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Suggest Treatment For Macular Degeneration In An Elderly Person

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Posted on Wed, 10 May 2017
Question: I am writing on behalf of a friend. She has macular degeneration, is approximately 78, and has lived in a nursing home for 3 years. She is ambulatory, though with a walker. She is lucent and plays bridge but loses track of the status of things (contract, what hand she's in, e.g.). I have suggested her nervousness as a cause of this and she has said she agrees. Specifically, she has, for awhile, had extreme difficulty distinguishing between red suits, i.e. diamonds and hearts. Surprisingly, she has now told that she believes she is having trouble with the black suits, i.e. clubs and spades. She is not content with her pc doctor nor eye doctor. Since we are close to Phila.Pa. I presume if there is help to be found, that is the place to go. My own pc doctor could give me a referral but I would much appreciate a referral with a very specific "definition" which might match her symtoms and from an eye specialist. Your help is appreciated.









To all doctors: I have a friend who has macular degeneration and I would appreciate as specific a referral as you could give me. She can read books and signs of about 3 in. tall at a distance of approximately 20 feet. Where her particular weakness shows when we are playing cards and she cannot distinguish between red suits, i.e. diamonds and hearts. She believes she is now having trouble distinguishing between the black suits, i.e. clubs and spades. She suggested she might be getting color blind. She also loses her focus when we are playing and "forgets whats going on". I believe she is about 78 years old and for three years has been in assisted living center. We are near Phila. which is a great place for doctors and research but I'm looking for as specific a referral as possible. Though I could (and might) ask my PC doctor for a referral I would to get a consensus referral from all of you based on the data I have given you nearness to Phila. if you would agree. Thank you again for your help. I just received some nice confirmation of how to handle my sinusitis from Dr. XXXXXXX Gibson.




doctor
Answered by Dr. Albana Sejdini (7 hours later)
Brief Answer:
Psychiatrist/Ophtalmologist...

Detailed Answer:
Hello,

I read your message and understood your medical problem.

I see that your friend is capable of reading books and signs at a 20 feet distance, she is quite active but gets distracted sometimes and loses her focus in what she is doing described by you that she forgets what was going on. Also, you note that she can not distinguish the forms of playing cards of the same color.


Recent studies have shown a connection between cognitive impairment and macular degeneration. Cognitive impairment includes deficits of memory, problem-solving, abstraction or orientation. These two conditions can be related as they both are neurodegenerative conditions and may coexist easily.

I recommend that she must see a psychiatrist too as these may be the first signs of dementia or Alzheimer disease and is very important to be detected on time before the specific symptoms appear as this will prevent the damage of the life quality and help her live normally.

Also, a consult with the eye doctor would be helpful as she is known to have macular degeneration which needs close follow ups as it leads to blindness. In fact, the problems she is having with distinguishing colors mistakenly could be first signs of blindness and should get further evaluated by ophthalmologist.

So, there are 2 specialists I'd recommend her:
1. Psychiatrist
2. Ophthalmologist

Hope this is helpful for you.

Thank you.
Dr.Albana
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Albana Sejdini (3 days later)
Thank you very much. I see the immediacy of the situation. But should I infer that since you gave me no specifics about whom to see in Phila.Pa (which is renown for its medical care) that you cannot or chose not to. I'd rather not guess unless you're saying you can only refer me back to my PC doctor. He is obviously, not a ophthamologist or a psychiatrist and I would think a referral from a psychiatrist/opthamologist (you, respectfully) could and would be much more specific and pointed to the problem at hand and likely the best specialist or center. And "going the extra mile" assistance would be appreciated as my friend is a worthwhile individual. Thank you again for your help, at this point. I will use it but want to XXXXXXX my efforts in the best direction. Sincerly, Dan
doctor
Answered by Dr. Albana Sejdini (13 hours later)
Brief Answer:
Following suggestions

Detailed Answer:
Hi back,

The specific specialist I'd recommend depends on the area you are located.

I'd recommend following specialists:
- G. XXXXXXX xxxxxxx, MD

Director, Cognitive Disorders Center

xxxxxxxxxxxxxxxxxxxxxxxxxxx
219 N. xxxxxxxxxxx
The XXXXXXX T. xxxxxxxx, MD xxxxxxxxx, 7th Floor XXXXXXX PA 19107

Phone: 215.762.6915
Fax: 215.762.6914

- XXXXXXX S. xxxxxx, M.D.
Wills xxxxx xxxxxxxxx xxxxxx
8025 xxxxxxBlvd. XXXXXXX PA 19152
Phone: (215) 423-0000


Hope this helps.
Dr.Albana


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Albana Sejdini (5 days later)
Thank you very much, That's exactly what I wanted.This should be a very good starting point. Someone also recommended, highly, a local eye center that's connected to Wills Eye in Phila. My plan,at this point, is to share all the information I have given you, along with your suggestions, and get their opinion. Perhaps they can handle this issue with an appropriate psychiatric referral. Or not, and presumably reinforce your opinions and coordinate with the doctors you suggested. This is great as I think I have pinpointed the experts needed to do what can be done. And the immediacy of your suggestions is very impactual. Thank you again.
doctor
Answered by Dr. Albana Sejdini (17 hours later)
Brief Answer:
Ok, two ways to contact these specialists as following....

Detailed Answer:
Hi back XXXXXXX

I am happy you found my suggestions helpful.

You can contact the doctors directly through the contact information provided.
Or can discuss with her caring doctor to refer these specialists for further assistance.

All the best and God bless.
Dr.Albana
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Albana Sejdini

General & Family Physician

Practicing since :2006

Answered : 7312 Questions

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Suggest Treatment For Macular Degeneration In An Elderly Person

Brief Answer: Psychiatrist/Ophtalmologist... Detailed Answer: Hello, I read your message and understood your medical problem. I see that your friend is capable of reading books and signs at a 20 feet distance, she is quite active but gets distracted sometimes and loses her focus in what she is doing described by you that she forgets what was going on. Also, you note that she can not distinguish the forms of playing cards of the same color. Recent studies have shown a connection between cognitive impairment and macular degeneration. Cognitive impairment includes deficits of memory, problem-solving, abstraction or orientation. These two conditions can be related as they both are neurodegenerative conditions and may coexist easily. I recommend that she must see a psychiatrist too as these may be the first signs of dementia or Alzheimer disease and is very important to be detected on time before the specific symptoms appear as this will prevent the damage of the life quality and help her live normally. Also, a consult with the eye doctor would be helpful as she is known to have macular degeneration which needs close follow ups as it leads to blindness. In fact, the problems she is having with distinguishing colors mistakenly could be first signs of blindness and should get further evaluated by ophthalmologist. So, there are 2 specialists I'd recommend her: 1. Psychiatrist 2. Ophthalmologist Hope this is helpful for you. Thank you. Dr.Albana