They will need to filter food out of the water when they are below 3" for sure. They cannot get enough energy from photosynthesis.
The food will need to be small enough for the clam to use it. Cyclopeeze is too big. Phytoplankton, especially nanochloropsis, is perfect size. Live phyto is best. If you feed dead phyto (marine snow, phytoplex, etc.) it can clump together and become too big.
Clams will look OK until a few days before they die. Once they start looking bad, it is usually just a matter of time. The only way to treat a clam is to give it proper requirements since they are not able to tell you when they are unhappy.
If your clam is over 3", then you probably don't need to feed it. They still need some nutrients from the water, but a normal amount of junk in your tank can keep it fed.