Self-Check for “Eye Frailty”

Frailty means
• fragility
• weakness
• transience
.

Frailty of the whole body is a relatively new concept.

In ophthalmology, “eye frailty” (Eye Frailty) has been described.

Addendum
A more detailed website has now been created by the Japan Eye Care Awareness Council (Nihon Ganka Keihatsu Kaigi).
Please refer to it.

Self-check for “eye frailty”

One can return from “frailty” to a healthy state

Regarding frailty,
in 2014 (Heisei 26) the Japan Geriatrics Societypublished a statement.

A sudden shift from a healthy state to one requiring nursing care is seen in cases such as stroke, but in many of the

late-stage elderly (age 75 and over), whose numbers are expected to grow, it is thought that a person passes through an intermediate stage called “frailty” and

gradually falls into a state requiring nursing care.

Frailty includes reversibility: with appropriate intervention, a person can return to a healthy state.

Therefore, by finding elderly people who have fallen into frailty early and intervening appropriately, we can expect to maintain and improve their functional ability.

Japan Geriatrics Society

In stroke and similar conditions, a person moves suddenly from a healthy state to one requiring care, but this is not common.

Usually,
physiological reserve (what a person can do) declines little by little.
People become gradually more vulnerable to stress, leading to impaired daily functioning, a need for nursing care, and death.

“Frailty” is the intermediate stage.

Decline in muscle strength → falls become more likely
Cognitive impairment and depression: mental and psychological problems
Living alone and financial hardship: social problems

are considered to be part of it.

Unlike the terms that carry an image of “no return”:
“senility,” “debility,” and “fragility” (an irreversible state of aging and decline with age),
in contrast,

“frailty”also carries the meaning that a person can returnto a healthy, normal state.

What is eye frailty (from the Japan Ophthalmological Society)

In many late-stage elderly people (age 75 and over), whose numbers are expected to grow,
various problems arise in the eyes with aging.

Definition of eye frailty

A state in which, on top of the increasing fragility of the eye that comes with aging,
various external and internal factors lower visual function,
or a state in which the risk of this is high.

“Eye frailty” countermeasure activities
Japan Ophthalmological Society, Strategic Planning Council
April 10, 2021 (Reiwa 3)

It was defined as above.

Changes in the eye related to eye frailty

• High myopia
• Diabetes or hypertension
• A family member with an eye disease
There are underlying predispositions of the eye (internal factors), such as these,

lifestyle, smoking, ultraviolet light, after surgery, after drug administration,
and others (external factors）

), and in addition,

changes that come with agingoccur.

○ Abnormalities of shape (morphological and structural changes)
Thin blood vessels become weaker
A little inflammation keeps accumulating (chronic inflammation)
The framework of the optic nerve gradually weakens (weakening of the lamina cribrosa)
Nerve cells gradually decrease (loss of retinal neurons)
Cataract progresses (clouding of the lens)
Loss of corneal endothelial cells

○ Abnormalities of function (functional changes)
It becomes harder to focus, and presbyopia progresses
(decreased accommodation, decreased fusional range, increased aberrations, decreased contrast sensitivity, and so on)

Goals of eye frailty countermeasures

Eye frailty self-check

Eye frailty self-check 1

1. My eyes tire more easily
2. Things sometimes become hard to see in the evening
3. I read newspapers or books for long periods less often
4. I sometimes make a mess on the table at mealtimes
5. I often feel I cannot see well even with glasses
6. I feel dazzled easily
7. Sometimes I cannot see clearly unless I blink
8. Straight lines sometimes look wavy
9. I have felt unsafe on steps or stairs
10. I have missed traffic lights or road signs

If two or more apply, you may have eye frailty.

Eye frailty self-check 2 (for younger people)

1. My eyes tire more easily
2. Things sometimes become hard to see in the evening
3. I feel I see less well than when I was young
4. I often feel I cannot see well even with glasses
5. Sometimes I cannot see clearly unless I blink

If even one applies, you may have pre-eye frailty.

What to watch for in daily life

Do not dismiss a sudden difficulty in seeing as “just age.”
(Japan Ophthalmological Society)

To keep a happy life and comfortable daily life over a lifetime:

» The importance of preventive medicine

I hope this gives you a chance to think about your own eyes and leads to early detection of problems.

Japan Eye Care Awareness Council: the official “Eye Frailty” awareness website is now available

(Added note)
In September 2021 the Japan Eye Care Awareness Council published an official website about eye frailty.

アイフレイル | 日本眼科啓発会議 ...

アイフレイル | 日本眼科啓発会議 アイフレイル啓発 公式サイト ｢アイフレイル｣とは、『加齢に伴って眼が衰えてきたうえに、様々な外的ストレスが加わることによって目の機能が低下した状態、また、そのリスクが高い状態』です。

Please look for a nearbyEye Frailty Advice Doctor.

* Japan Eye Care Awareness Council:
The Japan Eye Care Awareness Council was established in 2007 when the Japanese Ophthalmological Society, the Japan Ophthalmologists Association, and related organizations joined forces to raise public awareness of the importance of vision, and of the advanced and socially contributing nature of ophthalmic medicine. The eye frailty activities are carried out as a project of the council.

Japanese Ophthalmological Society (public interest incorporated foundation)
Japan Ophthalmologists Association (public interest incorporated association)
Japan Ophthalmic Instruments Association (general incorporated association)
Japan Contact Lens Association (general incorporated association)
Japan Ophthalmic Pharmaceutical Association (general incorporated association)

About frailty: introducing reference books

» [e-book]生活習慣病・重症化予防・フレイルに関する基礎知識冊子

» 在宅時代の落とし穴 今日からできるフレイル対策

» フレイル診療ガイド〈2018年版〉