Make it a family mission to live a healthier
- Safe driving
– Initiate a serious conversation with your loved
one and their physician about whether their vision
is sufficient to make driving safe for themselves
and other people on the road. Also, recognize that
your loved one may experience mixed emotions about
giving up driving as it signals an obvious sign of
lost independence. It’s important to provide support
through that transition.
options – Despite there being no cure for AMD, it
can be managed. An ophthalmologist may recommend
treatments ranging from vitamins, drug or laser
therapy, or, even a tiny FDA-approved telescope
implant for those patients who have progressed to
the most advanced form of the disease.
- Find support
– Across the country, there are local low vision
resource centers, such as
Lions Club International. These organizations
help people living with AMD better navigate their
environment via occupational therapy and low vision
assistive devices, for example. There are also
national AMD awareness groups that provide education
and resources, such as
Foundation and the
National Eye Institute, to name a few.
is another resource that provides education about
age-related macular degeneration and treatment
Age-related macular degeneration is common and will
grow in incidence as the boomer population ages.
Understanding how you can assist a loved one to best
manage the condition is vital because it will
enhance the family’s ability to enjoy life together.
Dr. Samuel Masket, founding partner of Advanced
Vision Care in Los Angeles, has been practicing
Ophthalmology in the Los Angeles area for over 30
years. He is a board- certified ophthalmologist and
Clinical Professor of Ophthalmology, David Geffen
School of Medicine, Jules Stein Eye Institute, UCLA,
and specializes in complex and complicated cataract