The recent publicity concerning the results of the Senile Macular Degeneration (SMD) study has created an unprecedented demand for ophthalmologists to evaluate the conditions of their patients with SMD as potential candidates for laser treatment.' This editorial is an effort to provide guidelines that will help practicing ophthalmologists to evaluate the conditions of their patients with SMD, especially those with recent visual symptoms.
See also pp 1191 and 1194.
Before the SMD study report, there was much pessimism about the value of any treatment for patients with SMD. Although SMD was acknowledged to be the major cause of severe visual loss among persons older than the age of 60 years,2,3 patients with drusen generally were not encouraged to make daily assessments of their central vision in each eye. Moreover, there was a difference of opinion about the need to examine or refer patients with SMD who had visual loss