Following the post-war period, the western world has seen a significant and consistent increase in life expectancy. Current data in the UK estimates the life expectancy in this country to be an average of around 80.

In 2008 a study commissioned by the RNIB estimated that about 2 million people in the UK have significant sight loss. The vast majority are older people aged 65 and over. A further study carried out in 2005 showed that as much as 50-70% of sight loss in the older population was due to preventable or treatable causes.

In view of this Barnard and Levit Optometrists feel it is extremely important to provide an eye examination that specifically caters to the senior age and the visual issues they may encounter.

Mr Salasnik specialises in Geriatric Optometry and Low Vision and is the practitioner of choice in our practice for senior citizens.

The Eye Examination for the Senior Age is based on the regular adult Eye Examination with certain specific enhancements.

Length of Appointment

A slightly longer appointment of 80 minutes is allocated. This is to enable extra time for more in-depth investigations when needed and also to allow for extra care and attention to be taken over refraction. Getting the prescription 100% accurate often takes a little longer in the senior age group because of issues like early cataract and other subtle aging changes.

Extra Investigations

The main causes of vision loss in the older age group are macular degeneration (AMD), glaucoma and diabetic retinopathy. Our aim is to diagnose these and other conditions as early as possible. When a condition is detected in its early stages it increases the likelihood of successful treatment and decreases the amount of damage the condition could have already caused.

For this reason Optical Coherence Tomography (OCT) using the Zeiss Cirrus HD-OCT  is routine in this examination. Even if there are no current visual issues, it is important to get a baseline measurement for the macula and optic disc to ensure any subtle changes are detected at the earliest opportunity.

Reduced pigment levels in the macular region is a known risk factor for AMD. Your optometrist at Barnard Levit is able to measure the pigment density at your macula using the MPS II and provide you with nutritional advice to help you maintain macular health. 

It has been estimated that more than 15% of people over the age of 65 suffer from dry eye. Your optometrist may use the TearScience LipiView system to diagnose the cause of the dry eye and, if appropriate, arrange further appointments where the LipiFlow and/or BlephEx treatments can be carried to improve the daily comfort of your eyes.

A common complaint expressed by Senior Citizens is that while they are able to read the letters well on the optometrists chart, as soon as they enter a room with dimmer lighting or circumstances where they are affected by glare, their vision deteriorates rapidly. We therefore will often use the CSV1000E chart, manufactured by VectorVision USA which accurately measures Contrast Sensitivity Function to give us an idea as to how your vision degrades under such circumstances

Many people develop smaller pupils as they get older and eye drops that dilate the pupils may be needed from time to time to ensure a full and comprehensive health check.

Advice and Recommendations

At the end of the examination, your optometrist will discuss the results with you, offer advice on optimising your vision if required with spectacles, explain any relevant eye health matters and answer any questions you may have. If an early condition is detected it may be monitored in-house or referred to a Consultant Ophthalmologist for further investigation and possible treatment. Sometimes the patient will be given an Amsler chart to monitor any subtle macula changes at home or may be given dietary advice or recommended dietary supplements to keep a condition at bay. On occasion, if the level of vision that is achieved with regular spectacles in not good enough for daily tasks, the patient will be referred to the Low Vision Clinic.

For the over 70s an annual examination is recommended although on occasion a patient may be seen more frequently when a condition is being monitored.

Special Situations

Unfortunately there are times where an elderly patient may have other health conditions. It is important that if these could impact on the appointment or the patient’s performance, that we know in advance. If the patient will not be able to climb the stairs please specify the need to be seen in one of the downstairs consulting rooms when booking an appointment (Disability and Domiciliary). On occasion there may be an early form of dementia and it is vital, wherever possible, that the patient is accompanied by a carer or relative who can provide a clear history and help the patient with any decisions they may need to make. The full examination will sometimes be too long to carry out at one time and we can then arrange to split the appointment into two shorter sessions on different days.