Elder Abuse Recognition and Intervention in Vision Care

  • Andrew G. Lee
  • Carmel B. Dyer
  • Yi-Hsien Renee Yeh
  • T. Ashwini Kini
  • Bayan Al Othman

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There are 700,000-1.2 million cases of elder abuse annually in the US, and internationally 2-10% of patients over 65 years old report a history of maltreatment. Less than 10% of the estimated elder abuse cases are reported. Elder abuse includes physical abuse, neglect, exploitation, abandonment, and sexual abuse, psychological abuse (i.e. humiliation, intimidation). Signs of abuse include physical trauma, poor hygiene, malnutrition, or dehydration. Signs also include unexplained broken glasses, noncompliance with prior treatment instructions, missed appointments, or nonspecific anxiety or depression. Abuse of the elderly is often from the spouse or children in the home. The 3-year relative mortality in the elderly with a history of abuse is 3 times greater than controls. The Elder Assessment Instrument is a highly sensitive but nonspecific test for elder abuse. Elder abuse is underreported by physicians, but physicians have a duty to report all cases of suspected abuse in most states. In many cases, the best solution is to treat the abuser’s underlying social and psychological issues and allow the older patient to remain at home.


This video covers the key points that all physicians need to be aware of, as any physician can spot the signs and help a patient suffering from abuse. Since very few physicians are trained in elder abuse, few will recognize the signs and have the appropriate tools to get help for the patient. This video discusses the signs as they may present in the course of a vision-care setting, how to address the problem, and what resources are available to those seeking to help their patients.

About the Author

Andrew G. Lee

Andrew G. Lee, M.D. is a graduate of the University of Virginia undergraduate school and the School of Medicine. He completed his ophthalmology residency and was the chief resident at Baylor College of Medicine in Houston, Texas in 1993. Following residency, Dr. Lee completed a fellowship in neuro-ophthalmology with Neil R. Miller MD at the Wilmer Eye Institute and was a post-doctoral Fight for Sight fellow at the Johns Hopkins Hospital in Baltimore, Maryland from 1993-1994. He was formerly an Associate Professor at Baylor College of Medicine and Adjunct Associate Professor at the M.D. Anderson Cancer Center in Houston from 1994-2000. He has published over 240 peer reviewed articles, 40 book chapters, and two full textbooks in ophthalmology. Dr. Lee serves on the Editorial Board of 12 journals including the American Journal of Ophthalmology, the Canadian Journal of Ophthalmology, and Eye. He has received the American Academy of Ophthalmology (AAO) Honor Award, the AAO Secretariat Award, and the AAO Senior Achievement Award.

Carmel B. Dyer

Carmel B. Dyer, MD, AGSF, FACP Ranked one of the nation’s top geriatricians, Carmel Bitondo Dyer, MD, has served as a clinician, researcher, educator, and administrator for more than 25 years. As executive director of the Consortium on Aging at The University of Texas Health Science Center at Houston (UTHealth) and executive vice chair of the Department of Internal Medicine at McGovern Medical School at UTHealth, Dyer promotes a circle of care concept to deliver comprehensive, age-appropriate care to older adults. Her areas of expertise include preventing elder abuse, developing innovative models of health care, and building inter-professional teams that work together on behalf of vulnerable patients. In addition to her executive leadership roles, Dyer is the Roy M. and Phyllis Gough Huffington Chair in Gerontology, Vincent F. and Nancy P. Guinee Distinguished Chair, and Professor in the Division of Geriatric and Palliative Medicine at UTHealth. She cares for patients at UT Physicians Center for Healthy Aging-Bellaire.

Yi-Hsien Renee Yeh

Yi-Hsien Renee Yeh Texas A&M College of Medicine

T. Ashwini Kini

T. Ashwini Kini, MD Neuro-ophthalmology fellow 2018-2019, Houston Methodist Hospital

Bayan Al Othman

Bayan Al Othman, MD Neuro-ophthalmology fellow 2018-2019, Houston Methodist Hospital


About this video

Andrew G. Lee
Carmel B. Dyer
Yi-Hsien Renee Yeh
T. Ashwini Kini
Bayan Al Othman
Online ISBN
Total duration
12 min
Springer, Cham
Copyright information
© Producer 2019

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Video Transcript


My name is Yi-Hsien Yeh from Texas A&M College of Medicine. In this video, we sit down with Dr. Andrew Lee, a ophthalmologist from Blanton Eye Institute at Houston Methodist Hospital, and Dr. Carmel B. Dyer, a clinical geriatrician from the University of Texas Health Science Center at Houston McGovern Medical School to discuss elder abuse.

In our conversation, we cover forms of elder abuse, how to identify elder abuse, and resources for the patients, to help you learn more about how to prevent and care for victims of elder abuse. Thank you for watching, and we hope you enjoy this educational video about elder abuse.