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Individual risk varies of course, but studies show that up to 43% of people with dry age-related macular degeneration (AMD) progress to wet AMD. This risk increases 10% every additional year. It’s the biggest risk to future vision health, and progression to wet AMD can result in permanent vision loss if left undetected.
Progression is subtle. Day-to-day changes in vision are not normally noticeable. The brain will compensate for poor vision in one eye with good vision in the other. It’s able to fill in any missing areas in the field of vision with the colors and patterns of the surrounding environment. It also uses information from what the opposite eye sees to create a complete, uninterrupted picture.
In clinical trials, only one-third of patients with dry AMD who progressed to wet AMD were aware of when leaking began. One of the indicators of wet AMD is that the blood vessels in the eye start to bleed, and this bleeding causes the macula to become damaged. This is what causes the visual distortions.
But by the time a person notices this kind of worsening vision, the vision required to drive would likely be lost. Most people with wet AMD—up to 85% in fact—have lost their driving vision by the time they have noticed any real change in their vision.
What a person with wet AMD will typically experience is their central vision—meaning the field of view directly in front of them—is distorted, very blurry, or blocked by dark areas. The words on a page, images on TV, people’s faces—this is central vision, and the person will essentially lose it.
It depends on how early it is caught. There are effective treatments for wet AMD, and they can be administered in the doctor’s office. But the effectiveness of treatment relies on early detection of wet AMD. Vision loss due to wet AMD is preventable if its onset is detected as soon as possible.
What’s important to know is that the best chance of protection for your vision is daily, at-home monitoring so that subtle changes are caught early. There are at-home detection methods used for this purpose that are very easy for patients to do on their own.
There are a few options. One is called the Amsler grid, which is a method that was developed in 1945. It’s a black and white grid with a small dot in the center. Its purpose is to check whether the lines start to look wavy or distorted or whether areas of the visual field are missing. The problem with the Amsler grid is that by the time noticeable distortions appear, irreversible vision loss may have already occurred. The Amsler grid has its limitations when it comes to true early detection.
Another option is an at-home vision-monitoring device called ForeseeHome. It’s designed for patients with dry AMD who are at risk of vision loss due to wet AMD. The device detects the kinds of subtle vision changes that when treated right away can potentially be reversed and vision can be preserved.
In a large clinical study, the vast majority of patients (94%) who used ForeseeHome regularly as part of a home monitoring program were able to maintain good, functional vision—20/40 or better—when wet AMD was detected. This was compared to patients in the study who only used other detection methods, such as the Amsler grid. Significantly fewer of those patients were able to keep their functional vision using the Amsler grid method, because it did not catch changes early enough.
The ForeseeHome device uses a test that takes about 3 minutes per eye per day. It’s easy to incorporate into your daily routine.
The test is a series of dotted lines appearing on the screen of the device. Using the mouse that comes with the device, click repeatedly on the “bumps” or “waves” that appear on the lines. The device then captures your responses.
Test responses are then compared to your personal baseline as well as a large database of “normal” test results. Data from each test are sent to Notal Vision, the company that makes the device, who then alerts your doctor’s office of any significant changes from the established baselines. A follow-up office appointment can then be scheduled.
Your doctor writes an order for a ForeseeHome device. In a couple of days, Notal Vision will contact you to obtain your insurance or Medicare information so they can validate your insurance coverage. The cost of the ForeseeHome device is covered by Medicare and private insurance for the majority of patients. The device is then shipped to your house.
Once you receive it, Notal Vision will give you personalized instructions on how to set up and use the device.
You don’t need a computer to use ForeseeHome. It can be used with Wi-Fi, cellular service, or a landline. Whichever one you use, Notal Vision will walk you through how to set up ForeseeHome and how to use it. If you need help at any point during the setup of ForeseeHome or when you are testing, you can contact Notal Vision at 1-888-910-2020, Monday–Friday, 8 am to 8 pm EST.
The ForeseeHome is intended for use in the detection and characterization of central and paracentral metamorphopsia (visual distortion) in patients with age-related macular degeneration, as an aid in monitoring progression of disease factors causing metamorphopsia including but not limited to choroidal neovascularization (CNV). It is intended to be used at home for patients with stable fixation.
The ForeseeHome AMD Monitoring Program is only available by physician order and is intended to be used as an addition to regular eye exams.
The ForeseeHome AMD Monitoring Program is covered by Medicare, subject to its coverage requirements for the test, to assess patients with dry AMD who are at risk of developing wet AMD.