The burgeoning presbyopic population: an emerging 20th century phenomenon.

Improved social welfare in the wake of the 'industrial revolution' set in train in mid-18th century Britain an escalation in population numbers which has been sustained through to the end of the 20th century--and is projected to continue into the 21st century. However, within the total population envelope the percentage-contribution of certain age groupings shows a striking pattern when viewed across nearly five centuries. For 350 years, up to the end of the 19th century, the over--40 year old section of the population comprised a steady 25% of the total population count of England (latterly England and Wales): over the same period the 60-plus section contributed nearly 10% of the total. Throughout the ten decades of the 20th century these proportions have both increased, such that with the arrival of the next millennium a two-fold increase in the percentage-contribution of both age groups will have occurred: nearly one-half (over 24 million) of the population of England and Wales will be aged over 40, or more than one-fifth (around 11 million) will be aged over 60 years. This 'ageing' of the general population will have economic and socio-medical implications both at home and abroad, since this is a demographic trend which is present/projected in all countries of the European Union (as presently constituted). The future practise of optometry will certainly be touched by these changes. Naturally a potential increase in demand for presbyopic refractive corrections from the growing volume of aged 40-plus individuals is possible. However of greater significance is the certain increase in age-related oculo-visual problems arising from within the growing aged 60-plus population. Greater acknowledgement and utilisation of the optometrist's skills, currently being reappraised through the profession's participation in 'collaborative care' schemes, may indicate the direction in which optometry should move in the early 21st century to remain a valuable--and valued--health care profession.