Wet AMD patients to be treated earlier

Man in clinic having an OCT scan

The National Institute for Health and Care Excellence (NICE) has cleared the way for eye patients to be treated on the NHS before they have to stop driving. 

National sight loss charity the Macular Society has welcomed the recommendation, which has been included in the new Clinical Guideline on the diagnosis and management of age-related macular degeneration (AMD). 

Currently, AMD patients with vision better than the legal driving limit are unable to receive treatment on the NHS, as their eyesight is deemed ‘too good to treat’. 

However, evidence highlighted in the Guideline has shown that treating patients with the ‘wet’ form of the condition earlier can be clinically and cost effective. 

Andy Gratton, who works on the Society’s Helpline, said: “We get more than 300 calls a year about driving, and people tell us that it’s one of the things they miss most when they have to give it up. If people are treated before their eyesight gets too bad to drive, they can continue their hobbies and stay independent for that much longer.” 

The Guideline also recommends that people with wet AMD should be offered treatment within 14 days of referral to the macula service. 

Cathy Yelf, chief executive of the Macular Society, said: “The new NICE Guideline on AMD is welcome as it reinforces some important areas of care for AMD patients. Currently, many patients are forced to wait until their vision deteriorates below the legal driving level, but the Guideline is clear that earlier treatment can be cost-effective. 

“The Guideline also emphasises that wet AMD patients need to be treated urgently and early to preserve their vision. Delays in treatment that currently affect many thousands of patients are unacceptable.” 

The Guideline also includes recommendations on non-drug strategies to manage AMD, such as group-based rehabilitation programmes. 

Cathy added: “It is also clear that good communication with patients is important, as is signposting to other support beyond the clinic or primary care practice. We hope that all eye care professionals will implement its recommendations at once.” 

Waqaar Shah, GP at Chatfield Health Care and chair of the Guideline committee, said: “People with AMD can feel isolated and are at increased risk of depression. It is important they are given the right support at the right time to help them with this condition. This new Guideline will help ensure therapeutic, social and psychological support is available to help patients in their daily lives.” 

It is recommended NHS organisations now compare their current practice with the Guideline and consider what changes may need to be made to put them into practice. The speed at which these recommendations are adopted by local NHS services will depend on the resources they have available and the other priorities they are dealing with.