Vision Problems Of Elderly Immigrants In Israel: A Prospective Study

Abstract

Eye disorders restrict sight and limit ability of elderly people to function. A model community-based outreach program, Negev Project Vision, was organized to address the eye care needs of the elderly -specifically, immigrants from the former Soviet Union and Ethiopia now living in Israel. Findings show that about 80% of the elderly screened were in need of eye care (e.g., medical or optometry-related services). Among those needing medical treatment, 67% had cataract; 14% trachoma; 9% glaucoma; 9% age-related macular degeneration, and 2% diabetic retinopathy. Half (50%) were found to have vision disorders that could be corrected by prescription eyeglasses. A post intervention interview showed that those provided eyeglasses tend to report a better health status, ability to function, address daily living conditions, as well as interact and a higher level of more with interaction with family and friends. This article discusses community outreach services and policy recommendations related to eye care of the elderly. Since the late 1980's, Israel has absorbed many immigrants who constitute about 20 percent of the present population. While the vast majority of these people are from the former Soviet Union, others came from Ethiopia. Among the population of immigrants, it is estimated that 16% are over 65 years of age (Brodsky et al., 2000). For many elderly immigrants, life before moving to Israel was a considerable challenge. For example, Ethiopian elderly left behind some of the most destitute living conditions in the world, characterized by average life expectancy of 47 years, lack of food and safe drinking water, and inadequate sanitation and sparse health services (UNICEF, 1995; Isralowitz, 2000). While not at the same level found in Ethiopia, living conditions with restrictions on food and adequate heath care in the former Soviet Union made life difficult there. Poor living conditions have been found to affect the nature and rate of deterioration that occurs among people over the age of 50 in terms of their vision and social, psychological, and physical ability to function (Brenner, et al., 1993). Studies show limited sight linked to the mental health of elderly people, their behaviors and social involvement (Horowitz, 1995; Wahl, et al., 1999a, 1999b). Visually impaired elderly people experience a range of emotions, including grief, anger, depression, anxieties and other negative feelings leading to decreased self-confidence and self-perception, lower morale, loss of control and feelings of vulnerability (Gillman, et al., 1986; Orr, 1991). Loss of vision is associated with adjustment difficulties that in turn lead to social isolation, detachment and feelings of loneliness (Heinemann, et al., 1988;Orr, 1991). Additional research shows vision disorders to be a major factor restricting indoor and outdoor daily living activities such as moving in and out of bed or a chair, walking or crossing roads, or traveling (LaPlante, 1988). Moreover, without the ability to read bus numbers, see traffic lights and notice close cars, travel becomes dangerous and stressful causing many elderly to become homebound. Vision disorders have a negative impact on instrumental activities of daily living (IADL) that include homemaking chores and on basic activities of daily living (ADL) such as dressing, washing, and eating (Branch, et al., 1989;Cherry, et al., 1991; Gillman, et al., 1986). NEGEV PROJECT VISION In Israel, eye care services are available to older persons needing medical treatment. Routine examinations and optometric care including the provision of eyeglasses are services that must be paid for by the individual. Such services are prohibitively expensive for many elderly persons, especially immigrants with a minimum fixed Vision Problems Of Elderly Immigrants In Israel: A Prospective Study