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July 2004

Is Part of the Ophthalmologist's Role in Age-Related Macular DegenerationChange Management of a Chronic Disease?—Reply

Arch Ophthalmol. 2004;122(7):1090. doi:10.1001/archopht.122.7.1090-c

In reply

We agree with Dr Jackson that patients with visual loss from age-relatedmacular degeneration experience grieving. Using the principles of change managementto help these patients work through their grieving and accept their disabilitycan be helpful. Ophthalmologists should remember that the number of stepsand the time necessary to achieve patient acceptance are variable and willlikely involve other professionals and family members. Ophthalmologists shouldindividualize the care for each patient and project the right mix of realismand optimism in helping patients live with their disability. The key approachDr Jackson identified was to "redefine the change in a positive manner" byemphasizing the usefulness of peripheral vision and encouraging visual rehabilitation.Educating patients to view this change positively takes time, physician encouragement,and family support.

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