The demographic shift towards an older population in the USA is well documented and has been discussed in other chapters in this text. The number of patients older than age 85 years (such as in our case vignette) is projected to double from 4.7 million in 2003 to 9.6 million in 2030, and by 2050 to 20.9 million. Ophthalmology as a specialty will be disproportionately affected by the demographic shift as the most common causes of chronic visual impairment all show an increased incidence and prevalence in the elderly population. The most common age-related visual problems with geriatric ophthalmic surgery implications are cataracts, glaucoma, diabetic retinopathy, and ARMD. The incidence of cataract dramatically increases with age and half of patients over the age of 75 will develop a visually significant cataract in one or both eyes. One quarter will have the non-exudative or “dry” form of ARMD, 5% will have the exudative or “wet” form of ARMD, and 2–10% will have glaucoma [1–5]. In addition, many other blinding disorders (e.g., giant cell arteritis, non-arteritic anterior ischemic optic neuropathy, cerebral stroke) are diseases primarily of the elderly.
KeywordsDiabetic Retinopathy Retinal Pigment Epithelium Giant Cell Arteritis Diabetic Macular Edema Proliferative Diabetic Retinopathy
This work was supported in part by an unrestricted grant from Research to Prevent Blindness, Inc., New York City, NY, the American Geriatrics Society, and the John A. Hartford Foundation.
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