Retrospective Evaluation of Reasons for Ophthalmology Outpatient Visits and Diagnostic Distribution in Geriatric Patients

Öz

Objectives: Older adults are particularly vulnerable to ocular diseases that impair vision, quality of life, and functional independence. Understanding ophthalmology outpatient visit patterns in this population is essential for planning age-sensitive eye care services. This study aimed to analyze the primary reasons for ophthalmology outpatient visits among older adults in Turkey. Materials and Methods: Medical records of patients aged ≥65 years attending an outpatient ophthalmology clinic between January and December 2024 were retrospectively reviewed. Demographic characteristics, presenting visual acuity, and primary clinical diagnoses were recorded and descriptively analyzed using predefined diagnostic categories. Results: Results: Patients aged ≥65 years accounted for 17.5% of all ophthalmology outpatient visits. Ocular surface diseases were the most common diagnostic category, followed by refractive errors and lens- and anterior segment–related conditions. The most frequent diagnoses were refractive errors, dry eye disease, and blepharitis. Most patients were aged 65–74 years, with a higher proportion of females. Visual impairment increased progressively with age. Conclusion: Ophthalmology outpatient visits among older adults are largely driven by common, potentially preventable or manageable conditions. Frequent ocular surface disorders, such as dry eye disease and blepharitis, may be effectively managed at the primary care level with appropriate referral pathways. Strengthening early identification and first-line management may reduce unnecessary specialist visits and help preserve visual function, supporting the planning and optimization of geriatric eye care services within a public health framework in Turkey.

Anahtar Kelimeler

• Elderly
• Eye Care
• Ophthalmology
• Geriatric Eye Diseases
• Outpatient Clinic

Geriatrik Hastalarda Göz Polikliniğine Başvuru Nedenleri ve Tanısal Dağılımın Retrospektif Değerlendirilmesi

Öz

Amaç: Yaşlı bireyler; görmeyi, yaşam kalitesini ve fonksiyonel bağımsızlığı olumsuz etkileyen oküler hastalıklara karşı özellikle hassastır. Bu popülasyonda oftalmoloji poliklinik başvuru nedenlerinin anlaşılması, yaşa duyarlı göz sağlığı hizmetlerinin planlanması açısından önem taşımaktadır. Bu çalışmanın amacı, Türkiye’de yaşlı bireylerin oftalmoloji polikliniklerine başvuru nedenlerini analiz etmektir. Gereç ve Yöntemler: Ocak–Aralık 2024 tarihleri arasında bir oftalmoloji polikliniğine başvuran ≥65 yaş hastaların tıbbi kayıtları retrospektif olarak incelendi. Demografik özellikler, başvuru sırasındaki görme keskinliği ve primer klinik tanılar kaydedildi ve önceden tanımlanmış tanısal kategoriler kullanılarak tanımlayıcı olarak analiz edildi. Bulgular: ≥65 yaş hastalar, tüm oftalmoloji poliklinik başvurularının %17,5’ini oluşturdu. Oküler yüzey hastalıkları en sık tanı kategorisi olup bunu refraksiyon kusurları ile lens ve ön segment ilişkili hastalıklar izledi. En sık tanılar refraksiyon kusurları, kuru göz hastalığı ve blefarit idi. Hastaların çoğu 65–74 yaş aralığında olup kadın hastaların oranı daha yüksekti. Görme bozukluğu sıklığı yaşla birlikte progresif olarak arttı. Sonuç: Yaşlı bireylerde oftalmoloji poliklinik başvuruları büyük ölçüde yaygın, önlenebilir veya yönetilebilir hastalıklardan kaynaklanmaktadır. Kuru göz hastalığı ve blefarit gibi sık görülen oküler yüzey hastalıkları, uygun sevk basamakları ile birinci basamakta etkin şekilde yönetilebilir. Erken tanı ve ilk basamak tedavi yaklaşımlarının güçlendirilmesi, gereksiz uzman başvurularını azaltabilir ve görme fonksiyonunun korunmasına katkı sağlayabilir. Bu yaklaşım, Türkiye’de geriyatrik göz sağlığı hizmetlerinin halk sağlığı perspektifiyle planlanması ve optimize edilmesine destek sağlayacaktır.

