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    BLOG: Discuss link between general health, vision

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    The View From Here

    BLOG: Discuss link between general health, vision
    February 27, 2026
    5 min read
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    Key takeaways:

    • Regular aerobic exercise and resistance training are key for seniors on GLP-1s to retain muscle mass and bone density.
    • Proactively educate patients about how GLP-1s can benefit their systemic health.

    As primary care providers, optometrists must take a broader view of the annual eye examination

    The long-term health of the eye and visual system depends on the health and fitness of their owner. The life expectancy of American citizens today is roughly 79 years, up from 76 to 77 years just 25 years ago

    If you factor out external items like suicide, illicit drug use and accidents, basically looking at metabolic health, this number increases to 81 to 82 years. The average age of retirement in the United States is roughly 64 years. This means that many Americans can expect to live on average for 15 to 20 years after retirement. What can we do, as optometrists, to maximize vitality and preserve great vision for our patients in these golden years?

    The rate of obesity in this population is 38% to 42%. The rate of metabolic syndrome rose from 50.2% to 62.4% in the latest data cycle. These are two of the largest chronic health issues that affect the quality of life and vision for our senior patients. Last summer, I penned a blog that discussed one of the biggest breakthrough treatments for these problems: What every optometrist should know about GLP-1 receptor agonists.

    In the time since I wrote that, positive data have only amplified the positive outcomes of these medicines. As both a member of this age cohort we are discussing and a user of one of these agents, I can attest to the “new lease on life” that can be provided by this line of treatment

    Independent of the role of GLP-1 medications in diabetes, these medicines can dramatically improve metabolic markers such as BMI, HbA1c, lipid profiles, blood pressure and C-reactive protein. Based on the results of recent studies on these medicines, including STEP, SURPASS, SELECT, LEADER, SUSTAIN-6, REWIND, LIRA and SATURN, the accompanying table illustrates this point

    Enlarge Table courtesy of Healio AI

    There are special considerations when using this treatment modality in the senior population. The typical adaptive symptoms of gastroparesis, nausea, dehydration, hypotension and low blood sugar must be closely monitored with special consideration of fall risk and fragility. Another large concern is the loss of muscle mass and changes in bone density. With this in mind, a simple weekly shot is not best practice. It is just the first step of a three-step plan for those with metabolic dysfunction.

    The next step is regular aerobic exercise. When you think about encouraging a course of regular exercise for older adults, there are many barriers to entry. How about a social activity that would be well accepted by this group, would be active and competitive, could be enjoyed by both men and women, and would be easier on the shoulders and perhaps played on a smaller court? What if we could cross the excitement of tennis with, say, a more docile sport, like ping-pong? Enter the exciting new world of pickleball! Founded in 1965 in Washington state to entertain restless young baby boomers, it slowly grew in popularity until this same generation rediscovered it around the turn of the century. This sport uniquely rewards anticipation, touch, positioning and pattern recognition rather than explosive speed, vertical power or maximal aerobic capacity. It stimulates visuospatial prediction, rapid decision-making, motor planning and social interaction. It uses a unique “dink” move that lightly taps a ball just over the net rather than running and slamming. Today, approximately 20 million people play pickleball in the U.S. About 2.1 million of these are age 65+, making this the second largest demographic group in the sport. For an active senior, this is an easy transition to better health.

    The last plank in the health senior living platform is resistance training; 25% to 40% of weight loss from GLP-1 use by seniors can be from lean muscle mass loss. This is not a desirable situation for this population. However, even mild strength training will preserve lean mass, increase resting metabolic rate, improve bone density and reduce fall risk. The program is not bodybuilding or Olympic training. It is mild weight training with perhaps just two sessions a week. Sessions are just six to eight exercises with one to three repetitions. This type of training also requires adequate protein intake, which is important with any GLP-1 plan but critical when including resistance training. The current guidelines suggest 1.2 g/kg/day to 1.5 g/kg/day protein recommended for preservation of muscle mass and function.

    So, when your senior patients present for their annual eye exam, pay close attention to their health history. When that history includes things like hypertension, dyslipidemia, sleep apnea, chronic kidney disease or prediabetes, look at their medicine list. If they are not using a GLP-1 medicine, ask them if their doctor has ever mentioned this option. If not, take the opportunity to educate them about this line of treatment. If they are already on a GLP-1 (rare if not also a person with diabetes), ask them about the other planks in GLP-1 health platform. Even if we are not the ones to prescribe these medicines (at least not yet), educate patients on a comprehensive program that improves their quality of life and decreases the risk for age-related eye and vision problems.

    I am a strong advocate of the comprehensive medically based eye examination. It is shocking to me how many patients I see in my peer group who struggle with chronic medical problems and yet have never been educated about a proactive treatment plan to treat the underlying cause of their multiple maladies. We are a critical part of the primary health care team and one that often sees these patients more often and knows them better than most of the other team members. I have yet to have a patient object to a frank discussion about their general health and how it might affect their vision in the long run. Some have even switched their physician to one with a more progressive treatment philosophy and adopted a more proactive approach to their health care.

    I encourage you to learn more about these new treatment options and make them part of your practice. I subscribe to the Healio Primary Care feed, and there is something new on GLP-1 research almost every week. Some even feature new work that suggests a trend to decrease the risk for vision loss from improved vascular health and neuroprotection. Adding this dimension to your practice is part of what makes optometry such an exciting and vibrant profession and, frankly, why I am still here.

    For more information:

    Scott A. Edmonds, OD,specializes in vision-based neurorehabilitation at Edmonds Eye Associates in Philadelphia. He can be reached at scott@edmondsgroup.com, linkedin.com/in/scott-edmonds-3427a2a and on X @scottedmondsOD

    Published by:

    Source:

    Expert Submission

    References:

    Disclosures:
    Edmonds reports no relevant financial disclosures

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