It’s said of age that those in their 50s are now the new 40s, and the 40s are the new 30s, but nobody thought to tell the eyes,”says eye practitioner Dr. Dagmar Lutzi of Waterloo, whose words sum up what baby boomers, born between 1945 to 1964, may be facing with eye health care.Although vision loss among boomers is projected to reach epidemic proportions globally, the statistics in Canada alone are staggering, calling for costly health care solutions and health intervention from government right down to individual citizens.
A detailed report from the Foundations for a Canadian Vision Health Strategy, prepared in 2007 for the National Coalition for Vision Health, shed sobering light from the storm of concern, very much brewing six years later, providing statistics from coast to coast.
The Coalition was established in 1998 to identify priorities for improving vision health, and also to promote and coordinate advocacy, education, initiatives and information- sharing networks, nationally and provincially.
The Strategy states that over four million Canadian adults are afflicted with one of the leading age-related blinding ocular diseases, placing glaucoma, diabetic retinopathy, cataracts and macular degeneration (AMD) highest on the list. The good news for boomers who heed the warning is that most of these diseases are treatable or preventable. Even refractory vision loss (AMD) responds to some form of low vision rehabilitation, and stem-cell research is currently the promise of the future, with its goal to eradicate AMD.
Meanwhile, the aim of the coalition stands firm in 2012, as it did in 2007: to decrease grim statistics through a vision health strategy that includes prevention and increased opportunities for a more timely diagnosis and treatment of blinding ocular disease.
“Unless Canadians rise to meet the challenge of this gathering storm, the quality of our vision health care system will erode and the number of Canadians needlessly experiencing avoidable blindness will surge,” the report states ominously.
Projected Vision Loss Statistics So, what exactly do the statistics show? As of 2007, 108,000 Canadians were legally blind; another 278,000 Canadians were visually impaired; 610,000 (self-reported) had difficulty seeing ordinary newsprint or the face of someone clearly at four metres away. From 1997 to 2007, the number of blind and visually impaired Canadians had increased 37 per cent, and this figure is projected to double between 2006 and 2031.
In the next 20 years, aging baby boomers born between 1945 and 1965 will have more than doubled the number of Canadians over age 64 – from 4.3 million in 2006 to 9.1 million in 2031. The number of Canadians aged 40 and older with visual impairment or blindness numbered 278,000 and l08,000, respectively, in 2007, and is forecasted to double by 2031 to 560,000 and 215,000, respectively. In 2006, estimates of the direct annual cost
of vision loss in Canada ranged between $2.7 billion and $2.9 billion. The estimated total of indirect cost of vision loss in 2006 was $7.9 billion, ranking vision loss the ninth most costly group over digestive and endocrine disorders, such as diabetes and thyroid conditions.
While advances in cataract surgery have been hugely successful to date and glaucoma is treatable, eye diseases, such as macular degeneration continue to challenge eye practitioners and researchers alike.
“Glaucoma is a disease that is usually dependent on genetics and age it is not easily preventable by alternative lifestyles,” Dr. Lutzi says. “(AMD) is on the rise because people are living longer, although we are getting increased amounts of UV coming through the atmosphere, which has also been linked to this condition. The primary treatment
for glaucoma is still topical eye drops and laser trabeculotomy. Cataract surgery made great inroads with the introduction of intraocular lens implants over 30 years ago, and remains highly effective.”
Catherine Tsilfidis, Ph. D., the Don and Joy Maclaren Chair for Vision Research, Ottawa Hospital Research Institute, concurs. “As far as I know, (AMD) is on the rise because of our aging population,” she says “It is estimated that one in nine people over the age of 65, and one in four over the age of 50 will get it. As our population ages, and a greater population of people are over 65, the incidence in the population will rise.”
Visual impairment also doubles the difficulties with daily living and social activities, doubles the risks of falls, triples the risk of depression, and quadruples the risk of hip fractures. Eye disease and conditions impact on every level of the health care system.
Vision Loss Prevention Initiatives Anti-VEG therapy, also used in the treatment of some cancers, is being used for patients with wet AMD to prevent further loss of vision, “and can actually slightly improve vision, but rarely to a pre-AMD level,” Dr. Lutzi cautions. People of every age are strongly encouraged to wear UV protection sun glasses to reduce the risk of cataract and AMD. Eye vitamins are available to reduce the risk of AMD, and people who smoke should consider butting out for good , as AMD has “definitely been linked to AMD,” Dr. Lutzi adds. A regular intake of dark green veggies is also helpful.
On a local level, eye practitioners are urged to provide education and take advantage of multi-media resources to get the message out to the general public to care better for their eyes, including going for regular checkups.
According to a recent CNW report that was based on a sub- sample survey of 452 respondents, aged 50-64, “Beyond examining vision and eye health, optometrists also have the ability to diagnose serious eye diseases like glaucoma, also known as the silent vision thief. Yet 45 per cent of aging (Canadian) baby boomers are not aware that optometrists can detect diseases like glaucoma. More importantly, many boomers are unaware that early detection and treatment can help prevent blindness or control serious eye disease.” An eye practitioner’s
ability to detect brain tumours behind the eyes can additionally save lives.
Strides in Stem Cell Research
Molecular biologists continue to forge significant partnerships with The Foundation Fighting Blindness (FFB), for one, including the support of other organizations, private sector and corporate donations, provincial and federal governments, to develop pioneering therapies to treat vision loss. The FFB and its partners currently support 21 trailblazing research groups at universities and hospitals across Canada, committing $5.5 million towards these projects.
Dr. Derek van der Kooy and his team exemplify one such group, credited with making the extraordinary discovery that retinol stem cells are present in the adult human eye.
The bottom line is that stem cell therapy and its potential could benefit more than a million Canadians at any stage of degenerative eye diseases, regardless of a person’s age, including those affected by AMD, retinitis pigmentosa, and corneal diseases that cause blindness. Combined with the development of hyaluronan and methylcellulose (HAMC), a biodegradable gel, to help spread implanted cells across the retina, and other drugs into HAMC to enable transplanted cells to make connections with the nerve cells of the eye, the hope and goal is to restore vision completely.
The time-frame is another question, however. Will baby boomers reap the benefit of today’s research and be spared the potential of contracting macular degeneration or other blinding ocular diseases?