Stereoacuity thresholds typically become increasingly elevated beyond the age of ______________
50 years
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The amplitude of accommodation decreases ____________ with age.
linearly
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Convergence ability does what with age?
stays the same
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When there is a reduction in accommodation that is symptomatic, resulting in blur, the patient is said to have what condition?
presbyopia
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the ability to accommodate ___________ with age.
decreases
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Symptoms of Presbyopia are typically first noticed at what age?
mid 40s
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One factor that contributes to presbyopia is ___________________
decreased elasticity of the lens capsule
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When the ciliary muscle constricts, it releases tension on the lens _______ and capsule, allowing the lens to bulge anteriorly.
zonules
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Presbyopia can be treated with what kind of lenses?
Convex (plus) lenses that compensate for the loss of near diotropic power
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How does astigmatism change as a person ages?
increasing diotropic power in horizontal meridian
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- a shift from WTR astig --\> ATR astig
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How should older patients be educated by their eye doctor?
educate patients about:
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-expected changes over time in vision
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-the manner in which these changes can affect ADL
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-proper use of lighting
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Ocular media becomes less clear with age and causes what 2 things?
increasing light scatter
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reducing contrast
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Visual acuity is __________ important than contrast sensitivity in everyday activities
less
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Retinal illuminance decreases with age as _________________ decreases.
pupil size (miosis)
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T or F: Normal aging can lead to degraded visual function without ocular pathology
True
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The elderly tend to adopt a more ____________ response criterion in psychophysical measurements than younger observers.
conservative
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As people age, there is a ___________ in the rate of dark adaptation and an ________ in absolute threshold.
decrease in dark adaptation
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increase in absolute threshold
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Visual acuity ________ with normal aging.
decreases
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Spatial contrast sensitivity declines with age at what 2 spatial frequencies?
intermediate and high spatial frequencies
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How do visual fields change with age?
become smaller
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How does peripheral sensitivity change with age?
decreases with age
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Sensitivity to temporally modulated stimuli does what with age?
declines with age
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UFOV
useful field of view
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-test of visual attention that is a psychophysical assessment of visual function in elderly
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Older drivers have disproportionately more accidents and citations than ______________
middle age drivers
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The number of people older than 65 years increased by a factor of _____ between 1900 and 1997.
11
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The number of people older than 65 years old is expected to double again by 2030 to become __________________ people.
72 million
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The rate of growth in the population 85 years and older is
even greater than 65 and older
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In 2019, about 16.5% of American population is was 65 years or older; it is expected to reach ____% by 2050.
22%
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In 1950, only _____% of population was over 65 years.
8%
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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
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How does vision development and change across lifespan?
infancy and childhood- rapidly enhance visual functions
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mid-adulthood: stable
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elderly: slow degradation
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What 3 things reduce contrast and retinal illuminance?
1.increased light scatter
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2. increased absorption by ocular media
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3. decreased pupil diameter (miosis)
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Overtime, what happens to the lens with old age?
-it becomes thicker and hardens such that accommodation is no longer possible
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-yellows and may develop opacities
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How do photoreceptors change with old age?
-gradual loss of photoreceptors
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-decrease in optical density of photopigments
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-less responsive to light
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What happens to foveal cone density with old age?
density decreases
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What happens to the visual pathways and cortex as someone ages?
cell loss and changes in neurotransmitters
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Dark adaptation changes how with old age?
increase in absolute threshold, decrease in rate of dark adaptation
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Resolution acuity changes how after 60 years of age?
decreases
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The spatial CSF _________ at intermediate and high spatial frequencies.
decreases
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How does temporal contrast sensitivity changes how with old age?
no change
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Visual fields become how with age?
smaller
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Normal aging can lead to degraded visual function that must be distinguished from the effects of _____________
pathology
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Ocular diseases and their associated vision losses are much more prevalent in ______________adults.
older
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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
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Any anatomical and physiological change observed in an older eye, if MINOR, may be considered to be due to _____________
normal aging
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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
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When presence of pigmentary mottling and drusen are more pronounced and accompanied with acuity loss, they are considered to be ________________-
age-related macular degeneration
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Activities of daily living
The basic activities a person usually accomplishes during a normal day, such as eating, dressing, and bathing.
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-it is important to ensure patients visual needs are met to perform these activities
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the ocular media becomes less clear with age, which causes what 2 things?
increased light scatter
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reduced contrast
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Most significant age-related changes occur in the crystalline lens, which include?
1. increased diameter and thickness
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2. Hardens
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3. Increases in optical density, and accumulates more light absorbing pigmentation
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If the lens undergoes some noticeable opacification, it is an early sign of what?
cataracts
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As pigmentation in the crytalline lens increases, the absorption of light by the lens becomes _________________-
wavelength dependent
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The lens of the neonate's eye is _______________ to all visible wavelengths.
transparent
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In the older eye, absorption of light is greatest for what kind of light?
short-wavelength light (violet and blue)
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In the older eye, absorption is worse in what kind of wavelengths of light?
intermediate and short
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What produces progressive yellowing of crystalline lens throughout life?
absorption of short-wavelength light (blue and violet)
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By what time frame is the yellowing of the lens noticeable?
3rd decade of life
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Loss of short-wavelength sensitivity can have a dramatic impact on color vision and cause what type of defects?
blue-yellow (tritan)
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What anatomically can occur to the photoreceptors with age?
-loss of photoreceptors
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-reduction in photopigment density
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-misalignment or improper oritentation of cones outer segments
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-resting membrane potential may decrease
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-decrease in level of neurotransmitters
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Possible postreceptor mechanisms for age-related loss include reduced receptor pooling due to
-reduced convergence onto bipolar cells
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-ganglion cell loss
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-decreased response amplitude of neurons
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-decreased levels of retinal neurotransmitters
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-cortical cell loss
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-decrease in levels of cortical neurotransmitters
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Psychophysical measurements
tests that rely on an observer's subjective response of what is seen or not seen
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-many elderly are reluctant to say that they detect a target unless they are very sure
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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
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It is critical that older adults be ____________ to read a lower line on a visual acuity chart.
encouraged
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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
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Many early studies that reported an age-related decline in vision may have ___________ the amount of sensory loss due to age.
overestimated
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Transmission of light changes how with age?
decreases with age
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cataract causes what 2 things?
1.decreased vision
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2. changes in refractive error
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Syneresis
vitreous liquifying ; causes reflections of light (patient may notice as floaters)
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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
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What type of color vision mistakes are elderly more likely to make?