With all of the recent and well-deserved attention given to novel treatments for wet AMD, it's easy to overlook the far more prevalent dry AMD. The relative lack of effective treatments also contributes to the same tendency.

Our cover story this month (p. 28) takes a comprehensive look at the challenge of helping patients who show signs of dry AMD and those aspects of managing the condition that are within your control. Managing in this case meaning delaying or, at worst, rapidly detecting the conversion to wet AMD. While there is good emerging science to support several options that may help, it appears that for the near future, dry AMD will rely far more on the art of medicine than the science. How you communicate with these elderly, sometimes depressed, often scared patients is as important as the treatments you bring to bear.

Even leaving aside the confounding challenge of reaching a patient threatened with a potentially blinding disease, this is no walk in the park. If recent data is to believed, many of them just don't fully understand what you're talking about.

The Centers for Disease Control and Prevention estimates that nine out of 10 average people have difficulty following routine medical advice, largely because it's often incomprehensible. U.S. Department of Education research suggests that "the overwhelming majority of adults have difficulty understanding and using everyday health information that comes from many sources, including the media, websites, nutrition and medicine labels, and health professionals." Add a serious medical diagnosis to the mix and the picture is even more bleak.

A UC, San Francisco study of 14,000 diabetes patients found that more than half the patients re-ported problems learning about their condition and 40 percent needed help reading medical materials. The patients with limited health literacy were 30 to 40 percent more likely to experience hypoglycemia than those with an adequate understanding of medical information.

Probably nothing surprising in that if you've been managing patients for any time, but the situation may be far worse than most physicians realize, according to those who conducted these studies.

As the great George Bernard Shaw said, "The greatest problem in communication is the illusion that it has been accomplished."