Case 1: Diagnosis and Plan

  • Clinically, most would diagnose this patient with age-related drusen or perhaps early AMD. Educate and monitor q1yr.
  • However – due to his significant functional delay (dark adaptation) and presence of SDDs and hypertransmission defects I recommended management of this patient similar to an intermediate AMD patient:
    • Full discussion on AMD diagnosis and risk of progression
      • SDDs and previous smoking history increase this patients’ risk
    • Amsler grid dispense
    • Consider ForeseeHome as better option over Amsler grid23
    • AREDS2 was recommended with the discussion that SDDs were not specifically studied for this formulation
    • The plan mostly consists of high quality education and then regularly monitoring in office.
    • The dark adaptation is already so delayed that this will not help clinical decision making by repeating in the future