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M ACU L A R D I SE A SE I SSU E

In optometry, supporting vision means looking beyond the prescription. As our population ages and conditions such as age-related macular degeneration (AMD) become more prevalent, many patients are doing everything medically recommended, yet still drifting away from the activities that give their lives meaning. The real challenge isn’t always clinical – it’s functional, emotional, and behavioural. Through conversations in residential care settings, a clear pattern is emerging: when optical support, compassionate coaching, and physical vitality are addressed together, patient outcomes shift. In this article Dee Makadia explores practical, clinic-ready ways to help patients with low vision maintain independence, confidence, and connection.

Supporting our

So, how do we adapt? I see three essential areas:

As the body slows down, circulation to the retina decreases, meaning less oxygen and fewer nutrients reach the retina. In macular disease, this matters. Encouraging gentle movement isn’t just good for general wellbeing; it supports eye health too.

• What daily tasks feel most challenging? (Start broad to build rapport, then refine your questions.)

These three aren’t separate – they overlap. Each one supports the others, helping older adults maintain independence, confidence, and a sense of purpose.

VISUAL AIDS THAT TRULY EMPOWER When I asked residents about their magnifiers, frustration was the common thread. Some had small, inexpensive lenses that distorted text. Others had high-end digital devices that were too complicated or too dim. The result was the same: disappointment.

By framing questions this way, you open the door to genuine emotional connection – and that changes everything. In one clinic I worked with, we introduced a simple ‘three discovery question’ rule. Team members asked open questions, so patients felt truly listened to, but the real impact came from the quality of the listening and the response. Each team member would acknowledge what the patient shared and then follow up with a thoughtful question that gently elevated the conversation. This approach led to higher patient satisfaction scores and overall team culture improved. Patients felt heard, and team members felt more supported and confident in their interactions.

I often demonstrate these in workshops – and the surprised response is always the same: “You mean something this simple can help my eyes?” The answer is yes.

Older lens designs, such as those introduced over 15 years ago, often rely on plastic lenses with high aberration and single LED lights. Many are too heavy or awkward for tremor- affected hands. And while digital magnifiers exist, the technology gap can be intimidating. One gentleman told me, “I just don’t understand it – there are too many buttons, and it’s not always got charge when I need it to work.”

CONNECTING SIGHT, MIND, AND BODY IN INDEPENDENT LIVING Good long-term vision relies on three pillars: aids, mental support, and physical vitality. Ignore one, and the outcome changes.

If you ever went to a residential care home 30 years ago, most residents would watch TV all day, sitting in the same chair. Research has since shown that television viewing time was associated with increased risk of cardiovascular mortality. Fortunately now, programs with varying levels of activity have been included in care facilities to encourage movement and interaction, protecting both mental and ocular health.

What’s clear is that modern magnifiers should focus on simplicity, brightness, and contrast. Devices with higher-lumen LEDs and easily adjustable colour temperature, can dramatically improve comfort and clarity. It’s also worth noting that blue light emitted from LEDs, while useful in moderation, has been linked to increased oxidative stress in retinal tissues, which may contribute to the progression of macular degeneration is being researched further. In addition, close proximity and long-term exposure to harsh LED lighting have been associated with ocular surface issues like pterygium, as highlighted by an ophthalmologist in a phone-repairer case study in Australia.

Compassion also extends to a patients’ support network. Encouraging caregivers, offering them reassurance, giving guidance, and inspiring confidence to not give up, plays a vital role in how successfully the patient progresses.

When families are invited to share observations, celebrate small wins, and understand how lighting, movement, and daily routines influence visual outcomes, it helps maintain meaningful consistency between home and clinic.

As clinicians, we can’t change every variable, but we can start the conversation. A few encouraging words, offering magnifier solutions with improved lighting, and discussions around the benefits of gentle activity can re-ignite hope. When patients feel empowered to act, they do.

THE PHYSICAL SIDE OF VISION: MOVEMENT, METABOLISM, AND THE EYES During a recent discussion with an ophthalmologist, we found ourselves circling back to one major theme: longevity begins with physiology. Blood pressure, glucose levels, and thyroid function all influence ocular health – and they’re all affected by movement, something that’s often overlooked in daily conversation.

Providing residents with the best suited magnifier is often the turning point. When vision aids become supportive rather than challenging, independence increases – but how else might we empower patients? Is a visual aid enough?

range. With two decades of clinical experience and extensive work with senior adults, he regularly delivers education sessions within residential care settings across Australia. He has a particular interest in practical low vision solutions that support independence and quality of life.

Eyehouse.com.au and the SeeBigger magnifier

COMPASSIONATE COACHING: SEEING THROUGH THEIR LENS In optometry, compassion isn’t an optional skill – it’s one of the most valuable lessons I learned from my mentors.

References available at mivision.com.au.

So, what’s the difference between empathy and compassion? Empathy allows us to understand a patient’s fear of losing independence. Compassion, however, goes one step further – it’s the commitment to never saying ‘nothing can be done’, and instead proactively guiding the patient toward a meaningful outcome.

• How we care for our eyes in the spring and summer of the eye cycle affects our ocular health in older age. • Vision care for older adults must address emotional, optical, and physical needs. • Ergonomic, brighter, clearer optics magnifiers improve usability and reduce frustration. • Compassionate coaching rebuilds motivation and confidence. • Gentle physical movement supports circulation, cognition, and ocular health.

Many of the residents I spoke with were initially focused on finding new products. But as the conversations continued, it became