A large proportion of the older population suffers from sight loss which in many cases, may be preventable or managed successfully with early detection and treatment. Conditions such as age-related macular degeneration, glaucoma and cataract, all of which cause a reduction in vision, become more prevalent in old age. Further down in this paper we will look at attitudes and awareness, both of which could have an impact on the prevention and management of eye conditions.

Age-related macular degeneration (AMD)

In Ireland, AMD is the leading cause of blindness in people over the age of 50. Its prevalence increases almost exponentially with age. Thirty-four per cent of all newly referred to NCBI in 2008 suffered from AMD. Early detection can provide access to effective treatment.

Glaucoma

Glaucoma is also a common condition affecting an increasing number of older people. A thorough eye examination can detect the signs of glaucoma in the early stages and before you realise there is a problem.
The cost of treatment at an early stage is significantly less than that of the treatment of the disease at an advanced stage, thus emphasising the critical importance of screening and detection of early disease by optometrists and eye specialists.

Cataract

Cataracts are also very common, affecting approximately half of those 65 years and older. Most of us will develop cataracts as we get older. There is treatment available so as the population ages the demand for cataract surgery will increase exponentially.

Diabetic eye disease

It is thought that one in 20 people in Ireland may have diabetes and indeed the same number may have it, but are as yet unaware of it. Approximately 8-10% of all diabetics develop potentially sight threatening conditions. Of the two types of diabetes, the most common age of onset of “non-insulin dependent (type 2) diabetes” is in the 50s, 60s and 70s.

Diabetic retinopathy is treatable if caught early. A national diabetic screening programme was recommended by the Department of Health and Children in 2006 and a pilot programme for the West was approved in 2007 but has yet to begin.

NCBI is extremely concerned that the Health Service Executive has put diabetic retinopathy screening low on its list of priorities. It is not acceptable that there be a stop-go approach to increasing this service which has a low cost input but a very high negative value if screening is denied to patients who are at risk of blindness.