Practice management

Doctors missing signs of AMD

According to the study, published in JAMA Ophthalmology, around 25% of eyes initially declared normal by a primary care ophthalmologist or optometrist following a dilated eye exam were later found to have characteristics of AMD.Study lead Dr David Neely from the University of Alabama said the results were surprising and indicated the need for specific training to identify AMD during fundus tests. He also said high quality retinal imaging processes were needed in primary care as they help with the accurate identification of AMD.{{quote-A:R-W:450-I:2-Q: Fortunately, the advanced forms, like exudative or wet AMD, are more readily diagnosed and sent promptly to vitreoretinal subspecialists for intervention, -WHO:Dr David Neely, Study lead from the University of Alabama}}The largest percentage of undiagnosed patients were older adults, which the team found “puzzling” given the subjects were older and “one would surmise that a patient’s advanced age would lead primary eye care physicians to more closely scrutinise the fundus for signs of AMD.”However, Neely did indicate that the study had limitations with regard to determining the reasons behind the under-diagnoses and more investigation was needed.He also suggested detailed fundus examinations are still useful for AMD screening, especially for patients with common risk factors like family history, old age, and hyperopia.“As treatments for the earliest stages of AMD are developed in the coming years, correct identification of AMD in primary eye care will be critical for routing patients to treatment as soon as possible so that the disease can be treated in its earliest phases and central vision loss avoided.“Fortunately, the advanced forms, like exudative or wet AMD, are more readily diagnosed and sent promptly to vitreoretinal subspecialists for intervention,” Neely said.The findings were based on the records of 644 participants aged 60 and above who were examined by 31 primary care ophthalmologists and optometrists.

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