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Ocular Characteristics of Home Care Patients Over the Age of 65 Who Are on the Verge of Developing Ocular Diseases

Year 2023, Volume: 45 Issue: 1, 110 - 117, 23.01.2023
https://doi.org/10.20515/otd.1171083

Abstract

The purpose of this study is to determine how frequently legal blindness, cataract, glaucoma, senile macular degeneration, and dry eye disease are seen in the elderly over the age of 65 receiving home care services, as well as to investigate the relationship between ocular pathologies and frailty levels. The eye findings of 74 elderly over the age of 65 who received home care services in a district were evaluated between April 1 and May 31, 2021, and the Edmonton Frailty Questionnaire was used in each case. The study was designed as a cross-sectional field study, with cases evaluated at home by an ophthalmologist using portable ophthalmic examination devices. Mild visual impairment was found in 18 (24.3%) of the cases, severe visual impairment in 36 (48.6%), and legal blindness in 8 (10.8%). 4 (5.4%) cases had ocular hypertension and glaucoma, 15 (20.3%) had dry eye, and 40 (54.1%) had senile macular degeneration. There were 46 (62.2%) cases with cataracts and 26 (35.1%) with previous cataract surgery. Frailty levels were found to differ statistically by senile macular degeneration (p=0.004) and visual acuity (p=0.003). Frailty levels did not differ statistically by glaucoma (p=0.169), cataract (p=0.152), or dry eye (p=0.918). Cataract, glaucoma, dry eye, senile macular degeneration, and severe vision loss are common among home care patients over 65. Vision loss and frailty levels were found to have a significant correlation in home care patients over the age of 65, indicating the importance of home care patients having regular ocular examinations.

