Vision Loss in the Elderly

1.  The common causes for vision loss in the elderly include: (1) diabetic retinopathy, (2) refractive error, (3) cataracts, (4) open-angle closure glaucoma, and (5) age-related macular degeneration (AMD).

2.  As a significant proportion of the above causes are preventable or treatable, it is recommended that screening for vision loss be part of periodic health examination in all persons older than 65 years.  The recommendation is to screen for vision loss every one to two years, by checking visual acuity (using a Snellen chart) and checking for any functional impairment or adapation due to vision loss (through targeted history-taking).

3.  If vision loss is detected or suspected, one should then proceed on to perform disease-specific screening.  These include diabetic retinal photography (for diabetic retinopathy), pin-hole testing (for refractive errors), red reflex testing using a handheld ophthalmoscope (for cataracts).  The use of tonometry and automated visual field testing (for open-angle closure glaucoma) and the Amsler grid (for AMD) are usually only employed in the specialist care setting.

4.  Studies have also shown that aggressive management of diabetes, hypertension and hyperlipidemia; encouraging smoking cessation; reducting ultraviolet light exposure; and appropriate response to medication adverse effects can preserve and protect vision in many elderly persons.

To read the article from which the above information was obtained, click here.

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