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In reply

We agree with Dr Jackson that patients with visual loss from age-related macular degeneration experience grieving. Using the principles of change management to help these patients work through their grieving and accept their disability can be helpful. Ophthalmologists should remember that the number of steps and the time necessary to achieve patient acceptance are variable and will likely involve other professionals and family members. Ophthalmologists should individualize the care for each patient and project the right mix of realism and optimism in helping patients live with their disability. The key approach Dr Jackson identified was to "redefine the change in a positive manner" by emphasizing the usefulness of peripheral vision and encouraging visual rehabilitation. Educating patients to view this change positively takes time, physician encouragement, and family support.

Donald S. Fong, MD, MPH; William E. Benson, MD; Valerie C. Crook, DSW

Correspondence: Dr Fong, Department of Research and Evaluation, Kaiser Permanente Southern California, 100 S Los Robles, Pasadena, CA 91101.

Arch Ophthalmol. 2004;122:1090.

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Is Part of the Ophthalmologist's Role in Age-Related Macular Degeneration Change Management of a Chronic Disease?
M. L. Jackson
Arch Ophthalmol. 2004;122(7):1090.
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