Anahtar Kelimeler

• Yaşlı
• Göz Sağlığı
• Oftalmoloji
• Geriatrik Göz Hastalıkları
• Poliklinik Başvurusu

Kaynakça

1. 1. Khan HTA, Addo KM, Findlay H. Public health challenges and responses to the growing ageing populations. Public Health Chall. 2024;3(3):e213.
2. 2. Navaneetham K, Arunachalam D. Global population aging, 1950–2050. In: Handbook of Aging, Health and Public Policy. Singapore: Springer; 2023.
3. 3. World Health Organization. Ageing and health [Internet]. Geneva: World Health Organization; 2022 Oct 1 [cited 2024 Jul 1]. Available from: https://www.who.int/news-room/factsheets/detail/ageing-and-health
4. 4. Turkish Statistical Institute. Life tables, 2022–2024 [Internet]. Ankara: Turkish Statistical Institute; 2024 [cited 2024 Jul 1]. Available from: https://www.tuik.gov.tr
5. 5. Coleman AL, Siegfried CJ, Johns KJ. Eye care for the aging eye [Internet]. San Francisco: American Academy of Ophthalmology; 2009 [cited 2024 Jul 1]. Available from: https://med.virginia.edu/ophthalmology/wp-content/uploads/sites/295/2015/12/AgingEye.pdf
6. 6. Ripa M, Schipa C, Rizzo S, Sollazzi L, Aceto P. Is visual impairment a risk factor for frailty in older adults? A systematic review and meta-analysis of 10-year clinical studies. Aging Clin Exp Res. 2023;35(2):227-44.
7. 7. Nagarajan N, Assi L, Varadaraj V, Motaghi M, Sun Y, Couser E et al. Vision impairment and cognitive decline among older adults: a systematic review. BMJ Open. 2022;12(1):e047929.
8. 8. Mehta J, Czanner G, Harding S, Newsham D, Robinson J. Visual risk factors for falls in older adults: a case-control study. BMC Geriatr. 2022;22(1):134.

