Selvin G J, Townsend J C
VA Medical Center, Boston, MA 02215.
J Am Optom Assoc. 1994 Jan;65(1):49-57.
Painstaking attention to detail is absolutely necessary for optometrists to provide the appropriate clinical management of the geriatric patient.
Clinical management techniques (pearls) are discussed which aid in the diagnosis and treatment of problems specific to geriatric patients. Factors noted in patient presentation are stressed and include physical appearance, ability to move about, and use of other senses. The most commonly occurring eye anomalies occurring in the geriatric population are discussed including iatrogenic drug side effects, pupillary anomalies, extraocular palsies, dry eye, corneal degenerations, refractive error changes, lenticular changes, glaucoma, age-related maculopathy, vitreoretinal disease, and ocular manifestations of systemic disease (vascular occlusive disease, diabetes, ischemic optic neuropathy, other neuro-ophthalmic disease).
Conditions relatively rare in the young population occur with regularity in the elderly population and often must be assumed to be present in concert with some typical patient presentations in the geriatric population.
Optometrists as primary health care providers often provide the only avenue individuals with blinding and sometimes life threatening conditions have in managing these conditions. Optometrists managing geriatric patients are required to know what happens to this population from an ocular disease as well as other function and dysfunction standpoint.
验光师要对老年患者进行恰当的临床管理,必须极其注重细节。
讨论有助于诊断和治疗老年患者特有问题的临床管理技术(要点)。强调患者表现中需注意的因素,包括外貌、活动能力及其他感官的使用情况。探讨了老年人群中最常见的眼部异常,包括医源性药物副作用、瞳孔异常、眼外肌麻痹、干眼、角膜变性、屈光不正变化、晶状体变化、青光眼、年龄相关性黄斑病变、玻璃体视网膜疾病以及全身性疾病的眼部表现(血管阻塞性疾病、糖尿病、缺血性视神经病变、其他神经眼科疾病)。
一些在年轻人群中相对罕见的病症在老年人群中经常出现,而且在老年患者的一些典型表现中往往必须假定这些病症同时存在。
验光师作为初级医疗保健提供者,常常是患有致盲甚至有时危及生命疾病的患者管理这些疾病的唯一途径。管理老年患者的验光师需要从眼病以及其他功能和功能障碍的角度了解该人群的情况。