References

  • 1) US Census Bureau. The Next Four Decades: The Older Population in the United States: 2010 to 2050. 2010. p. 10. [Google Scholar] [Ref list]
  • 2) Anderson G, Horvath J. The growing burden of chronic disease in America. Public health reports (Washington, D.C.: 1974) 2004;119(3):263–70. [PMC free article] [PubMed] [Google Scholar] [Ref list]
  • 3) He W, Goodkind D, Kowal P. An Aging World: 2015. Washington: Department of Health and Human Services – National Institutes of Health; 2016. [Google Scholar] [Ref list]
  • 4) Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology. 2014;121(11):2081-2090. doi:10.1016/j.ophtha.2014.05.013. PMID: 24974815.
  • 5) Unterlauft JD, Böhm MRR. Rolle des alternden visuellen Systems bei Glaukomen [Role of the aging visual system in glaucoma]. Ophthalmologe. 2017 Feb;114(2):108-113. German. doi: 10.1007/s00347-016-0430-6. PMID: 28074272.
  • 6) Fleckenstein M, Keenan TDL, Guymer RH, et al. Age-related macular degeneration. Nat Rev Dis Primers. 2021 May 6;7(1):31. doi: 10.1038/s41572-021-00265-2. PMID: 33958600.
  • 7) Song P, Du Y, Chan KY, et al. The national and subnational prevalence and burden of age-related macular degeneration in China. J Glob Health. 2017 Dec;7(2):020703. doi: 10.7189/jogh.07.020703. PMID: 29302323.
  • 8) Rocha EM, Alves M, Rios JD, et al. The aging lacrimal gland: changes in structure and function. Ocul Surf. 2008 Oct;6(4):162-74. doi: 10.1016/s1542-0124(12)70177-5. PMID: 18827949; PMCID: PMC4205956.
  • 9) Nien CJ, Massei S, Lin G, et al. Effects of age and dysfunction on human meibomian glands. Arch Ophthalmol. 2011 Apr;129(4):462-9. doi: 10.1001/archophthalmol.2011.69. PMID: 21482872; PMCID: PMC4291168.
  • 10) Song P, Wang H, Theodoratou E, et al. The national and subnational prevalence of cataract and cataract blindness in China: a systematic review and meta-analysis. J Glob Health. 2018 Jun;8(1):010804. doi: 10.7189/jogh.08-010804. PMID: 29977532.
  • 11) Bourne RRA, Flaxman SR, Braithwaite T, et al. Vision Loss Expert Group. Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis. Lancet Glob Health. 2017 Sep;5(9):e888-e897. doi: 10.1016/S2214-109X(17)30293-0. Epub 2017 Aug 2. PMID: 28779882.
  • 12) Rolfson DB, Majumdar SR, Tsuyuki RT, et al. Validity and reliability of the Edmonton Frail Scale. Age Ageing. 2006 Sep;35(5):526-9. doi: 10.1093/ageing/afl041. Epub 2006 Jun 6. PMID: 16757522.
  • 13) Aygör HE, Fadıloğlu Ç, Şahin S, et al. Validation of Edmonton Frail Validation of Edmonton Frail Scale into Elderly Turkish Population. Arch Gerontol Geriatr. 2018 May-Jun;76:133-137. doi: 10.1016/j.archger.2018.02.003. Epub 2018 Feb 16. PMID: 29499529.
  • 14) Chiang B, Asbell PA, Franklin B. Phenol red thread test and Schirmer test for tear production in normal and dry eye patients. Invest Ophthalmol Vis Sci. 1988;29:337.
  • 15) Pflugfelder SC, Tseng SC, Sanabria O, et al. Evaluation of subjective assessments and objective diagnostic tests for diagnosing tear-film disorders known to cause ocular irritation. Cornea. 1998;17:38.
  • 16) Paugh JR, Tse J, Nguyen T, et al. Efficacy of the Fluorescein Tear Breakup Time Test in Dry Eye. Cornea. 2020 Jan;39(1):92-98. doi: 10.1097/ICO.0000000000002148. PMID: 31513046; PMCID: PMC6893123.
  • 17) Gao Q, Prina AM, Ma Y, et al. Inequalities in Older age and Primary Health Care Utilization in Low- and Middle-Income Countries: A Systematic Review. Int J Health Serv. 2022 Jan;52(1):99-114. doi: 10.1177/00207314211041234. Epub 2021 Oct 21. PMID: 34672829; PMCID: PMC8645300.
  • 18) 25.Wolfram C, Schuster AK, Elflein HM, et al. The Prevalence of Visual Impairment in the Adult Population. Dtsch Arztebl Int. 2019 Apr 26;116(17):289-295.
  • 19) Green C, Goodfellow J, Kubie J. Eye care in the elderly. Aust Fam Physician. 2014 Jul;43(7):447-50. PMID: 25006605.
  • 20) Navarro Esteban JJ, Gutiérrez Leiva JA, Valero Caracena N, et al. Prevalence and risk factors of lens opacities in the elderly in Cuenca, Spain. Eur J Ophthalmol. 2007 Jan-Feb;17(1):29-37. doi: 10.1177/112067210701700105. PMID: 17294380.
  • 21) Li JQ, Welchowski T, Schmid M, et al. Prevalence and incidence of age-related macular degeneration in Europe: a systematic review and meta-analysis. Br J Ophthalmol. 2020 Aug;104(8):1077-1084. doi: 10.1136/bjophthalmol-2019-314422. Epub 2019 Nov 11. PMID: 31712255.
  • 22) Rasoulinejad SA, Zarghami A, Hosseini SR, et al. Prevalence of age-related macular degeneration among the elderly. Caspian J Intern Med. 2015 Summer;6(3):141-7. PMID: 26644880; PMCID: PMC4650788.
  • 23) Li JQ, Welchowski T, Schmid M, et al. Prevalence and incidence of age-related macular degeneration in Europe: a systematic review and meta-analysis. Br J Ophthalmol. 2020 Aug;104(8):1077-1084. doi: 10.1136/bjophthalmol-2019-314422. Epub 2019 Nov 11. PMID: 31712255.
  • 24) Slettedal JK, Traustadóttir VD, Sandvik L, et al. The prevalence and incidence of glaucoma in Norway 2004-2018: A nationwide population-based study. PLoS One. 2020 Dec 10;15(12):e0242786. doi: 10.1371/journal.pone.0242786. PMID: 33301476.
  • 25) Liu NN, Liu L, Li J, et al. Prevalence of and risk factors for dry eye symptom in mainland China: a systematic review and meta-analysis. J Ophthalmol 2014;2014:748654. [PMC free article] [PubMed] [Google Scholar]
  • 26) Han SB, Hyon JY, Woo SJ, et al. Prevalence of dry eye disease in an elderly Korean population. Arch Ophthalmol 2011;129:633–8.. [PubMed] [Google Scholar]
  • 27) Senchyna M, Wax MB. Quantitative assessment of tear production: A review of methods and utility in dry eye drug discovery. J Ocul Biol Dis Infor. 2008 Mar;1(1):1-6. doi: 10.1007/s12177-008-9006-2. Epub 2008 Jul 16. PMID: 20072630; PMCID: PMC2802411.
  • 28) Kabali H.K., Irigoyen M.M., Davis N.R., et al. Exposure and Use of Mobile Media Devices by Young Children”: Pediatrics 2015;136:1044-1050. Doi: 10.3389/fpsyg.2016.00690
  • 29) de Paiva CS. Effects of Aging in Dry Eye. Int Ophthalmol Clin. 2017 Spring;57(2):47-64. doi: 10.1097/IIO.0000000000000170. PMID: 28282314; PMCID: PMC5347479.
  • 30) van Nispen R, van der Aa H, Timmermans F, et al. Reducing avoidable visual impairment in elderly home healthcare patients by basic ophthalmologic screening. Acta Ophthalmol. 2019 Jun;97(4):401-408. doi: 10.1111/aos.13956. Epub 2018 Oct 27. PMID: 30369070.

