Glaucoma: Applying Glaucoma Strategies to AMD Care

Any glaucoma clinician knows that a robust VF strategy, coupled with structural measures, such as optical coherence tomography (OCT), provides a richer understanding of a patient’s disease than anatomical structure alone. Yet when it comes to age-related macular degeneration (AMD), I would argue that our diagnostic habits are quite different.

By
Mike Cymbor, OD, FAAO
October 1, 2025
4 min

Optometric Management

Objective:

To advocate for the incorporation of functional testing in the diagnosis and management of age-related macular degeneration (AMD), similar to practices in glaucoma care.

Key Findings:

Functional tests like CS and DA can reveal changes in retinal health before structural changes are visible.
DA can predict conversion to advanced AMD.
Microperimetry helps assess fixation and central visual field defects.

Interpretation:

Incorporating functional testing into AMD care can provide a more comprehensive understanding of the disease and improve patient outcomes.

Limitations:

Current diagnostic habits in AMD rely heavily on structural imaging.
There may be a lack of familiarity or training among clinicians regarding functional testing.