Eyes on Alzheimer’s
An irreversible and progressive degenerative brain disease, Alzheimer's disease currently affects 5.7 million Americans age 65 and older with projections estimating 13.8 million affected by 2050.
World Alzheimer's Day is Friday, Sep. 21, and doctors of optometry have an important role to play in the prevention and early detection of the ocular and visual changes that herald the onset of Alzheimer's disease.
Those with Alzheimer's live an average of eight years after symptoms manifest, but survival can range 4 to 20 years, per the Alzheimer's Association. Critically, early detection and diagnosis can allow patients and caregivers time to plan.
Alzheimer's clues could be found using common eye scan
Optical coherence tomography (OCT), the diagnostic imaging device, uses light to produce a cross-sectional or three-dimensional image of the retina with micrometer resolution to detect retinal diseases such as macular degeneration, glaucoma and diabetic retinopathy. But beyond eye care, OCT continues to capture researchers' attention as a noninvasive way to examine central nervous system tissue for tell-tale signs of neurodegenerative diseases.
Numerous studies, including within the past year, suggest spectral domain-OCT (SD-OCT) might warrant further consideration in early detection and diagnosis of Alzheimer's disease, the sixth-leading cause of death in the United States.
Optometry's role with Alzheimer's
Although vision changes naturally occur with age and don't always indicate a more serious condition, patients 60 years and older still should be wary of age-related eye health problems that may occur without any early symptoms. Regular, comprehensive eye examinations are critical in senior years and evolving understanding of neurological health increasingly turns to ocular health as a proxy.
Maryke Neiberg, O.D., associate dean of academic affairs at Midwestern University Chicago College of Optometry, who previously spoke with AOA Focus on optometry's role in Alzheimer's care, says patients typically do have difficulty with near-vision in the beginning stages of Alzheimer's, including crowding, alexia and figure-ground difficulties.
"The doctor of optometry has an important role to play in the prevention and early detection of the ocular and visual changes that herald the onset of Alzheimer's disease," Dr. Neiberg wrote in a continuing education article for the California Optometric Association. "We have an even more critical role to play in the education of our patients and the public about the preventable risk factors that are associated with Alzheimer's disease."
Early detection and treatment can reduce risk of blindness by 95%, yet a third of people with diabetes have diabetic retinopathy. More can be done, and that’s where upstream, integrated, value-based medicine aligns doctors and plans for the benefit of their patients.
Each 10-unit increase in OSDI scores reduced work productivity and activity impairment by 4%, a recent study shows.
Going the extra mile: That’s what sets doctors apart from online retailers, especially in the contact lens space. As technology advances, the range of available options makes it easier than ever to serve existing patients and identify new ones.