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Wet age-related macular degeneration is a leading cause of severe vision loss in the elderly population, both in the United States and worldwide. Early detection is vital so that treatment can be implemented promptly, in turn increasing the potential for successful prevention of blindness. Affordable, home-monitoring techniques such as usage of an Amsler grid may help decrease the latency between onset of wet age-related macular degeneration and initiation of treatment. This activity describes who is a candidate for a home Amsler grid and reviews how to use the Amsler grid. Additionally, this activity highlights the role of the interprofessional team in helping to identify patients who might benefit from this tool and educate these patients on how to use it. Objectives: Identify the indications for use of an Amsler grid. Explain how to use an Amsler grid. Describe how to interpret the results of an Amsler grid session. Review interprofessional team strategies to improve identification of patients who might benefit from the use of a home Amsler grid and to provide education to these patients. Access free multiple choice questions on this topic.

The Amsler Grid is a square-shaped grid used to detect or monitor metamorphopsia or scotoma involving the central visual field in various disorders of the macula and optic nerve head. Specifically, it is used as an inexpensive home monitoring device for early detection of metamorphopsia due to wet age-related macular degeneration. Also, it may be used as a macular function test before cataract surgery. The grid gets its name from Marc Amsler (1891-1968), a Swiss ophthalmologist, who described the chart in 1947.[1] He was a student of Jules Gonin (1870-1935). He might have gotten the idea of the grid from Edmund Landolt (1846-1926), who devised a similar small card with a grid pattern to be kept in the center of the perimeter.[1] Jacob Hermann Knapp (1832-1911) described scotoma and metamorphopsia in traumatic maculopathy with choroidal rupture using horizontal lines in 1869. Richard Forster (1825-1902) demonstrated metamorphopsia using a square grid in 1874.[1]

Appropriate use of the Amsler grid requires an interprofessional team. The nurses and optometrists who are involved in patient care should be taught how to handle the instrument properly without any damage. Also, the nurses should assist the clinician with giving proper instructions to the patient so that the final result will not be ambiguous. Often patients will use the Amsler grid at home. The nurse should monitor compliance and report to the ophthalmologist or optometrist if the patient is not compliant or inappropriately using the grid. It is also important to not to apply any mydriatic in the eye prior to the test. If the nurse or clinician accidentally uses a mydriatic, the team should be informed of the application and the test rescheduled on a later date. Interprofessional application and education of patients using the Amsler grid will result in the best outcomes. [Level V]