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Psychosocial adjustment in age related macular degeneration

School of Nursing, Midwifery and Social Work, University of Manchester, UK, penelope.stanford{at}manchester.ac.uk

Heather Waterman

School of Nursing, Midwifery and Social Work, University of Manchester, UK

Wanda B. Russell

Centre for Health Planning and Management, Keele University, UK

Robert A. Harper

Academic Department of Optometry, Manchester Royal Eye Hospital, UK

This article describes longitudinally the psychosocial adjustment to visual impairment of patients with age related macular degeneration (AMD). As part of a larger randomized controlled trial (RCT), the present study design consisted of the use of prospective qualitative diaries completed over 12 months by patients with AMD who were newly referred to a low vision clinic. Out of the patients recruited (n = 226), the completion rate of a full set of four diaries (n = 37) and one three-month diary (n = 194) was very good. Vision related to daily life in patients with AMD appears to decline over 12 months with limited psychosocial adjustment to visual loss. Seven themes were generated from the patients' accounts of their experiences, as recorded in the diaries: safety, loss of independence, isolation, support mechanisms, mood, effects of the media and psychosocial adjustment. There was little evidence in the diaries of psychosocial adjustment to visual loss. The relevance of the theory of grieving and cognitive and rational-emotional theory in the context of AMD is explored in detail.

Key Words: age related macular degeneration • cognitive and rational-emotional theory • grieving process • psychological adjustment • quality of life • visual loss

British Journal of Visual Impairment, Vol. 27, No. 2, 129-146 (2009)
DOI: 10.1177/0264619609102216


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