9. 9. Resnikoff S, Pascolini D, Mariotti SP, Pokharel GP. Global magnitude of visual impairment caused by uncorrected refractive errors in 2004. Bull World Health Organ. 2008;86(1):63-70.
10. 10. Stapleton F, Alves M, Bunya VY, Jalbert I, Lekhanont K, Malet F, et al. TFOS DEWS II epidemiology report. Ocul Surf. 2017;15(3):334-65.
11. 11. Schein OD, Muñoz B, Tielsch JM, Bandeen-Roche K, West S. Prevalence of dry eye among the elderly. Am J Ophthalmol. 1997;124(6):723–8.
12. 12. Hashemi H, Pakzad R, Heydarian S, Aghamirsalim M, Asadollahi M, Yekta A, et al. The prevalence of anterior blepharitis in an elderly population of Iran; the Tehran Geriatric Eye Study. Cont Lens Anterior Eye. 2021;44(6):101429.
13. 13. Assi L, Varadaraj V, Shakarchi AF, Sheehan OC, Reed NS, Ehrlich JR, et al. Association of vision impairment with preventive care use among older adults in the United States. JAMA Ophthalmol. 2020;138(12):1298-306.
14. 14. Hashemi H, Khabazkhoob M, Rezvan F, Yekta A. Prevalence and causes of visual impairment and blindness in elderly population; an urgent geriatric health issue: Tehran Geriatric Eye Study (TGES). Ophthalmic Epidemiol. 2023;30(3):249-59.
15. 15. Välimaa M, Koivunen K, Viljanen A, Rantanen T, von Bonsdorff M. Cohort comparison of vision and hearing in 75- and 80-year-old men and women born 28 years apart. Arch Gerontol Geriatr. 2025;129:105653.
16. 16. Sánchez-González MC, Sánchez-González JM, De-Hita-Cantalejo C, Vega-Holm M, Jiménez-Rejano JJ, Gutiérrez-Sánchez E. The effect of age on binocular vision normative values. J Pediatr Ophthalmol Strabismus. 2020;57(6):363–71.
17. 17. Hou T, Liu M, Zhang J. Bidirectional association between visual impairment and frailty among community-dwelling older adults: a longitudinal study. BMC Geriatr. 2022;22(1):672.
18. 18. Dinarvand D, Panthakey J, Hassan A, Ahmed MH. Frailty and visual impairment in elderly individuals: improving outcomes and modulating cognitive decline through collaborative care between geriatricians and ophthalmologists. Diseases. 2024;12(11):273.
19. 19. Salonen L, Kivelä SL. Eye diseases and impaired vision as possible risk factors for recurrent falls in the aged: a systematic review. Curr Gerontol Geriatr Res. 2012;2012:271481.
20. 20. Frank CR, Xiang X, Stagg BC, Ehrlich JR. Longitudinal associations of self-reported vision impairment with symptoms of anxiety and depression among older adults in the United States. JAMA Ophthalmol. 2019;137(7):793–800.
21. 21. Bikbov MM, Kazakbaeva GM, Rakhimova EM, Rusakova IA, Fakhretdinova AA, Tuliakova AM, et al. The prevalence of dry eye in a very old population. Acta Ophthalmol. 2022;100(3):262-8.
22. 22. Smadar L, Kapelushnik N, Ben-Simon GJ, Segev S, Soudry S, Abd-Elkader A, et al. The association between blepharitis and lower eyelid ectropion in a large cohort of patients. Semin Ophthalmol. 2025;40(5):400-4.
23. 23. Verjee MA, Brissette AR, Starr CE. Dry eye disease: early recognition with guidance on management and treatment for primary care family physicians. Ophthalmol Ther. 2020;9(4):877-88.
24. 24. Al-Namaeh M. Common causes of visual impairment in the elderly. Med Hypothesis Discov Innov Ophthalmol. 2022;10(4):191-200.
25. 25. Koç F, Erden V, Sefi-Yurdakul N. Causes of low vision and blindness in a Turkish adult population: the Izmir eye study. East Mediterr Health J. 2018;24(2):161-8.
26. 26. Hugosson M, Ekström C. Prevalence and risk factors for age-related cataract in Sweden. Ups J Med Sci. 2020;125(4):311-5.
27. 27. Kuzucu Üşümüş SA, Koçak Altıntaş AG, Özdemir A, Aypak C. Using the Amsler Grid Test for Age-Related Macular Degeneration Screening. Turk J Ophthalmol. 2024;54(1):11-6.
28. 28. AREDS2 Research Group; Chew EY, Clemons T, SanGiovanni JP, Danis R, Domalpally A, McBee W, et al. The Age-Related Eye Disease Study 2 (AREDS2): study design and baseline characteristics: AREDS2 report number 1. Ophthalmology. 2012;119(11):2282-9.
29. 29. Hashemi A, Khabazkhoob M, Hashemi H. High prevalence of refractive errors in an elderly population: a public health issue. BMC Ophthalmol. 2023;23(1):38.
30. 30. Abreu MDSN, Galdino MCP, Matos SDO, Cavalcanti CCLPB, Trigueiro DRSG. Construction of an ophthalmological calendar for the therapeutic follow-up of glaucoma in the elderly. Int J Environ Res Public Health. 2023;20(2):1237.
31. 31. Sharif A, Smith DR, Hellgren KJ, Jendle J. Diabetic retinopathy among the elderly with type 2 diabetes: a nationwide longitudinal registry study. Acta Ophthalmol. 2024;102(6):e883-92.
32. 32. Loh KY, Ogle J. Age related visual impairment in the elderly. Med J Malaysia. 2004;59(4):562-8.
33. 33. Vijaya L, George R, Asokan R, Velumuri L, Ramesh SV. Prevalence and causes of low vision and blindness in an urban population: The Chennai Glaucoma Study. Indian J Ophthalmol. 2014;62(4):477-81.
34. 34. Thapa R, Bajimaya S, Paudyal G, Khanal S, Tan S, Thapa SS, et al. Prevalence and causes of low vision and blindness in an elderly population in Nepal: the Bhaktapur retina study. BMC Ophthalmol. 2018;18(1):42.
35. 35. He Y, Nie A, Pei J, Ji Z, Jia J, Liu H, et al. Prevalence and causes of visual impairment in population more than 50 years old: The Shaanxi Eye Study. Medicine (Baltimore). 2020;99(20):e20109.
36. 36. Vold SD, Carroll RP, Nelson JD. Dermatochalasis and dry eye. Am J Ophthalmol. 1993;115(2):216-20. doi:10.1016/s0002-9394(14)73926-1.
37. 37. Woźniak-Roszkowska E, Iljin A, Noszczyk B, Antoszewski B. Evaluation of outcomes of lower eyelid entropion and ectropion surgical repair. Pol Przegl Chir. 2023;96(2):50-8.
38. 38. Aapola U, Nättinen J, Suurkuukka I, Tuomilehto J, Keinänen-Kiukaanniemi S, Saramies J, et al. Ocular surface health of the Finnish elderly population. Acta Ophthalmol. 2022;100(8):894-902.
39. 39. Di Marco E, Aiello F, Lombardo M, Di Marino M, Missiroli F, Mancino R, et al. A literature review of hypertensive retinopathy: systemic correlations and new technologies. Eur Rev Med Pharmacol Sci. 2022;26(18):6424-43.
40. 40. VanderBeek BL, Yu Y, Cardillo S, Hubbard R. Twenty-year trends in prevalence and incidence of diabetic retinal disease. Ophthalmology. 2025;132(7):767-74.
41. 41. Turk MA, Hayworth JL, Nevskaya T, Pope JE. Ocular manifestations in rheumatoid arthritis, connective tissue disease, and vasculitis: a systematic review and meta-analysis. J Rheumatol. 2021;48(1):25-34.
42. 42. Salameh N, Doumit CA, Jalkh E, Nehme J. Association between hydroxychloroquine intake and damage to the outer nuclear layer in eyes without manifest retinal toxicity. BMC Ophthalmol. 2024;24(1):414.