How do the developments of modern optometrists help people avoid the most common eye diseases – glaucoma and cataracts, and, if they occur, improve the quality of life of patients? This issue was raised during discussions at the conference «Pushkin Readings-2024: innovative digital solutions to socially significant problems in geriatrics». The conference is organized on the sidelines of the XVII International Forum «The Senior Generation», which is taking place these days at Expoforum. The discussions were held with the support of the North Western State Medical University named after Mechnikov.

 

The issue of preserving vision in old age and supporting patients who have suffered from inflammatory diseases of the visual organs is becoming increasingly relevant today. Given the progressive aging of mankind, the topic of preserving the high quality of life of people of the «silver age» comes to the fore. Full-fledged vision and hearing, as well as the ability to move and maintain all cognitive functions, are the tasks that doctors around the world are solving. During the discussions of the Pushkin Readings, Russian ophthalmologists spoke about the possibilities of outpatient, drug and surgical support for patients with glaucoma and cataract, as well as those suffering from presbyopia.

Presbyopia is an eye anomaly, loss of the ability to focus, in other words, age-related hyperopia. More than 1.5 billion people worldwide suffer from this disease. Uncorrected presbyopia accounts for 34% in developed countries and more than 50% in developing countries. «The age of patients with presbyopia falls at the peak of their professional activity, while a sharp decline in the working capacity of such people steadily leads to global financial losses», said Elena Klyushnikova, head of the ophthalmology department at the Northwestern State Medical University named after Mechnikov. «The problem becomes especially urgent in the light of the increase in the retirement age; the disease leads to a decrease in the quality of human life and to a violation of psychological well-being». According to medical forecasts, the number of patients with age-related hyperopia will steadily increase, and due to urbanization and population aging, it will reach almost 2 billion people by 2050.

By the beginning of 2024, the number of senior citizens in St. Petersburg was almost 1.5 million, or 26 percent of the total population. The city on the Neva River is also the leader in Russia in terms of the number of centenarians. As of March 2024, 28,000 people over the age of 90 lived in the city, including 466 Petersburgers who celebrated their centenary. Ophthalmologists call all these one and a half million people «potential presbyopes in need of vision correction».

Correction involves the use of complex types of intraocular lenses of two types: refractive-diffraction and EDOF lenses with increased depth of focus. In 2023, 88 complex intraocular lenses (56 refractive-diffractive and 32 EDOF) were implanted in the Department of Ophthalmology of the Northwestern State Medical University named after Mechnikov.

Zemfira Dautova, Deputy Chief Physician of the Medical and Preventive Center, cited a disappointing fact: according to WHO, glaucoma has taken the leading position in visual disability diseases today. The main problem is that patients most often seek medical help too late, when conservative treatment is no longer possible; the disease is also often detected accidentally, during the diagnosis of other diseases.

Natalia Mitrofanova, a doctor at the ophthalmological clinic of the North Western State Medical University named after Mechnikov, also stressed the importance of the issue: «According to official statistics, more than 1 million glaucoma patients were registered in Russia in 2022. If the patient is treated in the late stages, vision decreases irreversibly. And, unfortunately, the patients themselves do not always help the doctor in healing: only 35 percent of patients regularly perform all the oculist’s appointments and use prescribed medicine; many often let the disease take its course».

Vasily Ivaskov, Doctor of Ophthalmology at the Northwestern State Medical University named after Mechnikov, shared with the panelists ways to correct cataracts, another disease that often leads elderly patients to disability. Clouding of the lens of the eye closes the top three most urgent diseases of the visual organs of the elderly; about 100 million people live with it worldwide. During cataract surgery, the clouded lens is removed and an intraocular lens (mono, EDOF, MF) is implanted, as a result of which vision is restored.

The participants in the discussions were unanimous in their opinion: with the use of all new methods of conservative and surgical treatment, as well as with the assistance of the patient himself, in most cases it is possible to preserve the quality of both vision and the entire life of an elderly person.