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Resources

Mar 17, 2021

Mental Health Aspects of AMD Care

by: Jeffry D. Gerson, OD, FAAO
Ralph Waldo Emerson said, “It’s not the destination, it’s the journey.” A strange quote with which to start a piece about age-related macular degeneration (AMD), but one that we should take to heart. As eyecare providers, we think of the destinations of AMD. By this, I mean that we are looking for an initial diagnosis of dry AMD to manage, or the destination of wet AMD to make sure that referral is made to a retina specialist for anti-vascular endothelial growth factor (anti-VEGF) management. However, the journey for our AMD patients just starts at these points.

It is not unusual to feel some element of anxiety when we are faced with giving a patient a diagnosis of AMD. Have you ever thought of the other side of the coin? Between 10 and 30% of AMD, patients are affected by anxiety, often due to their poor vision.1 Not only do AMD patients suffer more frequently from anxiety than age-matched controls, but they are also at higher risk for depression, with approximately 40% of AMD patients affected by depression.2 Female patients with AMD who live alone and have more co-morbidities are at particularly high risk of depressive symptoms.3 It has been reported that AMD patients are more likely than age-matched controls to be pessimistic about their future.

We always consider referral of our wet AMD patients to a retina specialist, but how often do we even broach the topic of mental health? Do we ask specifically about anxiety or depression (both of which are more common in elderly populations in general) and make referrals to mental health professionals as indicated? Maybe this should become a part of our routine patient education and management strategies.

Source: Optometric Management

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