Function, Frailty, and Futility in Eyecare for Older Adults

Over the next forty years in the United States, there will be an unprecedented increase in the older adult population. By 2060, 98 million adults are expected to be 65 or older and will make up approximately 25% of the population. Any decline in visual function can severely impact an elderly person's quality of life. With a decline in physiological reserves, old and frail patients are more likely to have complications or poor outcomes with eye surgeries and treatments. They may also have difficulties adhering to treatment regimens because of cognitive impairment, physical disabilities, or other comorbidities. Some eye conditions in the elderly can result in significant visual impairment or blindness if not properly managed; and severe vision loss can lead to accidents, falls, depression, or overall decline in health, increasing the risk of mortality.

This book examines the three critical concepts in geriatric ophthalmology: function, frailty, and futility. This book will be among a limited number of published books on geriatric ophthalmology. The major difference between this book and prior publications is that this book emphasizes and centers on a comprehensive and balanced view of the patient's overall health status, functional abilities, and life expectancy, instead of focusing on the eye diseases alone.

This book will educate healthcare providers on the importance to treat each elderly patient as an individual taking into account their overall health, lifestyle, and treatment goals and not to generalize and make assumptions based on age alone.

Dr. Simon K. Law, MD, PharmD, is a Glaucoma Specialist and Clinical Professor of Health Sciences at David Geffen School of Medicine, UCLA, holding dual doctorate degrees in Medicine and Pharmacy. With his unique interdisciplinary expertise, Dr. Law brings a comprehensive approach to the diagnosis and treatment of eye conditions of the older adults. He was a former Dennis W. Jahnigen Career Development Scholars recipient of American Geriatrics Society and had served as the Chairperson of the Committee on Aging at the American Academy of Ophthalmology from 2018-2023, where he led initiatives to improve eye care for the elderly including maintaining an educational webpage on geriatric ophthalmology and organizing multiple symposiums on geriatric eyecare in Academy annual meetings. Dr. Law has a prolific academic career, having published over 100 research papers, book chapters, and books on a variety of topics on ophthalmology, contributing significantly to the global body of knowledge in his field. He has trained more than two hundred ophthalmology residents and fellows in his career. With his vast experience and commitment to advancing ophthalmic care for the geriatric population, Dr. Law continues to shape the future of his field and inspire the next generation of ophthalmologists.

Dr. JoAnn Giaconi, MD, is a Glaucoma Specialist and a Professor of Clinical Ophthalmology at the David Geffen School of Medicine.  In addition to an active clinical practice, she serves as the Vice Chair of Affiliate Hospitals for the Stein Eye Institute, Chief of Ophthalmology for the Greater Los Angeles Veterans Administration, and holds roles in teaching and advising at the medical school. These responsibilities uniquely position her as a key educator as students, trainees, and clinicians see an increasingly growing population of patients reaching older and older ages.  Dr. Giaconi has contributed to over 50 published research papers in the areas of glaucoma and medical education, and has lectured frequently, both nationally and internationally. Dr. Giaconi’s commitment to her profession is further highlighted by the leadership roles she has taken on in numerous organizations such as the American Academy of Ophthalmology (AAO). American Glaucoma Society (AGS), Association of University Professors of Ophthalmology (AUPO), Women in Ophthalmology (WIO), and the California Academy of Eye Physicians and Surgeons (CAEPS). Her dedication to her field has earned her several prestigious awards including the AUPO-AAO Excellence in Medical Student Education Award, the AGS Young Clinician-Scientist Award, and an Achievement Award and a Senior Achievement Award from the American Academy of Ophthalmology.