Leon Herndon Jr, MD, a glaucoma specialist, ophthalmologist, and professor of ophthalmology at the Duke University Eye Center, explains certain considerations ophthalmologists may need to take into account when treating older patients and the need for more specialists to meet clinical demand.
A concern is that over time, there may not be enough ophthalmologists to treat the growing rates of patients with glaucoma, said Leon Herndon Jr, MD, a glaucoma specialist, ophthalmologist, and professor of ophthalmology at the Duke University Eye Center.
Should primary open-angle glaucoma have an age-specific approach to treatment? If so, what can ophthalmologists do to better tailor care for a patient, based on their age?
We know that as patients get older, they'll have more trouble with complying with therapy; [with] arthritis, cognitive decline as we get older, [we] have to rely more on caregivers to give patients their drops. Some of the medications may have systemic side effects. Alpha-agonists may impact older patients' ability to be active, and topical beta-blocker therapy may also play a role systemically in older patient populations. So we do need to be a little more selective with our treatment options for the elderly. Laser options may be more reasonable for an older population that you might not want to subject to incisional surgery. I would say that yes, we do need to really factor the patient's age into our decision-making when it comes to their treatment options.
What challenges does the ophthalmology field face as more and more Americans continue to live longer?
As the patient population continues to age, we're going to see more and more glaucoma. And my concern is that over time, we may have fewer and fewer ophthalmologists who are available to meet this manpower demand. So we do need to make efforts to train the next generation of those who will take care of glaucoma patients and pay attention to their patients’ needs when it comes to their home environment, as well as their cognitive and physical abilities.