Medical retina optometrist at York Teaching Hospital, Amy Green, shared her lessons on age-related macular degeneration (AMD) during the AOP’s Locum Clinical Skills Conference 2025 (8 October, Manchester).
Green, who also works at the University of Bradford and Cardiff University, began her presentation by discussing possible variations between dry AMD patients – for example those with medium or large drusen, those who might be smokers, and those with a family history of the condition.
Optical coherence tomography (OCT) is an accurate tool for monitoring of early macular degeneration, Green said.
She showed attendees OCT scans that highlighted how the equipment can be used for this purpose.
Green also emphasised the importance of discussing AMD with patients in community practice.
“There are a lot of things that we can talk about in primary care that may reduce people’s risk of developing things like late-stage macular degeneration, such as wet macular degeneration or the geographic atrophy,” Green told attendees.
She added: “With certain signs, if we can identify those, we can have those conversations early and try and either reduce the risk of developing the wet macular degeneration, or, in some cases, possibly prevent the macular degeneration in the first place.”
Being able to identify features of AMD via OCT images is the first step in being able to manage these patients effectively, Green said.
There is a missing cohort of patients who are at risk of losing their sight due to dry AMD, she noted.
“We want to be able to identify those people that are at risk [before dry AMD develops], just like we would in a diabetic screening service, and pull them out of the population so that we can identify them and get them early treatment, because early treatment preserves the vision,” Green said.
She advised that practitioners strongly suggest patients stop smoking, and that the DVLA is notified if AMD is found in both eyes.
Optometrists could also consider a referral for magnifiers, she suggested.
Green also noted the importance of conversations around diet with these patients.
Practitioners should advise patients to “eat your greens – and all the other colours as well,” she said.
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