Final: Aging on Vision

Question 1

What is senile miosis? What does it result in?

Answer 1

Shrunken pupil due to age.

Results in decrease in retinal illumination, and increased depth of field

Question 2

What are 3 normal changes to the crystalline lens as we age?

Answer 2

1) Presbyopia: decrease in amplitude of accommodation
2) Yellowing of Crystalline Lens
3) Increased Light Scatter

Question 3

What are 2 normal changes to refractive error as we age?

Answer 3

1) “With the rule” to “against-the-rule” astigmatic shift

2) Increase in myopia (“second sight”)* w/nuclear sclerosis development

Question 4

True or False: There is no significant change in 
 macular pigment density

Answer 4

True

Question 5

What does decreased retinal illuminance result in?

Answer 5

Results in vision that is less bright or more dark. Perceptually, it is not as dramatic.

Question 6

What kind of changes do we have with spectral sensitivity as we age?

Answer 6

• Decreased sensitivity for all wavelengths due to prereceptoral light loss (miosis, lens changes)
• Greater decrease for short-wavelength (blue) light due to yellowing of lens and greater sensitivity of SWS cones for metabolic damage (e.g., diabetes)

Question 7

As we age, what might happen to our color vision?

Answer 7

-Increase in tritan abnormalities
more evident on desaturated D-15 testing
secondary to yellowing of lens, and metabolic disease.

-Chromatopsias
Xanthopsia: yellowish tint to perception
Cyanopsia: bluish tint to perception
-common immediately upon cataract removal

Question 8

As we age, what might happen to our increment thresholds?

Answer 8

Mild increase of all increment thresholds (decrease in sensitivity) with increasing age.

Relatively more pronounced in macular area (flattening of
“hill of vision”)

Question 9

As we age, what might happen to our extent of visual fields? When is the fastest decrease of attentional field of vision?

Answer 9

-Little change associated with normal aging found with standard automated perimetry.

More stimuli are misidentified when older patients are required to divide their attention among two or more stimuli simultaneously
-Referred to as testing of the 
“Attentional” or “Useful” field of vision.
Fastest decrease begins around age 70 years.

Question 10

As we age, what might happen to our contrast sensitivity? When does this usually begin? What is this due to?

Answer 10

Decreases beginning around age 65 mainly for midrange & high spatial frequencies.
Due to miosis, lens & vitreous changes, and neural factors.

Question 11

What happens to VAs as we age?

Answer 11

Begin to decrease in mid 20’s in almost a linear pattern

Question 12

What happens to visual recognition acuity as we age?

Answer 12

• Mild decrease in high-contrast recognition acuity beginning around age 60-65.
• Significantly greater decreases found in low-contrast recognition acuity

Question 13

True or False:
High-contrast recognition acuity measurements does adequately reflect an older patients loss of visual function in the real world.

Answer 13

False; it does NOT adequately reflect an older patients visual function.

Question 14

What is disability glare? When does an accelerated increase in glare begin? What is it due to?

Answer 14

-Decreased spatial resolution in presence of bright, surrounding light. It begins to accelerate at age 65. It is largely due to light scatter.

Question 15

What 2 clinical tests test disability glare? What is the high contrast test? What is the low contrast test?

Answer 15

1) Brightness Acuity Tester (BAT)
High-contrast acuity w/ glare

2) Berkeley (Disability) Glare Test
Low-contrast acuity w/ glare

Question 16

What is glare recovery time? How does age affect glare recovery and about what age would someone might experience an accelerated increase?

Answer 16

Glare recovery is the time required to recover acuity after exposure to bright light. Age 60 is when there is an accelerated increase.

Question 17

Between the ages of 60 to 80+, how much increase of glare recovery time would we expect to see?

Answer 17

8-fold increase in time

Question 18

What happens to flicker perception as we age When does it start to decrease? When does an acceleration in progression typically begin?

Answer 18

• Gradual linear decrease in critical flicker fusion 
(to ~ 40 - 45 Hz) beginning at age 20 yrs.
• An accelerated progression usually begins around age 70.