You are using an outdated browser. Please upgrade your browser to improve your experience.
Become a Fellow
ACP offers a number of resources to help members make sense of the MOC requirements and earn points.
Understanding MOC Requirements
Earn MOC points
The most comprehensive meeting in Internal Medicine.
April 11-13, 2019
Internal Medicine Meeting 2019
Prepare for the Certification and Maintenance of Certification (MOC)
Exam with an ACP review course.
Board Certification Review Courses
MOC Exam Prep Courses
Treating a patient? Researching a topic? Get answers now.
Visit AnnalsLearn More
Visit MKSAP 18Learn More
Visit DynaMed Plus
Ensure payment and avoid policy violations. Plus, new resources to help you navigate the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
Access helpful forms developed by a variety of sources for patient charts, logs, information sheets, office signs, and use by practice administration.
ACP advocates on behalf on internists and their patients on a number of timely issues. Learn about where ACP stands on the following areas:
© Copyright 2018 American College of Physicians. All Rights Reserved. 190 North Independence Mall West, Philadelphia, PA 19106-1572
Toll Free: (800) 523.1546 · Local: (215) 351.2400
ILLUSTRATION: There are yellowish-white discrete and confluent deposits of varying sizes in this macula. These formations are known as drusen and are considered to be one of the early signs of macular degeneration. Clinically, drusen are defined as "hard" as opposed to "soft" drusen. Hard drusen are smaller, more sharply defined and are less clinically significant. Soft drusen, such as these are larger, irregular and are more significant as a harbinger of ARMD. There is some pigment clumping in this macula indicating partial atrophy of the retinal pigment epithelial layer.
DISCUSSION: This is an example of the "dry form" of ARMD, most likely with some degree of visual loss. A self testing device known as "The Amsler Grid" is used to aid in diagnosis and is essential in following the course of ARMD. This is a card with multiple perpendicular lines that form a grid. The patient focuses on the center of the grid with one eye and notes any distortion in the lines or absence of any squares. Such abnormalities may indicate a change to the more abrupt onset and more severe "wet form" of ARMD.
There is no "cure" for the disease. However, a formulated combination of antioxidants, vitamins and zinc has been shown to reduce severe visual loss by 25% over a six year period. While reading and driving vision may become compromised, it is important that patients know that they will not be completely blind but will retain peripheral vision. Smoking and a hereditary history are risk factors for ARMD. Low vision aids will help with reading.
While considerable strides have been made in treatment, particularly in the wet form, ARMD remains the most common cause of legal blindness in the United States.