APHA Vision Care Section's working group eyes the future.

With its lens trained on the aging U.S. population, APHA's Vision Care Section is about to bring the future into sharper focus. The Section has launched an innovative new working group to address the growing concern over the provision of health care to the 68 million people who will be 65 or older in 2030.

The Aging and Visual Performance Working Group will promote health and well-being through a combined emphasis on vision and eye health and interdisciplinary partnerships. To accomplish that goal, group leaders will recruit health care professionals from other disciplines to collectively explore efforts under way throughout the health care landscape to accommodate increasing numbers of older adults who will demand accessible and affordable health care.

The working group's chief concern is how to effectively train and prepare health, social and behavioral science professionals to prepare as a community to address the growing needs of an aging population, "not just for vision care, but for other aspects of health care as well," said Vision Care Section Chair Greg Hom, OD, MPH. Hom noted that the initiative's work cuts across several APHA Sections and Special Primary Interest Groups, including the Gerontological Health, Mental Health, Public Health Nursing, Social Work and Podiatric Health Sections, as well as the DisAbility Forum.

"The average life expectancy of people is increasing," said Hom, an optometrist in private practice in San Diego. "With people living longer, there will be a need for more intensive and attentive care to more elderly people."

According to the U.S. Census Bureau, the number of Americans ages 65 and older has tripled since 1900, and the senior population itself is growing older. As the baby boom generation ages and Americans enjoy longer, healthier lives, the incidence of age-related eye diseases such as macular degeneration, diabetic retinopathy, cataract and glaucoma will increase. Other visual changes that naturally accompany aging, such as presbyopia and floaters, will also increase, as will the risk of vision-related falls, hip fractures, traffic accidents and depression.

The working group's initial effort, under way now, is to contact educational programs around the nation, starting with schools and colleges of optometry, to identify educational priorities and skill sets necessary to deal with the needs of an increasingly aging population and translate them into a public health issue. To assist with the effort, the Pennsylvania College of Optomety has agreed to serve as a central clearinghouse, or nerve center, through which messages can be disseminated to the working group.

"Our ultimate goal is to increase the number of programs, to increase the faculty, to increase the educational experience and to tailor it toward geriatric education, because it is a special knowledge set," said Bill Monaco, OD, a co-chair of the working group.

Of the approximately 125 medical schools in the country, only about five have geriatric departments, said Monaco, a private-practice optometrist in Delaware who specializes in nursing home care.

"The boomers are really driving this engine," Monaco said. "It is crucial that we plug into this population at a time when they are active, viable and still doing great stuff. They are making industries stand on their heads because they are so active and healthy."

However, with age-related eye diseases and other chronic illnesses almost inevitable among older people, unprecedented numbers of older Americans will turn to family, friends and public support systems to help them manage their day-to-day lives. If the infrastructure is not firmly in place to meet their long-term care needs, a public health crisis could occur. To prepare for the changes ahead, the new working group will explore how eye care professionals can work with health care providers in other disciplines to create a comprehensive roadmap to lead them into the future.

Older patients are "very complex," Monaco said, and have "multisystem problems, so a multidiscipline approach makes sense."

Working group co-chair Satya Verma, OD, recently contacted the deans of the nation's approximately 16 optometry schools to ask if the schools have separate geriatrics departments or offer specific courses or clinical training rotations in gerontology.

"At its core, the survey attempts to learn if the schools are including or providing gerontology in the curriculum," said Verma, past chair of the Vision Care Section and board member of the National Council on Aging.

Of the nine schools that have responded to the survey, none reported having a separate geriatrics department, though several of the schools said they offer specific courses in gerontology.

Satya said he is working to create an advanced studies track in gerontology at the Pennsylvania College of Optometry, where he is a faculty member and also directs the college's community eye care program.

When all the surveys are returned, the information will be disseminated to everyone involved and ideas will be sought on how to strengthen gerontological programs across the country, but not just for vision.

"Vision is just a component of it," Satya said. "I want to see beyond vision. We need to help older adults enjoy life until the very last breath they have. That is my personal mission, my zeal."

For more information on the Vision Care Section's work, e-mail [e-mail].