Internal Medicine

P1: SBT

0521779407-02 CUNY1086/Karliner 0 521 77940 7 June 7, 2007 19:18

80 Age Related Maculopathy

Age Related Maculopathy...............................

SAAD SHAIKH, MD and MARK S. BLUMENKRANZ, MD

history & physical

History

■Elements of history recommended at initial visit:

➣Symptoms

➣Medications

➣Medical and ocular history

➣Family & social history

➣Risk Factors

genetic predisposition in AMD appropriate environmental

influences

Cardiovascular disease, specifically hypertension

Smoking history

Caucasian ethnicity

Older age (6.4% of persons aged between 65 and 74 years, and

19.7% of persons 75 and over had evidence of AMD in one or

both eyes)

■Physical Examination

➣Assessment of best corrected visual acuity

➣Vision testing with an Amsler grid

➣Refererral to an ophthalmologist for:

biomicroscopic examination of the macula

peripheral retinal examination

evaluation of treatment options

Signs & Symptoms

■Early ARM

➣The presence of drusen alone may not give rise to symptoms

■Later ARM

➣Distortion, decrease in visual acuity, or scotomas are common

symptoms of choroidal neovascularization or secondary hemor-

rhage, or as scarring or geographic atrophy occur.

tests

■Comprehensive eye examinations every one to two years in patients

more than 65 years of age who do not have conditions requiring

intervention. Daily at home Amsler’s grid usage for detecting the

progression of age-related macular degeneration