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AMDF Macular Degeneration Patient Experience Survey

Thank you for participating in our survey!

Your responses will help us direct resources toward developing solutions for people living with and affected by AMD.

If you would like to see the results of this survey, and/or join our mailing list, please provide your contact information at the end.

Your participation is greatly appreciated and has the potential to help many people.

The first 8 questions are about your initial diagnosis appointment.
1.When did you receive your initial diagnosis of age-related macular degeneration (AMD)?
2.At what age did you receive your initial diagnosis of AMD?
3.Did you receive an initial diagnosis of Age-related macular degeneration (AMD) as the result of a routine eye exam, or because you noticed a change in your vision?
4.If you noticed a change in your vision, was it:
5.If your doctor recommended any treatment at your diagnosis appointment, were there questions about the treatment you did not ask?
6.Did you have questions about your treatment that you did not ask?
7.Did you feel comfortable asking questions during your diagnosis appointment?
8.If you did not feel comfortable asking questions at your AMD diagnosis appointment (select all that apply):


The next set of questions is about your current treatment plan. 

9.When you go to your eye specialist are you accompanied by someone who acts as your advocate and can take in information or ask questions if you are too stressed at the time?
10.Do you always report changes in your vision between scheduled visits?
11.If you do not report changes in your vision between scheduled visits is it because (select all that apply):
12.Were lifestyle changes, such as exercise or losing weight, suggested as part of your treatment plan?
13.Were nutritional changes suggested as part of your treatment plan?
14.Are you receiving anti-VEGF eye injections as treatment for your wet AMD?
15.If you are receiving anti-VEGF eye injections, how long do you expect to need these treatments?
16.What are your expectations of your treatment (select all that apply):
17.Were you told that, even with treatments to stop the wet form of AMD, your AMD might progress in ways that current treatments do not address?
18.After an eye specialist consultation do you feel empowered to treat your AMD?
19.Do you talk about the emotional aspect of living with AMD vision loss with (select all that apply):


Tell us a little more about your experience

20.You often see examples of AMD vision loss represented by photos with the center blacked out or blurred, but this is an oversimplification of what people with AMD experience. Can you describe what your vision loss “looks” like?
21.While most people can understand the bigger aspects of vision loss, like losing the ability to drive or read, it’s often little things that our loved ones and the public-at-large don’t understand about vision loss. What are the every day “little” obstacles/frustrations you face as a result of vision loss due to AMD?
22.Is there anything else you would like to add?
23.Thank you again for filling out our survey! We hope this will lead to important insights about patient care and experience. If you'd like to see the results of the survey and/or join our mailing list, enter your information below. We won't share your personal information with any other party, and you can opt out at any time. We respect our email subscribers with relevant information.
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