Friday, March 10, 2006

AMD Rehabilitation 91

Chapter Six
Vision Rehabilitation by Mark E. Wilkinson, OD


It is a major blow when someone loses vision from AMD, especially when the second eye is affected. The stages of adjusting to any major loss – including shock, anxiety, denial, mourning, and depression – are well known (see Appendix 6-1). Some people with AMD pass through these stages quickly, whereas others require more time and may need professional help to work through them before they come to acknowledgment, acceptance, and finally adjustment and adaptation. If you have AMD, you may be afraid that you are going blind, but we can reassure you that it is rare for someone with AMD to lose all of their vision. We’re also rapidly learning more and more about how you can reduce the chances that you’ll get AMD in the first place. And the treatments for AMD are improving, so there’s a good chance that you’ll retain at least some of your central vision if you already have AMD.

About a third of people with AMD become depressed when they lose vision. No one with AMD can afford to be depressed. If you have AMD, you’ll need the energy to watch out for new symptoms and to go to the doctor. You’ll need to be able to get talking books, to log on to the computer and obtain the latest information, to call your friends for rides if you can’t drive, and to socialize. Depression accompanying vision loss sets up a vicious cycle which may cause you to isolate yourself or even give up. Then things will only get worse.

Because healthcare is now so specialized, your eye doctor may not ask you if you’re depressed, and your family doctor may not realize how much vision you’ve lost. You may slip through the cracks, so to speak, unless you tell them you’re depressed. Patients these days have to be their own advocates. It’s natural for anyone to mourn a loss of vision, but be sure to tell your doctor if you’re experiencing any signs of depression, including feelings of sadness or hopelessness, loss of interest in daily activities, weight loss or gain due to a change in your appetite, a feeling that getting up and moving takes a great effort, feelings of guilt or anxiety without an obvious reason, problems concentrating or making decisions, or thoughts of death or suicide. (See Appendix 6-2 for a full list of the signs of depression.).

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