Lecturer raises awareness of aging population with strabismus

Issue: May 10, 2012

Michael X. Repka

SAN ANTONIO — Among older adults with strabismus, 25% have ocular motor neuropathies, a speaker said here. Strabismus is reported annually in 0.68% of adults aged 65 years and older.

Perspective from Robert S. Gold, MD

"[This is] a really important area for us to make sure that we are capable of managing in the future," Michael X. Repka, MD, said during the Costenbader Lecture at the American Association for Pediatric Ophthalmology and Strabismus meeting.

Only a small proportion of strabismic patients undergo surgery, and perhaps enhanced outreach to physicians, insurers and patient groups would promote awareness of this discipline, he said.

There will be many more adult strabismic patients, simply due to the aging population, who will require diagnostic and surgical procedures. The Medicare population aged 65 years and older will double to nearly 80 million by 2030, according to Dr. Repka; concordantly, the need for adult strabismus evaluation grows.

Ophthalmologists face challenges in treating adult strabismus.

"Pediatric ophthalmology in adult strabismus is a niche specialty for the accountable care organizations, and we risk actually being left by the wayside," Dr. Repka said. "We need value-based measures for strabismus. We need to demonstrate how, what scale or standard, or at least have a role in creation of those things."

Disclosure: Dr. Repka has no relevant financial disclosures.

Perspective

Robert S. Gold, MD

At the Costenbader Lecture, Michael X. Repka, MD, discussed how, as pediatric ophthalmologists, we must establish guidelines for how our adult strabismus patients should get appropriate medical and surgical treatment in the future. Many pediatric ophthalmologists are finding that adults requiring or requesting strabismus surgery is an increasing part of their practices. In my practice, approximately 30% of my strabismus surgeries are on adults with thyroid disease, cranial nerve palsies, re-operations from childhood strabismus, and other causes resulting in diplopia. As Dr. Repka stated, we must be advocates for our adult strabismus patients so that we can offer them appropriate treatments for their specific conditions and have their insurance providers cover these medically necessary services for the well-being of our patients.

Robert S. Gold, MD

OSN Pediatrics/Strabismus Section Editor

Disclosures: Dr. Gold has no relevant financial disclosures.