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AMD and Depression
By Dr. Erica A. Hacker, O.D.

This time of the year can be challenging for individuals who live with chronic illness. For those with age-related macular degeneration (AMD), the leading cause of blindness in older Americans, depression is a major risk. AMD affects as many as 15 million Americans, and as the disease progresses it affects a person's ability to enjoy everyday activities like driving, reading, writing, watching television, and cooking.

There is hope. A new intervention that combines low vision therapy with psychological rehabilitation has been shown to cut the risk of depression by 50 percent. In a study funded by the National Eye Institute, part of the National Institutes of Health, researchers tested an approach called behavior activation with the goal to increase the depressed person's participation in activities that can improve mood and to promote self sufficiency.

For the study, the 188 participants met with an optometrist twice and were prescribed low vision devices such as hand-held magnifiers. The participants then were randomly split into two groups. One group received behavior activation therapy from a specially trained occupational therapist who worked with them on using the low vision devices, making changes in their homes, increasing social activities, and setting their own personal goals. The study found that this therapy reduced the risk of depression by 50 percent.

This mix of behavior activation with low vision rehabilitation is what we do at Blind & Vision Rehabilitation Services. We use all of these techniques. While the study included two sessions of outpatient low vision rehabilitation followed by six hours of in-home therapy, our approach can vary and is based on the patient's individual needs. Some patients receive more outpatient sessions. Some receive only in-home therapy. All of these approaches take into consideration the patient's interests and goals and use any and all methods appropriate.

Blind & Vision Rehabilitation Services of Pittsburgh is a nationally accredited, 107-year- old nonprofit leader in programs and services for people of all ages who are blind, vision impaired, or have other disabilities. We believe in independence through rehabilitation. Our mission is to change the lives of persons with vision loss and other disabilities by fostering independence and individual choice. We offer comprehensive and personalized computer instruction, employment and vocational services, personal

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