four out of ten Older people with diabetes develop a Diabetic retinopathy, one of the most common eye health problems in this group. For this reason, it is necessary that older people with diabetes undergo a fundus examination annually to detect the onset of this disease.
This was one of the ideas developed by the Dr. Naiara Fernandezresponsible for Assistance at Igurco Servicios Sociosanitarios of Grupo IMQ, during his conference “Comprehensive geriatric assessment: definition of objectives by areas in the approach to visual limitation”recently taught at the Clinical Surgical Institute of Ophthalmology () of Bilbao.
As this expert recalled “screening these aspects on a regular basis is essential. For example, it must not be forgotten that half of the elderly people who have diabetes are unaware that they have it and, therefore, if they are not controlled on a regular basis, the risk of presenting visual insufficiency, among many other health aspects, increases”.
The Igurco Care Manager recommended carrying out a comprehensive geriatric assessment of the elderly person with visual limitation, since “By considering its clinical, functional, cognitive and social area, we can establish those objectives to be achieved after correcting the pathology causing visual limitation; Being the main objective of the intervention the promotion of autonomybetter health outcomes, and, ultimately, the improvement in quality of life of the older patient.
The comprehensive geriatric assessment (VGI) is a process designed from geriatrics and gerontology, to identify and quantify the physical, functional, social and mental problems that the elderly person presents, with the aim of in order to develop a plan for the treatment and follow-up of said problems. This tool is accompanied by assessment scales, which allow a comprehensive understanding of the health status of the elderly to be obtained, since they also evaluate the relevant biopsychosocial aspects.
Problem derived from visual loss
the geriatrician of Yoinsist on the need to contextualize health problems and relate them to the physical and vital state of the elderly. “For example, with undiagnosed loss of visual acuityfrom geriatrics we consider that this elderly person is with a high risk of falling and, consequently, to have a broken hip who can see compromised not only their quality of life and their health, but also their own ability to fend for itself; that is, its autonomy”.
«It has been proven that vision loss not only increases the risk of falls and dependency, but also has a very negative influence on the appearance of disorders such as depression, nutritional disturbances and life weariness derived from the inability to carry out habitual or pleasurable activities such as walking, reading or sewing, to give some everyday examples”. the geriatrician warns.
In the Diabetic retinopathythe blood vessels that supply and nourish the back of the eye can be affected by diabetes, “directly affecting vision. In diabetes, we also have proliferative diabetic retinopathy and diabetic macular edema”clarified the geriatrician.
It should be remembered that even though the 23% of patients with diabetes will develop Diabetic retinopathy (one of the main causes of blindness) five years after diagnosis only between 20 and 30% of diabetics undergo an annual retinal examination to detect signs of retinopathy, according to data from the Spanish Diabetes Federation ().
The figures indicate that 23% of patients with diabetes will develop this pathology 5 years after diagnosis, 60% will suffer from it at 10 years and 80% at 15 years. Besides, more than half of people blind due to diabetes had never seen an ophthalmologiststand out from the FEDE.
More frequent than the previous problems is the presbyopia or eyestrainwhich is the most prevalent visual disease among the elderly population, produced during the normal aging process by the loss of elasticity of the crystalline lens, points out the Dr. Naiara Fernandez.
Also a Very common pathology in the visual health of the elderly are cataracts, with prevalence figures of one in two people over 65 years of age. In this pathology, the crystalline lens suffers a drop in its transparency, which translates into a loss of sharpness in vision and color distortion.
In it glaucoma, it is the optic nerve that suffers the damage. Is a major cause of blindness and therefore early diagnosis is essential. In this sense, the elderly, people with great myopia and people with a family history of glaucoma are risk groups.