In my opinion, this is really a three-fold problem in my retina practice. The first major challenge in managing AMD patients is being able to manage patient expectations of the disease. AMD is an aging process of the eye and over time may impact one's central vision. Although there continues to be many therapeutic options to treat the exudative complications of the disease (wet AMD), patients may still suffer loss of visual function regardless.
The second challenge is despite improvements in technology, many AMD patients are not referred to retina for care until they have already developed some loss of visual function in one or both eyes. I think we have great technology available to us in eye care and we as providers should be able to make the diagnosis of exudative AMD sooner so that patients can be referred for timely treatment prior to loss of visual function or even symptoms for that matter.
And finally, the third challenge in managing AMD patients is the burden of treatment for exudative AMD. Most patients will require monthly intravitreal treatment for the first 3-6 months and then periodically for the rest of their lives, not to mention the follow-up visits deemed necessary to monitor the disease. This is not only a burden on the patient, but the family members as well who often are taking time out of their lives to provide transportation to and from the office. Fortunately, there may be new treatments on the horizon that are designed to reduce the burden of monthly injections using compounds and delivery methods that may last several months effectively treating the complications in a more time release fashion.