How early diagnosis can help your AMD patients

February is Age-related Macular Degeneration (AMD) awareness month. To mark it, we’ve put together advice for optical professionals on how to help their patients with early diagnosis.

When patients initially learn they have AMD, the risk of losing their sight can be frightening. The potential loss of independence, ability to drive and being a burden on their loved ones can be overwhelming. At this time, patients often struggle to absorb and process new information - right when it is most important they do so.

Optometrists are often the first professionals to notice early signs of AMD. But, as there are limited opportunities for referral, the initial AMD conversation with patients can often seem like it would take more time than is available in an appointment.

However, the truth is that, in order to help the millions of people living with this condition, getting early diagnosis and care is key to slowing its progression. The earlier patients understand their condition, the sooner they can make lifestyle changes and the better chance they have of preventing sight loss.

This article highlights the importance of early diagnosis, gives advice on speaking to patients and explains how OcuPlan can help alleviate some of the time pressures on optometrists.

How many people have AMD in the UK?#

AMD is the most prevalent long-term eye condition in the UK. The Royal National Institute of Blind People (RNIB) report that 48% of all registered blind people state AMD as the main cause of their sight loss.

The RNIB also estimates that there are more than 4 million people living with signs of AMD. Of those, 700,000 are experiencing sight loss, with millions more at risk.

Plus, this number is set to grow, with RNIB predicting there’ll be a 25% increase in the number of people living with late-stage AMD by 2032.

This growth in the rates of AMD makes raising awareness of the condition’s symptoms and how to make a successful diagnosis even more important.

Why is early diagnosis of AMD so important?#

A recent survey of macular disease patients found that 55% of them had experienced some symptoms of sight loss before they were officially diagnosed. This is despite the fact that, in a majority of cases, it is possible to diagnose AMD before any symptoms of sight loss occur.

As a progressive disease, there is no cure for any form of AMD and no treatment at all for dry AMD. However, recognising symptoms, gaining an early diagnosis and getting professional advice about lifestyle changes they can make could have helped these patients (and many more) slow down AMD’s impact on their sight.

Yet, for eye care professionals, there are some difficulties around the early diagnosis of AMD that restrict their patient care options.

Challenges of early AMD diagnosis#

The main difficulty optometrists face with AMD is that the diagnosis process, unlike those of other long-term eye conditions, is inconsistent.

This inconsistency means some optometrists can be hesitant when it comes to the initial diagnosis of AMD, particularly in the early stages.

One optometrist we interviewed said, “Regular eye examinations enable me to detect AMD, but discussing the findings with the patient can be difficult. Especially when a referral to an ophthalmologist is not an option.”

In the early stages of AMD, without a definitive treatment option or support service to signpost patients to, eye care professionals can be left feeling frustrated. This is also caused by the lack of time they have to give their patients essential information and advice.

“I have so much to tell them regarding explanation, education, risk factors, optical appliances and signposting. If only I had the time.”

How to talk to patients about AMD#

To help professionals give their AMD patients the care they need in the early stages of their condition, we asked Consultant Ophthalmologist, Dan Calladine to give his advice.

Have confidence in your diagnosis

Dan’s first piece of advice is to trust in the technology you’re using and your skills in identifying the signs of AMD. Without the support of a set diagnosis process, this can often feel difficult, but you can be reassured by your experience and the accuracy of the devices you use.

“All optometrists are skilled at spotting the early signs of age-related changes in the retina on fundoscopy,” said Dan. “But, historically, it was more difficult to see the progression.

“With OCT technology, we’re now able to see the smallest of changes in conditions, which is critical in identifying progression in conditions such as AMD."

Start the conversation early

Once you’ve identified the signs of AMD, even if you can’t give an official diagnosis, it’s worth talking to patients about what you’ve found, says Dan.

“I always encourage my optometrist network to speak to their patients about AMD as soon as they see a slight change on their OCT scan.”

"Despite the inconsistencies in the diagnosis process", says Dan, "giving patients advice on the lifestyle changes they can make to reduce the progression of AMD will benefit them in the long term.

“As eye care professionals, we know there are a huge number of people living with this condition. Without a formal diagnosis process, there will always be inconsistencies,” Dan explains.

“The important thing for me is that all patients are put first and if they can be made aware of their eye health and the risk factors that will really help.”

Keep advice positive and proactive

The lack of treatment can threaten to make every patient conversation about AMD overwhelming and worrying. However, Dan says that taking a positive and proactive approach to these discussions can make a real impact on a patient’s eye health, despite the lack of treatment options.

“While there is no treatment, there are still things patients can be doing to help prevent AMD from progressing, says Dan.

“The earlier they start to make lifestyle changes, such as stopping smoking, improving their diet, taking eye supplements and regularly using an AMSLER grid to test for Wet AMD, the better chance they have in preventing sight loss.”

By keeping the tone of your conversation with patients helpful and reassuring, you can help to communicate the prevention steps they need to take and give them the care they need without putting extra strain on resources.

Dan explains, “In the early stages, it’s important not to overly worry patients…. I normally make them aware of a few age-related changes at the back of the eye. I recommend keeping a watch on them while also offering advice on lifestyle changes.”

How OcuPlan can help#

After listening to the challenges of eye care professionals and the needs of patients, OcuPlan provides a care pathway to give reassurance and guidance to people with AMD.

This benefits AMD patients by giving them the information and support they need in the early stages of their condition to slow down its progression. For busy optometrists, it provides a care pathway to help provide guidance and support to AMD patients.

By signposting patients to OcuPlan, eye care professionals will give patients access to:

• A consultant review from home - with the OcuPlan Remote Service, a consultant ophthalmologist reviews the patient’s scans and provides a comprehensive report with personalised advice on protecting their vision, for an affordable one-off fee.
• Regular monitoring - for patients who would like ongoing in-person care, an OcuPlan membership arranges regular tests at their local optician and consultations with their chosen consultant ophthalmologist for a fixed monthly fee. Patients can get a quote in minutes.
• Help and guidance - newly diagnosed patients can feel overwhelmed and struggle to absorb new information. Our free Info Pack helps them learn about their condition, from lifestyle changes to supplement recommendations and treatment information.

Patients who would like to know more about OcuPlan can request a free OcuPlan Info Pack from My OcuPlan, which explains how OcuPlan works and the support available to them.

In short, by signposting patients to OcuPlan as soon as you spot the signs of AMD, you can help your patients access the information and support they need to slow down the progression of their AMD.

The Macular Society does an incredible job of supporting patients with macular disease through a variety of advice and services. OcuPlan takes every opportunity to make sure AMD patients are aware of all the help available to them.

For any further information on how OcuPlan helps patients with macular disease and how we can support your practice, you can talk to our team by calling 0207 173 5200 or email support@ocuplan.co.uk