Since age-related macular degeneration (AMD) is the most frequent cause of severe vision loss in the Western Hemisphere, it is likely that all ophthalmologists will examine increasing numbers of patients with AMD as the population ages. Unlike the patient with cataract for whom treatment usually improves vision and the patient with diabetic retinopathy for whom treatment usually stabilizes vision, the majority of patients with the neovascular form of AMD cannot expect their vision to improve or stabilize with or without treatment.1,2 Nevertheless, ophthalmologists can provide an accurate description of the condition, reasonably precise prognostic information, access to low vision rehabilitation services, and a great deal of compassion. Occasionally, we can offer treatment. What follows is my approach to counseling a patient who presents with monocular loss of vision from the neovascular complications of AMD.
I begin by confirming the diagnosis to the patient and family members. I emphasize that