The future blurs as Haywood's eyes age

By Shelby Harrell Staff Writer | Apr 28, 2014
Photo by: Shelby Harrell David Markoff, an ophthalmologist at Mountain Eye Associates in Clyde, checks 87-year-old Hattie Polk's eyes after she received a surgery to treat severe dry eye.

When it comes to a rapidly increasing aging population, some ophthalmologists in Haywood County don’t have a clear solution in sight.

Longer life spans in combination with aging baby boomers are expected to double the population of Americans aged 65 years or older during the next 25 years to about 72 million.

Statistics show that by the year 2030, older adults will account for roughly 20 percent of the U.S. population.

The potential increase in patients is beginning to worry ophthalmologists like Dr. David Markoff and Dr. Steven Hartzell, both who mostly treat elderly patients at the Clyde branch of Mountain Eye Associates

“It’s not just us, it’s across medicine,” Markoff said about the influx of older patients. “But there won’t be 50 percent more medical students graduating every year.”

Mountain Eye Associates is a medical practice specializing in comprehensive routine, medical, surgical, and consultative eye care. Its four branch locations have been serving Haywood County since 1977. In addition to Markoff and Hartzell, Mountain Eye is home to two optometrists Kristel Causby and Robert Dickey.

Markoff said most of his patients are 60 and older. This is partly because a person’s eyesight worsens as the body ages.

“At age 40, people start to notice that they can’t see up close anymore,” Markoff said.

“The lens of the eye starts to become cloudy, and that’s what a cataract is,” Hartzell added.

Both Markoff and Hartzell are concerned about an influx of their patient intake in the future — something that is already taking up most of their time.

“It will not only affect our practice but it will put that much more strain on our business,” Markoff said before taking a bite of his sandwich on his hurried lunch break. “It will be hard for me to see more than I already do and still give proper care.”

“People don’t want to be treated like a fact — they want attention and concern, and we try to give that to them,” Hartzell added.

One way Markoff and Hartzell are trying to prepare for a population boom is by requiring more training so their current staff can perform more tasks for them.

“…We can handle more people in a day or have more skilled positions under (us) to handle things,” Markoff said. “A lot of staff who work for us provide excellent service.”

The most common vision problem in the U.S. is cataracts. Statistics show that more than half a million people age 40 and older in North Carolina currently have cataracts.

Aside from treating cataracts, Markoff and Hartzell see many patients who suffer from glaucoma, severe dry eye and age-related macular degeneration (AMD). In North Carolina,  66,184 over the age of 40 have glaucoma and 42,588 people age 50 and older have AMD.

Glaucoma is a disease of the optic nerve that is usually associated with elevated eye pressure, Markoff said. AMD causes damage to the macula, a small spot near the center of the retina and the part of the eye needed for sharp, central vision that is needed to see objects that are straight ahead. Those with severe AMD are mostly limited to peripheral vision.

“Everyone worries about AMD — that’s a big thing,” Hartzel said.

AMD may be treated depending on what form it’s in. There is currently no proven treatment for dry AMD, but treating the wet form may involve the use of anti-VEGF treatment, thermal laser treatment or photodynamic therapy. Glaucoma can be treated by medication (eye drops), laser therapy or surgery. Corrective lenses or laser surgery may be able to treat cataracts.

To help prolong eye health in aging eyes, Markoff and Hartzell recommend not smoking, exercising and eating nutritious foods. But in some cases, eye diseases like glaucoma cannot be avoided.

“You could have a perfect life and still have the code for it and still have issues,” Markoff said.

“Exercise can help your eye pressure, but it won’t determine whether or not you get the disease," Hartzell added.

Mountain Eye offers a number of services and treatment options, including routine eye exams for adults and children, diabetic eye care, glaucoma treatment and surgery, cataract surgery, laser vision correction surgery (LASEK), eye emergencies and even therapeutic and cosmeticBOTOX® treatments.

Mountain Eye Associates offers four locations: at 486 Hospital Drive in Clyde; 65 Park Street in Canton, 1898 S. Main Street in Waynesville and 8 Doctor’s Drive, Suite 200, in Sylva. For more information visit