Göz Hastalıkları Açısından Kör Noktada Bulunan 65 Yaş Üzeri Evde Bakım Hastalarında Oküler Özellikler

Year 2023, Volume: 45 Issue: 1, 110 - 117, 23.01.2023
https://doi.org/10.20515/otd.1171083

Abstract

Bu çalışmanın amacı, evde bakım hizmeti alan 65 yaş üzeri yaşlılarda ne sıklıkta yasal körlük, katarakt, glokom, senil maküla dejenerasyonu ve kuru göz hastalığı görüldüğünü tespit etmek ve göz patolojilerinin olguların kırılganlık düzeyiyle ilişkisini incelemektir. 1 Nisan 2021-31 Mayıs 2021 tarihleri arasında 74 olguya bir ilçede evde bakım hizmeti alan 65 yaş üzeri yaşlıların göz bulguları değerlendirilmiş ve her olguya Edmonton Kırılganlık Anketi uygulanmıştır. Çalışma kesitsel özellikte bir saha araştırması olarak planlanmış ve bir göz hastalıkları uzmanı tarafından olgular taşınabilir oftalmik muayene cihazlarıyla evlerinde değerlendirilmiştir. 18 (%24.3) olguda hafif düzey, 36 (%48.6) olguda ileri düzeyde görme kaybı ve 8(%10.8) olguda yasal körlük tespit edilmiştir. 4 (%5.4) olguda oküler hipertansiyon ve glokom, 15(%20.3) olguda kuru göz ve 40 (%54.1) senil maküla dejenerasyonu izlenmiştir. 46 (%62.2) olgunun kataraktı olduğu, 26’sının (%35.1) daha önceden katarakt cerrahisi geçirdiği görülmüştür. Senil maküla dejenerasyonuna (p=0.004) ve görme keskinliğine (p=0.003) göre kırılganlık düzeyleri arasında istatistiksel olarak anlamlı farklılık tespit edilmiştir. Glokoma (p=0.169), katarakta (p=0.152) ve kuru göze (p=0.918) göre kırılganlık düzeylerinde istatistiksel olarak anlamlı bir farklılık bulunmamıştır. Katarakt, glokom, kuru göz, senil maküla dejenerasyonu ve şiddetli görme kaybı 65 yaş üzeri evde bakım hastalarında yüksek oranda görülmektedir. 65 yaş üzeri evde bakım hastalarının görme kaybı ile kırılganlık düzeyleri arasında anlamlı korelasyon saptanmış olup, evde bakım hastalarının göz muayeneleri aksatılmamalıdır.

