Overlooking your eyes could lead to serious health and quality of life problems as you age.
Patients sometimes avoid eye doctors and exams, and primary care physicians don't always ask them about their eyes. Of the more than 2,000 adults between ages 50 and 80 years old surveyed in the National Poll on Healthy Aging, 18% said they hadn't had their eyes checked by an eye doctor in there or more years, and some weren't even sure when their last exam was.
Another 58% of older adults said their regular doctors didn't ask about their eyes. The poll was conducted by the University of Michigan Institute for Healthcare Policy and Innovation, sponsored by AARP and Michigan Medicine.
The only patients who were asked about their eyes were those with history of eye disease or diabetes, or who were from low-income households. About 17% of respondents said they took an eye-chart vision test in their regular doctor's office.
Still, avoiding proper eye examinations or visits to an optometrist or ophthalmologist (the former graduated optometry school while the latter graduated medical school) can be detrimental to adults as they age. More than a third of participants said they hadn't gotten around to getting an eye exam, and a quarter said it was easier to get reading glasses over the counter.
Another 40% said they didn't have to go for an eye exam because they weren't having any problems seeing. (Even if you have 20/20 vision, you should still get a comprehensive eye exam, according to insurance company Aetna).
In addition to not getting diagnosis and treatment for eye diseases, even deteriorating vision can erode a person's quality of life.
"Vision loss affects an older adult's overall health, risk of falling, social interactions, and quality of life," says Alison Bryant, senior vice president of research for AARP. "But not everyone has coverage for routine vision care and eyeglasses."
A quarter of survey participants said they didn't go because of the cost, and nearly as many said they didn't have insurance coverage. Even though eye health tends to deteriorate as we age, older adults don't always have access to vision care. They may qualify for Medicare benefits at 65, or before, if they're on Social Security disability insurance, but Medicare doesn't offer comprehensive vision benefits.
For example, Medicare Part A is primarily for hospital insurance, and would only cover vision care when it's part of a medical emergency or injury, according to eHealth Medicare, which helps patients understand and find proper policies. Medicare Part B covers some vision care, but not routine vision exams or vision correction, such as eyeglasses or contact lenses (the only exception is after cataract surgery, which Part B does cover). Some patients with high risk of glaucoma would be covered for screenings. Medigap, which is insurance private companies offer to cover what Medicare doesn't, also does not include routine vision benefits.
Some populations at risk include adults with diabetes, who should have a yearly eye exam, as well as older African-American and Hispanic patients who are more likely to develop glaucoma. An eye exam may reveal signs of ocular disease before noticeable changes in vision, the researchers said.
Almost all of the poll's participants (86%) said they wear glasses or contact lenses and a quarter said they'd been diagnosed with one of the more common eye diseases, such as cataracts and glaucoma. The study authors said the results may underestimate the low level of screening because vision impairment may keep people from participating in the research.
Older Americans are attuned to the high costs of health care. Although many Americans are enrolled in Medicare in their old age, economists expect they incur an average of $122,000 in medical costs between their 70th birthday and when they die, paid mostly out of pocket (except for low-income Americans covered by Medicaid).
About 5% of people over 70 will see out-of-pocket medical bills amounting to more than $300,000, and another 1% will accrue medical bills of more than $ 600,000. Health care costs continue to rise, especially for retirement, and for some people it's so much they wait for tax refunds to go to the doctor or pay off medical bills.
Even without an eye specialist, older adults can get help. Primary physicians could play an important role in assisting patients in getting better vision care, the researchers noted. This is especially important as vision tends to change as people get older, and with aging comes the possibility of developing issues with eyesight. Older adults, especially those with diabetes, are encouraged to seek annual eye exams and screenings.