- •Geriatric Ophthalmology
- •Foreword
- •Preface
- •Contents
- •Contributors
- •Medical Knowledge
- •Case Vignette
- •Practice-Based Learning and Improvement
- •Patient Care
- •Medical Knowledge
- •Interpersonal and Communication Skills
- •Professionalism
- •Systems-Based Practice
- •Case Resolution
- •References
- •Refractive Error in the Geriatric Population
- •Case Vignette
- •Patient Care
- •Medical Knowledge
- •Interpersonal and Communication Skills
- •Professionalism
- •Systems-Based Practice
- •Scenario Resolution
- •References
- •Cataracts and Cataract Surgery
- •Case Vignette
- •Patient Care
- •Medical Knowledge
- •Interpersonal and Communication Skills
- •Professionalism
- •Practice-Based Learning and Improvement
- •Systems-Based Practice
- •Case Resolution
- •References
- •Glaucoma in the Elderly
- •Case Vignette
- •Patient Care
- •Medical Knowledge
- •Interpersonal and Communication Skills
- •Professionalism
- •Practice-Based Learning and Improvement
- •Systems-Based Practice
- •Case Resolution
- •References
- •Diabetic Retinopathy and Its Management
- •Case Vignette
- •Systems-Based Competency
- •Communication Skills and Professionalism
- •Management of Diabetic Retinopathy in Older People: Medical Knowledge and Patient Care
- •Management of Diabetic Macular Edema
- •Practice-Based Learning
- •Management of the Level of Diabetic Retinopathy
- •Case Resolution
- •References
- •Case Vignette
- •Patient Care
- •Management of AMD in Older People
- •Management of Intermediate and Often Large Drusen
- •Management of the Neovascular Stage
- •Impact on Patient’s Perception of Quality of Life Because of Vision
- •Case Resolution
- •References
- •Low Vision: When Vision Fails
- •Case Report
- •Practice-Based Learning and Improvement
- •Medical Knowledge
- •Patient Care
- •Interpersonal and Communication Skills
- •Professionalism
- •Systems-Based Practice
- •Case Resolution
- •References
- •Visual Loss and Depression
- •Case Vignette
- •Introduction
- •Practice-Based Learning
- •Communication Skills
- •Systems-Based Learning
- •Professionalism
- •Patient Care Summary
- •References
- •Visual Loss and Dementia
- •Case Vignette
- •Introduction
- •Perimetry
- •Neuroimaging
- •Practice-Based Learning
- •Communication Skills and Professionalism
- •Systems-Based Practice
- •Patient Resolution
- •References
- •Visual Loss and Hearing Loss
- •Case Vignette
- •Introduction
- •Practice-Based Learning
- •Communication Skills
- •Professionalism
- •Systems-Based Care
- •Summary
- •References
- •Visual Loss and Falls
- •Case Vignette
- •Introduction
- •Practice-Based Learning
- •Practice-Based Improvement
- •Systems-Based Learning
- •Communication Skills
- •Patient Care Summary
- •References
- •Elder Abuse
- •Case Vignette
- •Patient care
- •Five Common Manifestations of Adult Maltreatment (Adapted from. Lachs et al.3)
- •Medical Knowledge
- •Eight Red Flags for Elder Abuse (Adapted from Purdy10)
- •Interpersonal Skills and Communication
- •Nine Questions to Ask a Suspected Victim of Adult Mistreatment2
- •Professionalism
- •Practice-Based Learning and Improvement
- •Systems-Based Practice
- •Elder Abuse Resources (Adapted from Aravanis2 and Kleinschmidt 7)
- •Case Resolution
- •References
- •Functional Impairment and Visual Loss
- •Case Vignette
- •Practice-Based Learning and Improvement
- •Patient Care
- •Medical Knowledge
- •Interpersonal and Communication Skills
- •Professionalism
- •Approach to the Visually Impaired Patient
- •Systems Based Practice
- •Case Resolution: System-Based Practice
- •References
- •The Research Agenda-Setting Project (RASP)
- •Screening for Comorbidities
- •Case Vignette
- •Introduction
- •Practice-Based Learning
- •Communication Skills
- •System-Based Learning
- •Professionalism
- •Patient Care Summary
- •References
- •Refer Comorbidities
- •Case Vignette
- •Introduction
- •Practice-Based Learning
- •Communication Skills
- •System-Based Learning
- •Professionalism
- •Patient Care Summary
- •References
- •Index
Visual Loss and Depression |
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Assessment of the affect and mood in this patient is helpful in determining that depression might be an issue compounded by her visual loss and the loss of function and activities of daily living. Upon further questioning, she reported that not being able to read and do her crossword puzzles was a significantly negative impact of her visual loss on her daily quality of life. The astute clinician picked up on the family’s report that she seemed more withdrawn recently and was not eating very well and although it might be worsened by her vision, these were felt to be signs of overlying depression. The ophthalmologist simply asked the patient ‘‘Did she feel sad or depressed often?’’ and she responded ‘‘yes’’ and elaborated on the additional issues concerning loss of function and independence and, in particular, the impact of her vision on her daily life. The ophthalmologist contacted the patient’s primary care physician and she was evaluated and treated medically for depression. A low-vision consultation was obtained and the low-vision specialist was able to improve her vision with optical aids to the point where she resumed her crossword puzzles. Four months later, the patient’s family sent a thank-you letter to the ophthalmologist thanking her for ‘‘giving their grandmother back to them.’’ The patient returned six months later after treatment for her depression and was accompanied by her grateful family members.
References
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2.Rovner BW, Zisselman PM, Shmuely-Dulitzki Y. Depression and disability in older people with impaired vision: a follow-up study. J Am Geriatr Soc. 1996;44:181–184.
3.Rovner BW, Ganguli M. Depression and disability associated with impaired vision: the MoVies Project. J Am Geriatr Soc. 1998;46:617–619.
4.Carabellese C, Appollonio I, Rozzini R, et al. Sensory impairment and quality of life in a community elderly population. J Am Geriatr Soc. 1993;41:401–407.
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6.Galaria II, Casten RJ, Rovner BW. Development of a shorter version of the geriatric depression scale for visually impaired older adults. Int Psychogeriatr. 2000;12:435–443.
7.Horowitz A, Reinhardt JP, Boerner K. The effect of rehabilitation on depression among visually disabled older adults. Aging Ment Health. 2005;9:563–570.
8.Brody BL, Roch-Levecq AC, Gamst AC, et al. Self-management of age-related macular degeneration and quality of life: a randomized controlled trial. Arch Ophthalmol. 2002;120:1477–1483.
9.Kohn R, Epstein-Lubow G. Course and outcomes of depression in the elderly. Curr Psychiatry Rep. 2006;8:34–40.
10.Lapid MI, Rummans TA. Evaluation and management of geriatric depression in primary care. Mayo Clin Proc. 2003;78:1423–1429.
11.Rovner BW, Casten RJ, Hegel MT, Tasman WS. Minimal depression and vision function in age-related macular degeneration. Ophthalmology. 2006;113(10):1743–1747.
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A.G. Lee |
12.Tolman J, Hill RD, Kleinschmidt JJ, Gregg CH. Psychosocial adaptation to visual impairment and its relationship to depressive affect in older adults with age-related macular degeneration. Gerontologist. 2005;45:747–753.
13.Horowitz A, Reinhardt JP, Kennedy GJ. Major and subthreshold depression among older adults seeking vision rehabilitation services. Am J Geriatr Psychiatry. 2005;13:180–187.