Coronavirus and Wet Age-Related Macular Degeneration
During the current coronavirus crisis, non-urgent medical visits may be postponed. However, if you have wet AMD, it is very important to continue to have intraocular anti-VEGF injections to protect your vision. These should be given at the frequency recommended by your ophthalmologist, which can vary from patient to patient depending on how actively the abnormal blood vessels in the retina are leaking.
Studies have shown that missing injections will generally lead to worse vision. In some cases, after a discussion with your ophthalmologist, it may be acceptable to postpone an injection a bit, or space injections out more, to balance the coronavirus risk against the vision risk.
If it is necessary to come to the ophthalmologist’s office for an injection, some measures should be taken to reduce coronavirus risk. These can include social distancing of at least six feet whenever possible, washing hands with soap and warm water for 20 seconds, not touching your face, and wearing a mask.
It is likely that the ophthalmologist’s office will be less crowded than usual, as the American Academy of Ophthalmology has recommended that non-urgent visits be postponed. Also, your ophthalmologist will take additional precautions to protect you, which may include wearing a mask, washing hands frequently, as usual, and, unfortunately, spending less time talking with you, especially when up close.
If you have symptoms that could be caused by coronavirus (fever and cough) or have been exposed to someone known to have a coronavirus infection, call your ophthalmologist’s office before coming in to discuss when/if you should come, and what precautions will be taken to protect others in the office.
ADVICE FOR PEOPLE WITH WET AGE-RELATED MACULAR DEGENERATION:
- Continue your anti-VEGF injections
- Maintain social distancing
- Avoid touching anything (pens, clipboards, door handles)
- Wash your hands or use alcohol-based hand sanitizer after
- contact with surfaces
- Wear a mask
- Do not touch your face
- Coronavirus and Dry Age-Related Macular Degeneration
If you have dry AMD, you should most likely postpone your AMD checkups unless you have a change in your vision that could indicate conversion to wet AMD. To check for this, use an Amsler grid once a week. To do this, keep your glasses on and check one eye at a time, closing the other eye. Look at the dot in the center of the graph. If you notice missing or wavy lines on the graph, which are different from what you usually see (your baseline), then call your ophthalmologist to discuss a possible appointment.
If you were told to take vitamins for your AMD, then continue to take those, but do not use throat lozenges that have zinc, as the zinc in the vitamins combined with the zinc in the lozenge may be too much.
As much as possible, eat a diet that’s protective for AMD. This will, most likely, also keep your immune system in a healthy state to fight off a possible coronavirus infection. The diet is plant-rich, with lots of spinach, kale, collard greens, and other vegetables and fruits of all kinds. Eating fatty fish like salmon, sardines, tuna, or mackerel twice a week is also thought to be protective.
If you smoke, this would be an ideal time to give it up, as smoking is a risk for AMD and will also weaken the immune response and compromise the breathing functions in your lungs, should you get a coronavirus infection.
ADVICE FOR PEOPLE WITH DRY AGE-RELATED MACULAR DEGENERATION:
- Postpone non-urgent office checkups
- Use an Amsler grid at home
- Continue taking vitamins
- Do not use throat lozenges with zinc unless advised by your
- Eat a diet good for eye health
- Reduce or quit smoking
Conditions in specific locations of the country will likely vary over the coming months regarding the coronavirus, but these general principles will apply.
The good news is that most people with AMD will pull through this epidemic with life and vision intact, especially with patients, ophthalmologists, neighbors, and our country communicating effectively and working together.
Author: Joshua Dunaief, MD, PhD, Scheie Eye Institute, University of Pennsylvania