Ophthalmology is the study of the eye and how it functions. It also includes the study of eye diseases, their diagnosis and treatment. Ophthalmologists, optometrists and opticians all play a vital role in providing eye care for seniors. To make sure that your loved one is seeing the proper professional for their eye care needs, there are three different types of eye care professionals whose scope of patient care differs as follows:
Ophthalmologists are licensed medical doctors who provide a broad spectrum of eye care needs. Ophthalmologists diagnose and treat eye diseases, perform surgeries and prescribe/fit contact lenses and glasses.
Optometrists are licensed to strictly practice optometry and provide a more narrow range of services. Their scope of service includes screening for eye abnormalities, prescribing medications for eye diseases and examining the eye to fit contact lenses and glasses.
Opticians are trained professionals who can design, verify and fit vision correction devices such as contacts, and eyeglass lenses and frames. They are not allowed to test vision, diagnose or treat eye diseases. While they can use prescriptions written by optometrists or ophthalmologists, they cannot prescribe medications for patients.
A major health care concern among seniors is vision loss. By the age of 65, one out of three people will have some kind of vision-reducing eye disease. The most common of these vision-reducing eye diseases are glaucoma, cataracts, age-related macular degeneration and diabetic retinopathy.
Glaucoma is a group of eye conditions that lead to damage to the optic nerve which carries information about what you see with your eyes, to your brain. When the fluid in the eye is slowed or blocked, the pressure will build up pressing on the optic nerve and causing damage. It is the second most common type of cause of blindness in the U.S.
Cataracts occur when vision is affected by a clump of proteins that cloud the lens of the eye causing blurry vision. As the disease progresses, the eye slowly changes to a yellowish or brownish color. Vision will lose its sharpness and a brownish will tint will become apparent. The risk of cataracts increases with age and it is estimated that by the age of 75, more than half of the senior population will have had cataracts and/or cataract surgery.
Age-related macular degeneration (AMD) usually occurs in people over the age of 50. Since the risk of AMD increases with age, it is considered a normal part of aging. However, as a person with AMD gets older, it becomes chronic issue. Factors that may affect a person’s risk of developing AMD are smoking, family history, and race. Studies have found that the prevalence of AMD is more common in Caucasians than people of African descent.
AMD is the leading cause of vision loss in the elderly as it destroys an individual’s sharp central vision which is what allows a person to see objects clearly. The part of the eye that allows you to see fine detail is called the macula which is located in the back of the eye and made up of millions of light-sensing cells. When an individual has AMD, these cells begin to die and the retina’s sharp detailed vision is affected. If there is damage to the macula, when light rays pass through, the fine detailed parts and often colors of the image get filtered out on the way to the brain. This produces a less detailed perceived image and eventually a gray splotch may appear in the center of an person’s vision. While AMD does not cause complete blindness, it can impair one’s ability to read, drive or recognize faces. Severe loss affects depth perception and can also result in hampering a person’s ability to function and perform basic activities of daily living such as driving a car, reading, cooking and walking safely.
There are two forms of AMD: “dry” and “wet.” Those with the dry form (early stage AMD) often find that the progression of degeneration is so slow that they hardly notice the change in their vision and actual loss may not occur for some time. When a person suffers from wet AMD (advanced AMD), not only are the macula damaged, but the blood vessels under them begin to leak blood and fluid, causing rapidly increasing damage to the macula. All people with AMD begin with the dry form first which can rapidly progress in a very short period of time, potentially causing vision loss in one or both eyes.
Diabetic retinopathy occurs when diabetes causes damage to the small blood vessels in the back part of the eye, called the retina. Like film in a camera, the retina is the part of the eye that creates a picture of the light and images that your eye takes in. The retina then sends the information from the optic nerve to the brain to “develop” the picture into the image you actually see. People with long-term or uncontrolled type I and type II Diabetes are both at risk for diabetic retinopathy which may cause blurred vision, halos, shadows or holes in vision and trouble seeing at night. The two types of diabetic retinopathy are non-proliferative which develops first and then proliferative diabetic retinopathy which develops as the disease progresses. Other vision issues that are also associated with diabetic retinopathy include glaucoma, macular edema, cataracts and retinal detachment.
Vision impairment has also been associated with an increased risk for depression and the decreased ability to perform the activities of everyday living. In addition to age, other risk factors associated with eye disease and injury are improper nutrition, smoking, alcohol intake, infections, medicinal side effects, damage from sun exposure and accidental injuries. Because of these risks, your loved one should see an eye care professional regularly to have annual eye checkups.
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