This year, the first of the baby boomers turn 65. The medical community expects a giant wave of older patients over the next two decades. One of the busiest docs will be the ophthalmologist. That’s because glaucoma, cataracts and other eye diseases are common with age.
Eye specialists are getting ready for a flood of new patients.
Richard Cornett is fighting glaucoma. The eye disease is more common once you’re 60. Richard is 67.
"It was sobering and a little bit frightening," says Cornett, "because you only have your eyes one time. That’s the reason I wanted to be very careful to maintain them."
Last month, Cornett underwent surgery at UCLA’s Jules Stein Eye Institute. He visits his doctors regularly to keep the glaucoma at bay – and his eyesight intact. Millions of baby boomers now turning 65 will soon do the same.
Bill Rich is with the American Academy of Ophthalmology. "Ophthalmology sees more elderly patients than any other specialty. We provide the most common surgical procedure performed in Medicare. And with the explosion of technology and the aging of the baby boomers, it’s anticipated that the demand for surgical services will double between the years 2010 and 2016. So obviously that’s a huge crunch on our manpower."
Rich says the old “solo practitioner” model can’t handle the crush of new patients. What’s needed is a team approach.
That means ophthalmologists working in medical groups with general eye care practitioners – like optometrists that give patients more face-to-face time and do eye exams likely to spot eye diseases early. That’ll free up ophthalmologists to hone in on surgery or delicate eye care only they can provide.
"So that at the top of the pyramid," says Rich, "the physician is seeing more concentrated pathology, and is able to concentrate their time and resources on those more complex needs."
Bill Rich says today, more than half of the American Academy of Ophthalmology’s member physicians work with optometrists.
Anne Coleman, an ophthalmologist at UCLA, says ties are especially good in Southern California. "There has been a very good interaction – at least in Los Angeles; I’ve done focus groups with a lot of the optometrists here, and I think they are very interested in the public, and working with ophthalmology. I think you really need the people out in the community, diagnosing the diseases, treating the diseases, taking care of dry eye, you don’t necessarily need that many surgeons doing it."
The Southern California College of Optometry in Fullerton is training a new generation of optometrists with coursework devoted to age-related eye diseases. Dr. Rebecca Kammer says the student optometrists work closely with older patients.
"We teach them, with our older patients, to slow down," says Kammer, "to speak louder and really to take that time. So I think every graduate now is aware that you can’t select your patients. You can’t say, 'I’m just going to see 20-year-olds.' You are going to see from birth to... 104, you know. And so you need to be able to set up your office accordingly."
Dr. Kammer teaches courses in low-vision rehabilitation, which offers therapy and tools to partially blind patients so they can live on their own. There’s a need for rehab specialists because some age-related eye diseases have no cure. But Dr. Kammer says Medicare doesn’t pay for rehab care – so few eye doctors specialize in it.
Medicare also doesn’t cover rehab tools like magnifiers and scanners, like this one – it reads fine print. "This medication is aspirin. Take two tablets, every eight hours."
Kammer says many older patients can’t afford to pay for these tools out of pocket, and won’t ask a son or daughter or other family member to help them with the cost. "They say, 'Oh, I only have 10 years left to live. I don’t want to burden anyone. I don’t need these things.'"
But don’t expect that answer from baby boomers. Dr. Jane Ann Munroe directs Admissions at the Southern California College of Optometry. She’s also a baby boomer.
Dr. Munroe says whether it’s a high-tech scanner or the latest laser eye treatment, she expects Baby Boomers will stop at nothing to save their eyesight – and their independence.
"You know, just look at the generation that we are, relative to who our parents were – very active, we’re more computer savvy. And all these things require good vision to meet vision demands. And just the precious nature of taking care of someone’s sight? I mean, that is quite, quite a calling."
And quite a big job ahead for eye specialists.