Case Studies

Age related macular degeneration (AMD)

A fresh perspective on preventing sight loss

Lady reading paper

Age related macular degeneration (AMD) is the biggest cause of sight loss in the UK. Symptoms can start when around 50 years old and by the age of 75, around one third of the UK population are affected to some extent.

Commissioned by DOCET, Insitu has produced a five-part online learning course about AMD for UK optometrists.

Covering the latest research, diagnostic tools, expert clinical opinion, and patient insights, this in-depth online learning resource allows optometrists to keep their knowledge and skills in step with current best practices for identifying, managing, and treating AMD.

Our course gives a unique insight into a patient’s journey through the health care system and shows that the outlook for a patient with wet AMD is considerably brighter today than it was a decade ago.

The need

AMD is a painless eye condition affecting the retina, and in particular, the macula, the part of the eye used for sharp vision. It is usually detected at a routine eye exam or when a patient has trouble performing daily tasks such as driving, reading, or recognising faces. The condition leads to a gradual worsening of vision. In cases known as ‘wet active AMD’, vision can decline rapidly, and urgent treatment is required at a hospital to stop further sight loss.

Optical Coherence Tomography (OCT) is an advanced imaging technology that creates images of the retina showing incredible detail. With correct interpretation, OCT images can enable AMD and other retinal diseases to be better evaluated in high street practices and can help to avoid unnecessary referrals to hospital eye services.

Through building this course for DOCET, we have been able to give optometrists:

  • practice in interpreting OCT clinical data
  • insights into the remarkable advances in treating and managing AMD
  • suggested ways of working with patients and their families to provide care and support.

How we made it

At Insitu, we’re fascinated by how people learn, and we strive to make learning worthwhile and rewarding. We are also an enquiring partner alongside our clients. We are willing to dig deep, explore questions, and find answers to create smarter learning with long-term value.

Alongside this, we’re also patient. Deep learning, like this AMD project, can’t be written overnight and requires long research, development, and production phases. We’re adept at keeping a complex project running over many months – and keeping it fresh, at the same time.

For this project, our goal was to produce a comprehensive online learning programme built around informative video interviews with patients and clinical experts and real-life surgical procedures.

In particular, a key goal was for learners to become familiar with the physical appearance of the macular region in OCT images and understand the correlation with traditional retinal pictures to better know changes in the eye linked with AMD.

Our learning designers worked to fully discover the subject at an academic and clinical level. They reviewed literature, current research data, and clinical practice, and then collaborated with optometrists, ophthalmologists, and nurses to go beyond initial resources and build something truly new.

At the same time, our video production and graphic design teams created an extensive media library of clinical imagery, custom graphics, and medical illustrations.

And for clinical accuracy and relevance to medical professionals, we worked closely with optometrists and ophthalmology specialists at Bradford Teaching Hospitals NHS Foundation Trust.

Challenges and solutions

The course contains over 100 clinical OCT data images, each one carefully selected from hundreds of anonymised case records. Annotations and clinical descriptions were then added to each data image. To maintain confidence in the datasets across multiple teams, we built a bespoke workflow to maintain data integrity throughout the research, writing, design, review, product build and delivery stages of the project.

Filming inside live surgical environments required months of careful planning, coordination, and relationship building with nurses, doctors, and administrators. We had to negotiate a careful balance between our content needs, and the absolute priority of working safely and sympathetically with patients.

Once we were given access to the hospital, our highly experienced camera crew were able to get the footage we needed, including surgical procedures and patient interviews.

A real help for practitioners

We are exceptionally proud to have delivered this substantial course on an important area of optometry, which has a direct positive impact on day-to-day practice.

Our course gives a unique insight into a patient’s journey through the health care system, the power of OCT imaging, and the molecular science behind AMD.

It gives optometrists a fresh perspective, showing that the outlook for a patient with wet AMD is considerably brighter today than it was a decade ago and that there is a high likelihood that, if caught early, good vision can be preserved in the affected eyes.


“The Insitu team have brought a fresh perspective to my work managing AMD and I’ve been impressed by their willingness to get stuck into the clinical detail. Together, we’ve delivered a definitive piece of work, which will benefit any optometrist wanting a better understanding of all aspects of AMD management.”
- Dr Charlotte Hazel, Senior Research Optometrist
Bradford Teaching Hospitals NHS Foundation Trust
“Insitu are really good at seeing a different narrative than the day-to-day story. For this project, this was enabled by a highly educated team, who understood how to weave a good story across video, text, data and artwork to bring out key insights and provide a lasting resource for UK optometrists.”
Bettina Noelle-Fox, CPD Manager