Dry Macular Degeneration
Dry macular degeneration is where deposits and pigment from the retina accumulate at the macula. This can cause some distortion and a slow reduction in visual acuity
If a patient with known dry macular degeneration develops sudden onset reduction of vision they should attend an ophthalmologist/optometrist within the week to assess for fluid accumulation. Patients with dry macular degeneration should be encouraged to cover one eye in turn on a weekly basis and look at straight objects and measure their level of distortion in order to monitor for acute deterioration. If these symptoms occur it may be the wet type of macular degeneration where new blood vessels are formed which leak fluid under the retina.
There is no treatment for dry macular degeneration but patients should be encouraged to maintain a healthy lifestyle eating plenty of green leafy vegetables, and stopping smoking. Protecting eyes from the sun with a good pair of UV sunglasses is also advised. There is also some evidence of benefits from vitamin supplements. Advise patients to speak to their local pharmacist for more information on these.
Wet Macular Degeneration
The wet type of macular degeneration can be treated with intra-vitreal injections with anti VEGF (vascular endothelial growth factors) which aims to stabilise vision and prevent further decline in vision by reducing fluid accumulation and preventing new blood vessel development.
If patients present with vision of 6/60 or better who
have signs of wet macular degeneration they should be referred urgently for
consideration of this treatment. However if vision is poorer anti-VEGF may not
be advised.
Who to refer:
Please see Lothian GP and optometry ophthalmology referral pathway.
Urgency of the condition for details on how soon patients should receive an appointment.
Please see condition specific information for descriptions and management of many common ophthalmological conditions.
Patients who present with a problem with their only seeing eye should be advised to see an optician/ophthalmologist for review.
How to refer:
We require a referral letter for EVERY patient.
The preferred referral process is via SCI Gateway. If sending/forwarding a referral via SCI gateway please include past medical history, allergies and medications
SCI Gateway > PAEP/SJH > Ophthalmology AMD > LI AMD
If you do not have access to fax or SCI Gateway e.g. if you have arranged an appointment out of hours please send a written referral letter with the patient to bring to their appointment.
Only if SCI Gateway is unavailable should a letter be typed or handwritten. Please write legibly and include your examination findings.
If you have arranged an appointment in the acute referral clinic and you are referring from within another hospital in Lothian please use TRAK to type the referral letter.
Dry macular degeneration
Patients with dry macular degeneration should be given routine lifestyle advice such as taking a diet rich in green leafy vegetables, vitamin supplementation, stopping smoking and protection from UV light.
They should be advised to attend routine optometrist visits. They should also be made aware of signs of wet macular degeneration such as distortion and sudden decrease in vision in one or both eyes.