References

  • 1) US Census Bureau. The Next Four Decades: The Older Population in the United States: 2010 to 2050. 2010. p. 10. [Google Scholar] [Ref list]
  • 2) Anderson G, Horvath J. The growing burden of chronic disease in America. Public health reports (Washington, D.C.: 1974) 2004;119(3):263–70. [PMC free article] [PubMed] [Google Scholar] [Ref list]
  • 3) He W, Goodkind D, Kowal P. An Aging World: 2015. Washington: Department of Health and Human Services – National Institutes of Health; 2016. [Google Scholar] [Ref list]
  • 4) Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology. 2014;121(11):2081-2090. doi:10.1016/j.ophtha.2014.05.013. PMID: 24974815.
  • 5) Unterlauft JD, Böhm MRR. Rolle des alternden visuellen Systems bei Glaukomen [Role of the aging visual system in glaucoma]. Ophthalmologe. 2017 Feb;114(2):108-113. German. doi: 10.1007/s00347-016-0430-6. PMID: 28074272.
  • 6) Fleckenstein M, Keenan TDL, Guymer RH, et al. Age-related macular degeneration. Nat Rev Dis Primers. 2021 May 6;7(1):31. doi: 10.1038/s41572-021-00265-2. PMID: 33958600.
  • 7) Song P, Du Y, Chan KY, et al. The national and subnational prevalence and burden of age-related macular degeneration in China. J Glob Health. 2017 Dec;7(2):020703. doi: 10.7189/jogh.07.020703. PMID: 29302323.
  • 8) Rocha EM, Alves M, Rios JD, et al. The aging lacrimal gland: changes in structure and function. Ocul Surf. 2008 Oct;6(4):162-74. doi: 10.1016/s1542-0124(12)70177-5. PMID: 18827949; PMCID: PMC4205956.
  • 9) Nien CJ, Massei S, Lin G, et al. Effects of age and dysfunction on human meibomian glands. Arch Ophthalmol. 2011 Apr;129(4):462-9. doi: 10.1001/archophthalmol.2011.69. PMID: 21482872; PMCID: PMC4291168.
  • 10) Song P, Wang H, Theodoratou E, et al. The national and subnational prevalence of cataract and cataract blindness in China: a systematic review and meta-analysis. J Glob Health. 2018 Jun;8(1):010804. doi: 10.7189/jogh.08-010804. PMID: 29977532.
  • 11) Bourne RRA, Flaxman SR, Braithwaite T, et al. Vision Loss Expert Group. Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis. Lancet Glob Health. 2017 Sep;5(9):e888-e897. doi: 10.1016/S2214-109X(17)30293-0. Epub 2017 Aug 2. PMID: 28779882.
  • 12) Rolfson DB, Majumdar SR, Tsuyuki RT, et al. Validity and reliability of the Edmonton Frail Scale. Age Ageing. 2006 Sep;35(5):526-9. doi: 10.1093/ageing/afl041. Epub 2006 Jun 6. PMID: 16757522.
  • 13) Aygör HE, Fadıloğlu Ç, Şahin S, et al. Validation of Edmonton Frail Validation of Edmonton Frail Scale into Elderly Turkish Population. Arch Gerontol Geriatr. 2018 May-Jun;76:133-137. doi: 10.1016/j.archger.2018.02.003. Epub 2018 Feb 16. PMID: 29499529.
  • 14) Chiang B, Asbell PA, Franklin B. Phenol red thread test and Schirmer test for tear production in normal and dry eye patients. Invest Ophthalmol Vis Sci. 1988;29:337.
  • 15) Pflugfelder SC, Tseng SC, Sanabria O, et al. Evaluation of subjective assessments and objective diagnostic tests for diagnosing tear-film disorders known to cause ocular irritation. Cornea. 1998;17:38.
  • 16) Paugh JR, Tse J, Nguyen T, et al. Efficacy of the Fluorescein Tear Breakup Time Test in Dry Eye. Cornea. 2020 Jan;39(1):92-98. doi: 10.1097/ICO.0000000000002148. PMID: 31513046; PMCID: PMC6893123.
