Quality of Life in Age-Related Macular Degeneration - CNIB

health professional about the hallucinations of whom 59 (21% of those
experiencing hallucinations) were given an explanation. Some explanations
were inaccurate or unhelpful e.g. psychological (N=1), brain confusion (N=1),
stress (N=2), nothing to do with MD (N=1). In a study of 100 patients treated
with PDT for predominantly classic CNV, five (5%) described experiencing
structured hallucinations following treatment 110 .
These studies indicate that people may be reluctant to report hallucinations
for fear of being diagnosed with dementia or otherwise considered ‘crazy’ 76 109 .
This concern alone may impact on QoL, severity of MD and hallucinations
notwithstanding. Mitchell reported that hallucinations were associated with
poorer psychological well­being (W­BQ12 15 ) after controlling for severity of
MD 75 . Scott reported that, even among people with relatively good VA, those
experiencing hallucinations demonstrated higher levels of emotional distress
(General Health Questionnaire [GHQ] 111 ) and decreased function (SIP 31 )
compared with those without hallucinations 109 . Health professionals need to
be aware of the likelihood of hallucinations in MD and ask patients if they
have experienced them. Reassurance about the benign nature of the
phenomenon and its often limited duration would prevent much distress 112 113 .
Cohen et al 110 suggested that all patients who undergo PDT should be told
beforehand that hallucinations are a possible side effect of treatment. Such
pre­emptive education may be the best approach for all people diagnosed
with MD 90 .
6. Rehabilitation
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