Age-related Macular Degeneration (AMD) is a leading cause of vision loss in people 50 years of age and older.¹ It is also the leading cause of legal blindness in those older than age 65.² Those who are diagnosed with the condition and generally not familiar with it, tend to be shocked and extremely frightened and unsettled with what it means for their sight — and their life. We know all too well that those feelings become exacerbated when they hear that “this is a progressive condition,” and “there is currently no cure.” 
            Here are three action steps I personally take to keep that fear at bay. 
 
1. Take the Time for Discussion
           One of my biggest takeaways in my 25 years of working in this field is that one-on-one time with patients, particularly AMD patients who have just been diagnosed, is critical. Being prepared to spend ample time with them and answer their questions in a compassionate way is an essential part of ensuring their AMD journey begins with the right understanding.
          With some patients, an initial conversation about AMD can be fairly simple and to the point, about five minutes, to adequately educate without overwhelming. But it’s never a one-size-fits-all approach, and other patients may need more time. If this is the case, give them that extra time so they can begin to process the diagnosis with you by their side.
          For me, these conversations typically include an overview of the condition, what their diagnosis means for them and all the ways we can help reduce the risk of progression together, with a customized action plan. I always close our conversations by reiterating that I’m just a phone call away should any additional questions arise. 
          I also take the time to share several educational materials and tools, such as an Amsler grid or digitally based device, so they can regularly monitor their vision and alert me to any changes that may signal progression. Using these tools, we create a clear and written (so they can refer to it later) AMD management plan that is specific to their individual needs. A sample AMD management plan typically includes the following actionable and controllable items. I encourage patients to do everything they can to check every item on this list:
         • Taking an ocular nutritoonal supplement with a formula recommended for people who have moderate to advanced AMD.
         • Monitoring vision at home weekly with an Amsler grid or digitally based device to spot any changes.
         • Quitting smoking.
         • Shielding the eyes from the sun.
         • Eating a diet rich in fruits and veggies, especially dark, leafy greens.
         • Being active to get the heart pumping for at least 30 minutes three times a week.
         • Maintaining overall health and keeping eye doctor appointments. 

2. Provide Hope and Resources
          From the initial diagnosis through follow-up appointment to check on disease progression, patients experience a wide range of emotions. I try to remind them time and time again that incurable does not mean untreatable, and that all the steps outlined in their customized management plan can help them reduce their risk of AMD progression. 
          I also inform patients of online resources, such as the Macular Degeneration Association website (https://macularhope.org), where they can turn for more information, and industry-sponsored websites that offer AMD patients a sense of community that they can lean on for support and learn about the journeys of other patients.   
            
3. Consider Ocular Nutritional Supplementation
          Studies show that taking a specific combination of nutrients can help reduce the risk of progression in patients who have moderate-to-advanced AMD. What’s more, it is difficult to get the levels of nutrients found in these ocular nutritional supplements from diet alone or even with a multivitamin. This is where ocular nutritional supplementation comes in.
          For my patients who have moderate-to-advanced AMD, I always discuss the importance of taking a specific ocular nutritional supplement every day, in addition to their daily multivitamin, as a part of their management plan. Additionally, I explain the proven science behind this specific formulation, giving them the confidence that there is something they can take to help them reduce their risk of moderate-to-advanced AMD progression, in addition to eating well and exercising. 
 
Consistent Support
         An AMD diagnosis can be frightening, but arming patients with the knowledge, understanding, and support they need to combat their fear and ensure they are confident in the treatment plan that their eye care professional prescribes can have an enormous positive impact on their treatment, vision and life overall. OM
 
References

1. John Hopkins Medicine Website. Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/agerelated-macular-degeneration-amd#:~:text=Age%2Drelated%20macular%20degeneration%20is,ability%20to%20see%20fine%20details. (Accessed Feb. 18, 2022.)
2. CDC Website. Retrieved from https://www.cdc.gov/visionhealth/resources/features/macular-degeneration.html#:~:text=AMD%20is%20a%20major%20cause,vision%20needed%20to%20see%20clearly. (Accessed Feb. 18, 2022.)

           Dr. Gerson has authored several manuscripts for journals, serves on several advisory boards, and frequently gives lectures to optometrists and optometry students on AREDS2 supplementation for their moderate-to-advanced AMD patients. He is a fellow of the Academy of Optometry and the Optometric Retina Society, and he is a member of the American Optometric Association and the Kansas Optometric Association, which named him the 2008 Young OD of the year. Dr. Gerson is a consultant for Bausch + Lomb.