Impact of Vision Care, Specifically Diabetic Retinopathy, on Older Adults

Falls are the current leading cause of injuries for older Americans, and many of them result in permanent disability and fatalities. The risk of falling for older adults doubles if they have impaired vision from a degenerative eye disease like diabetic retinopathy.

In the midst of the COVID-19 pandemic, more older adults are living independently. This makes it even more crucial of a time to be focusing on vision care and, more importantly, on care toward diabetic retinopathy. Not to mention, November celebrates National Eye Disease Awareness Month.

Degenerative eye issues are conditions that can develop from ultraviolet radiation, from aging or from other health conditions that impact eyesight, such as diabetic retinopathy, cataracts, glaucoma and age-related macular degeneration. For example, age-related macular degeneration and glaucoma are the leading causes of vision loss of people over 50, while diabetic retinopathy and cataracts can be caused by the impact of diabetes on blood sugar and blood vessels in the eyes, says Dr. Mark Ruchman, chief medical officer at Versant Health.

Eyesight changes due to aging are inevitable, and the risk of systemic disease increases as people grow older. However, there are simple preventative measures that aging people, particularly those living with diabetes, can take to protect their eyesight, reduce their risk of vision loss and enjoy the wonders of healthy vision, says Ruchman.

The single most important preventative measure against degenerative eye diseases like diabetic retinopathy, which can be costly to both patients and managed care plans, is access to regular eye exams that can detect vision—and other health issues—early and allow for immediate intervention, he says.

"Twenty percent of people first learn that they are diabetic as a result of an eye exam when the eye doctor examines the optic nerve, retinal blood vessels and the back of the eye for the telltale signs of the disease," Ruchman says. "Nearly 30% of diabetics suffer from diabetic retinopathy, and in the senior population, this can impact quality of life by increasing the risk for dangerous, and even fatal, falls. A regular eye exam is a critical component of any health and wellness program to reduce blindness from this disease. And yet, even with the threat of blindness, research shows that many diabetics skip their annual eye exam."

In addition, while diabetic retinopathy is specific to the eye, the vascular changes that occur with the eye disease are present throughout the body. If abnormal blood vessels are found in the eye, it's possible the disease has also affected the kidneys, skin, brain, heart, etc., with the significant multisystem morbidity that this would imply. In addition, visual loss exacerbates all functions of quality of life especially depression in the elderly, Ruchman adds.

Regular eye exams for all ages are encouraged, of course. Although, through a managed vision care plan that serves as a guide for eye health, aging adults can make lifestyle changes that not only prevent degenerative eye diseases like as diabetic retinopathy, but also manage their whole body health, as eye health and overall health are closely linked.

Prevention also includes quitting smoking. People who smoke have a have a higher risk of developing degenerative eye diseases. Aging adults should also consider taking steps to maintain a healthy weight, as research suggests that people who are overweight are more likely to develop conditions like cataracts and glaucoma.

According to Ruchman, early prevention can also help financially.

"By the age of 65, one in every three individuals has some form of vision-reducing eye disease, and having impaired vision more than doubles the risk of falls for seniors, which can be costly for health plans, their members and families," he says. "Each year about $50 billion is spent on non-fatal fall injuries and $754 million is spent on fatal falls. Improving seniors’ access to vision care, including eye exams that test visual acuity, is an easy and cost-effective solution to protect vision and overall health, minimize human suffering and mitigate the financial impact of falls among the elderly. Timely intervention for degenerative diseases, such as diabetic retinopathy, cataracts and glaucoma, can preserve vision and reduce the likelihood of falls."