Clinical pearls in optometric management of the geriatric patient.
BACKGROUND: Painstaking attention to detail is absolutely necessary for optometrists to provide the appropriate clinical management of the geriatric patient. METHODS: Clinical management techniques (pearls) are discussed which aid in the diagnosis and treatment of problems specific to geriatric patients. Factors noted in patient presentation are stressed and include physical appearance, ability to move about, and use of other senses. The most commonly occurring eye anomalies occurring in the geriatric population are discussed including iatrogenic drug side effects, pupillary anomalies, extraocular palsies, dry eye, corneal degenerations, refractive error changes, lenticular changes, glaucoma, age-related maculopathy, vitreoretinal disease, and ocular manifestations of systemic disease (vascular occlusive disease, diabetes, ischemic optic neuropathy, other neuro-ophthalmic disease). RESULTS: Conditions relatively rare in the young population occur with regularity in the elderly population and often must be assumed to be present in concert with some typical patient presentations in the geriatric population. CONCLUSIONS: Optometrists as primary health care providers often provide the only avenue individuals with blinding and sometimes life threatening conditions have in managing these conditions. Optometrists managing geriatric patients are required to know what happens to this population from an ocular disease as well as other function and dysfunction standpoint.