  • 17) Gao Q, Prina AM, Ma Y, et al. Inequalities in Older age and Primary Health Care Utilization in Low- and Middle-Income Countries: A Systematic Review. Int J Health Serv. 2022 Jan;52(1):99-114. doi: 10.1177/00207314211041234. Epub 2021 Oct 21. PMID: 34672829; PMCID: PMC8645300.
  • 18) 25.Wolfram C, Schuster AK, Elflein HM, et al. The Prevalence of Visual Impairment in the Adult Population. Dtsch Arztebl Int. 2019 Apr 26;116(17):289-295.
  • 19) Green C, Goodfellow J, Kubie J. Eye care in the elderly. Aust Fam Physician. 2014 Jul;43(7):447-50. PMID: 25006605.
  • 20) Navarro Esteban JJ, Gutiérrez Leiva JA, Valero Caracena N, et al. Prevalence and risk factors of lens opacities in the elderly in Cuenca, Spain. Eur J Ophthalmol. 2007 Jan-Feb;17(1):29-37. doi: 10.1177/112067210701700105. PMID: 17294380.
  • 21) Li JQ, Welchowski T, Schmid M, et al. Prevalence and incidence of age-related macular degeneration in Europe: a systematic review and meta-analysis. Br J Ophthalmol. 2020 Aug;104(8):1077-1084. doi: 10.1136/bjophthalmol-2019-314422. Epub 2019 Nov 11. PMID: 31712255.
  • 22) Rasoulinejad SA, Zarghami A, Hosseini SR, et al. Prevalence of age-related macular degeneration among the elderly. Caspian J Intern Med. 2015 Summer;6(3):141-7. PMID: 26644880; PMCID: PMC4650788.
  • 23) Li JQ, Welchowski T, Schmid M, et al. Prevalence and incidence of age-related macular degeneration in Europe: a systematic review and meta-analysis. Br J Ophthalmol. 2020 Aug;104(8):1077-1084. doi: 10.1136/bjophthalmol-2019-314422. Epub 2019 Nov 11. PMID: 31712255.
  • 24) Slettedal JK, Traustadóttir VD, Sandvik L, et al. The prevalence and incidence of glaucoma in Norway 2004-2018: A nationwide population-based study. PLoS One. 2020 Dec 10;15(12):e0242786. doi: 10.1371/journal.pone.0242786. PMID: 33301476.
  • 25) Liu NN, Liu L, Li J, et al. Prevalence of and risk factors for dry eye symptom in mainland China: a systematic review and meta-analysis. J Ophthalmol 2014;2014:748654. [PMC free article] [PubMed] [Google Scholar]
  • 26) Han SB, Hyon JY, Woo SJ, et al. Prevalence of dry eye disease in an elderly Korean population. Arch Ophthalmol 2011;129:633–8.. [PubMed] [Google Scholar]
  • 27) Senchyna M, Wax MB. Quantitative assessment of tear production: A review of methods and utility in dry eye drug discovery. J Ocul Biol Dis Infor. 2008 Mar;1(1):1-6. doi: 10.1007/s12177-008-9006-2. Epub 2008 Jul 16. PMID: 20072630; PMCID: PMC2802411.
  • 28) Kabali H.K., Irigoyen M.M., Davis N.R., et al. Exposure and Use of Mobile Media Devices by Young Children”: Pediatrics 2015;136:1044-1050. Doi: 10.3389/fpsyg.2016.00690
  • 29) de Paiva CS. Effects of Aging in Dry Eye. Int Ophthalmol Clin. 2017 Spring;57(2):47-64. doi: 10.1097/IIO.0000000000000170. PMID: 28282314; PMCID: PMC5347479.
  • 30) van Nispen R, van der Aa H, Timmermans F, et al. Reducing avoidable visual impairment in elderly home healthcare patients by basic ophthalmologic screening. Acta Ophthalmol. 2019 Jun;97(4):401-408. doi: 10.1111/aos.13956. Epub 2018 Oct 27. PMID: 30369070.
There are 30 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section ORİJİNAL MAKALE
Authors

İbrahim Ethem Ay 0000-0002-3468-7096

Ayşen Til 0000-0002-2283-1847

Publication Date January 23, 2023
Published in Issue Year 2023 Volume: 45 Issue: 1

Cite

Vancouver Ay İE, Til A. Göz Hastalıkları Açısından Kör Noktada Bulunan 65 Yaş Üzeri Evde Bakım Hastalarında Oküler Özellikler. Osmangazi Tıp Dergisi. 2023;45(1):110-7.


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