Spotting macular degeneration: Be watchful and start early

The potential of preventive strategies and early interventions to curb resulting vision loss puts this condition squarely in the sights of primary care physicians.

By Kathleen Phalen Tomaselli, AMNews correspondent. Sept. 1, 2003.

It's the difference between clear vision -- sharp contrasts and vivid lines -- and a world of shadows and faceless silhouettes. But it often slips past physicians' notice and rarely makes patients' lists of complaints, even though it can significantly undermine physical and mental well-being and quality of life.

The problem is macular degeneration. It affects as many as 25 million to 30 million people around the world and in the United States is the leading cause of vision loss and legal blindness in adults older than 60. As baby boomers age, incidence rates are expected to triple by 2025. Still, the epidemic numbers haven't pushed AMD onto primary care physicians' radar screen.

"This is an invisible problem for the family doctor," says Lylas G. Mogk, MD, founding director of the Visual Rehabilitation and Research Center of the Henry Ford Health System in Detroit and chair of the Vision Rehabilitation Committee of the American Academy of Ophthalmology. "Even people with advanced AMD will walk in the office and you won't know, because they often hide it."

But a growing body of research indicates that primary care and family physicians now can play an important role in helping delay or even halt the vision loss that the condition causes. The keys are prevention and early intervention techniques.

"Today there are a number of options," said Paul Sternberg, MD, chair of the Dept. of Ophthalmology and Visual Screening at Vanderbilt Medical Center and School of Medicine, Nashville, Tenn. "It's not like 10 years ago, when nothing could be done."

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