Up to 30 percent of American adults have used telemedicine in the past year, according to the Department of Health and Human Services. Virtual visits with doctors and other specialists offer patients a range of benefits, from lower costs for appointments to the convenience of accessing quality care from home and less time spent at the doctor’s office — an issue that became particularly important during the COVID-19 pandemic.
While there’s no doubt that telemedicine is a great option for many people — especially during a global pandemic — it’s not always an adequate replacement for in-person visits and evaluations. And for a condition like wet age-related macular degeneration (AMD, which is also known as advanced neovascular AMD), it may not be a viable option for many appointments, if any.
“Right now, telemedicine is limited for patients with wet macular degeneration,” says Rahul Khurana, MD, an ophthalmologist at Northern California Retina Vitreous Associates in Mountain View and a clinical spokesperson for the American Academy of Ophthalmology (AAO). “Many [people] have to be evaluated in the clinic, which often involves testing their vision, getting images in the office, and [performing] an intervention or a treatment. Unfortunately, those things aren’t really possible to get with telemedicine at this time.”
Calculating the Risk-Reward Ratio
Dr. Khurana says it’s important for people with wet AMD to continue seeing their retina specialists at the office as scheduled. “If you have neovascular AMD, you’re at risk of permanent vision loss,” he says. “It’s not something you can ignore.”
There may be some circumstances in which you can stretch out the time between visits, but that would depend on factors like how long you’ve been receiving treatment and how stable your vision already is, the AAO says.
“Everyone manages neovascular AMD a little bit differently,” Khurana explains. “Some people try to go as long as possible between treatments.”
Khurana points out that going as long as you can between treatments may even save you a visit or reduce the risks associated with having certain treatments done at the same time.
He adds that one of the challenges with telemedicine is that your doctor may not be able to make an accurate diagnosis based on your description of your symptoms, because formal testing cannot be done during a telehealth appointment.
“It really does require coming in to get evaluated and treated,” he says. Also, if you wait too long and the condition worsens without treatment, you may lose your vision, which you may not be able to get back.
Healthy Habits Support Eye Health Between Visits
Practicing healthy habits, such as eating a balanced diet, exercising regularly, and not smoking, not only contributes to good health overall but also helps support eye health, according to the American Macular Degeneration Foundation.
Wearing sunglasses with ultraviolet protection can help protect your eyes outdoors, Khurana says.
There’s a lot of good evidence that certain lifestyle modifications — such as taking AREDS 2 (Age-Related Eye Disease Study 2) nutrition supplements — can be particularly beneficial for people who have wet AMD in one eye and dry AMD in the other, he adds.
“If the other eye is dry, you don’t want that to progress” to the wet form of AMD, which causes vision loss, Khurana says.
Although no lifestyle habits can prevent wet AMD or replace treatment for it, they can help you maintain better eye health between appointments.
In the meantime, despite ongoing efforts to develop methods for testing visual acuity and other eye health parameters via telemedicine, any treatment required will, for the foreseeable future, almost certainly require an in-person office visit.
