VD Final

What happens to stereopsis with age?

decreases

Stereoacuity thresholds typically become increasingly elevated beyond the age of ______________

50 years

The amplitude of accommodation decreases ____________ with age.

linearly

Convergence ability does what with age?

stays the same

When there is a reduction in accommodation that is symptomatic, resulting in blur, the patient is said to have what condition?

presbyopia

the ability to accommodate ___________ with age.

decreases

Symptoms of Presbyopia are typically first noticed at what age?

mid 40s

One factor that contributes to presbyopia is ___________________

decreased elasticity of the lens capsule

When the ciliary muscle constricts, it releases tension on the lens _______ and capsule, allowing the lens to bulge anteriorly.

zonules

Presbyopia can be treated with what kind of lenses?

Convex (plus) lenses that compensate for the loss of near diotropic power

How does astigmatism change as a person ages?

increasing diotropic power in horizontal meridian

- a shift from WTR astig --\> ATR astig

How should older patients be educated by their eye doctor?

educate patients about:

-expected changes over time in vision

-the manner in which these changes can affect ADL

-proper use of lighting

Ocular media becomes less clear with age and causes what 2 things?

increasing light scatter

reducing contrast

Visual acuity is __________ important than contrast sensitivity in everyday activities

less

Retinal illuminance decreases with age as _________________ decreases.

pupil size (miosis)

T or F: Normal aging can lead to degraded visual function without ocular pathology

True

The elderly tend to adopt a more ____________ response criterion in psychophysical measurements than younger observers.

conservative

As people age, there is a ___________ in the rate of dark adaptation and an ________ in absolute threshold.

decrease in dark adaptation

increase in absolute threshold

Visual acuity ________ with normal aging.

decreases

Spatial contrast sensitivity declines with age at what 2 spatial frequencies?

intermediate and high spatial frequencies

How do visual fields change with age?

become smaller

How does peripheral sensitivity change with age?

decreases with age

Sensitivity to temporally modulated stimuli does what with age?

declines with age

UFOV

useful field of view

-test of visual attention that is a psychophysical assessment of visual function in elderly

Older drivers have disproportionately more accidents and citations than ______________

middle age drivers

The number of people older than 65 years increased by a factor of _____ between 1900 and 1997.

11

The number of people older than 65 years old is expected to double again by 2030 to become __________________ people.

72 million

The rate of growth in the population 85 years and older is

even greater than 65 and older

In 2019, about 16.5% of American population is was 65 years or older; it is expected to reach ____% by 2050.

22%

In 1950, only _____% of population was over 65 years.

8%

Changes in visual function that occur with aging can be seconday to _________________, or can occur in the absence of disease in healthy eyes.

ocular disease

How does vision development and change across lifespan?

infancy and childhood- rapidly enhance visual functions

mid-adulthood: stable

elderly: slow degradation

What 3 things reduce contrast and retinal illuminance?

1.increased light scatter

2. increased absorption by ocular media

3. decreased pupil diameter (miosis)

Overtime, what happens to the lens with old age?

-it becomes thicker and hardens such that accommodation is no longer possible

-yellows and may develop opacities

How do photoreceptors change with old age?

-gradual loss of photoreceptors

-decrease in optical density of photopigments

-less responsive to light

What happens to foveal cone density with old age?

density decreases

What happens to the visual pathways and cortex as someone ages?

cell loss and changes in neurotransmitters

Dark adaptation changes how with old age?

increase in absolute threshold, decrease in rate of dark adaptation

Resolution acuity changes how after 60 years of age?

decreases

The spatial CSF _________ at intermediate and high spatial frequencies.

decreases

How does temporal contrast sensitivity changes how with old age?

no change

Visual fields become how with age?

smaller

Normal aging can lead to degraded visual function that must be distinguished from the effects of _____________

pathology

Ocular diseases and their associated vision losses are much more prevalent in ______________adults.

older

Why is it sometimes hard to distinguish between normal aging and early pathology?

because the measurement variability increases with age, bc people age at different rates

Any anatomical and physiological change observed in an older eye, if MINOR, may be considered to be due to _____________

normal aging

The presence of some pigmentary mottling and a few drusen is common in the retina of ___________________

older individuals and could be considered a result of normal aging

When presence of pigmentary mottling and drusen are more pronounced and accompanied with acuity loss, they are considered to be ________________-

age-related macular degeneration

Activities of daily living

The basic activities a person usually accomplishes during a normal day, such as eating, dressing, and bathing.

-it is important to ensure patients visual needs are met to perform these activities

the ocular media becomes less clear with age, which causes what 2 things?

increased light scatter

reduced contrast

Most significant age-related changes occur in the crystalline lens, which include?

1. increased diameter and thickness

2. Hardens

3. Increases in optical density, and accumulates more light absorbing pigmentation

If the lens undergoes some noticeable opacification, it is an early sign of what?

cataracts

As pigmentation in the crytalline lens increases, the absorption of light by the lens becomes _________________-

wavelength dependent

The lens of the neonate's eye is _______________ to all visible wavelengths.

transparent

In the older eye, absorption of light is greatest for what kind of light?

short-wavelength light (violet and blue)

In the older eye, absorption is worse in what kind of wavelengths of light?

intermediate and short

What produces progressive yellowing of crystalline lens throughout life?

absorption of short-wavelength light (blue and violet)

By what time frame is the yellowing of the lens noticeable?

3rd decade of life

Loss of short-wavelength sensitivity can have a dramatic impact on color vision and cause what type of defects?

blue-yellow (tritan)

What anatomically can occur to the photoreceptors with age?

-loss of photoreceptors

-reduction in photopigment density

-misalignment or improper oritentation of cones outer segments

-resting membrane potential may decrease

-decrease in level of neurotransmitters

Possible postreceptor mechanisms for age-related loss include reduced receptor pooling due to

-reduced convergence onto bipolar cells

-ganglion cell loss

-decreased response amplitude of neurons

-decreased levels of retinal neurotransmitters

-cortical cell loss

-decrease in levels of cortical neurotransmitters

Psychophysical measurements

tests that rely on an observer's subjective response of what is seen or not seen

-many elderly are reluctant to say that they detect a target unless they are very sure

Younger observers are much more likely to ______________ on a psychophysical visual test.

guess or push for a lower line; older individuals have to be pushed

It is critical that older adults be ____________ to read a lower line on a visual acuity chart.

encouraged

By using a forced-choice procedure, it is typically found that stimuli can be detected or discriminated at levels ______________- than the thresholds found by regular VA.

far lower

Many early studies that reported an age-related decline in vision may have ___________ the amount of sensory loss due to age.

overestimated

Transmission of light changes how with age?

decreases with age

cataract causes what 2 things?

1.decreased vision

2. changes in refractive error

Syneresis

vitreous liquifying ; causes reflections of light (patient may notice as floaters)

Yellowing of the lens causes more light absorption of what kind of light?

short-wavelength light--\>elderly have a harder time detecting blue/white light

What type of color vision mistakes are elderly more likely to make?

Tritan (blue/yellow defects)