Senescence And The Eye Flashcards by Sarah Heath

Aging changes in the cornea

DECREASED WOUND HEALING (long revocery from surgery)
breakdown in the barrier function of the corneal epithelium
decreased sensitivity

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Aging changes in corneal endothelium

DECREASE IN CELL DENSITY
polymegathism (greater than normal variation in size)
pleomorphism (increased variability in size and shape)

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Hassall-Henle bodies

Endothelial indentations 
Decemets membrane thinckens
Peripheral 
Use retro or specular 
Assymptomatic 
Rule out Fuch's
Drop out of endothelial

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Hudson-Stahli line

Iron deposits in epithelial cell cytoplasm

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Limbal girlde of Vogt

Degeneration of bowmans layer
-3 and 9 o clock
Series of white deposits

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The most common aging change in the cornea

Corneal arcus

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What are the deposits in corneal arcus

Cholesterol and cholesterol esters

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Clinical significance of corneal arcus

There is no clinical significance in elderly persons, but in those under age 40, hyperlipidemia should be suspected

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How many people will you see with arcus that are over age 80

About 100%

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Is corneal arcus bilateral or ipsilateral

Bilateral

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Krukenberg’s spindle

Pigment deposits on the posterior cornea with a vertical orientation, increases with age

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Aging changes in the sclera

fatty deposits may cause the sclera to appear yellow

- concentration of certain proteoglycans is decreases, causing scleral thinning and loss of elasticity

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Anterior chamber changes with age

narrows
volume decreases
narrowing mroe significant in women and may be related to the higher incidence of the angle closure glaucoma in elderly women
decrease in aqueous production

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Age related IOP *

No age related increase in IOP seen in healthy individuals with pressure below 22mmHG

AGE NOT A REASON FOR HIGH IOP

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Aging changes in the iris

The dilator muscle becoems atrophic and the sphincter muscle becoems sclerotic, making it more difficult to dilate the older pupil pharmacology

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Why is there a loss of pigment from the epithelium is evident at the pupillary margin and on transillumination

The root is thinner, so there may be more pigment loss there and transillumination defects there

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Aging changes in ciliary body

CT increases
no significant correlation between loss of ciliary muscle contractile ability and age**
aqueous decreases
volume of anterior chamber decreases

What is the significance of loss of ciliary muscle contractile ability and age

There is no correlation!

Aging changes in the crystalline lens

clinical manifestations of aging are presbyopia and cataract formation
use UVR-absorbing lenses

When are cataracts expected to more common

In those exposed to greater levels of sunlight

When does the crystalline lens stop growing

Never, grows throughout life

When does the increase in the lens size occur the most

Between 8 and 40, accompanied by an increase in surface curvatures, a forward movement of the center of the lens, and a decrease in anterior chamber depth

Age related changes in the vitreous

The gel volume decreases and the liquid volume increases, this process is known as vitreous liquefaction or vitreous syneresis

What forms floaters with age

As the dissolution of the HA-collagen complex occurs, the macromolecules moves out of the collagen network, causing the fibrils to coalesce into fibers and then into bands

What is one of the most common abnormalities that occurs at the posterior retinal-vitreous interface?

Posteiror vitreous detachment caused by the traction from the collagen bundles to the vitreous

What happens when the vitreous pulls away from the optic nerve

If glial tissue is torn away with the vitreous, a circular condensation, Weiss' ring (senile annular ring), may be visible within the vitreous

What is responsible for the clinical appearance of drusen

Calcification and deposits in the inner collagenous layer of Bruch's -as lysosomal activity in RPE decreases with age, atypical material (including lipofushcin) may accumulate in Bruch's membrane

Age changes in lamina cribrosa

Changes inthe laminar pores in the aged lamina cribrosa may take the nerve fibers passing through the openings more susceptible to injury, contributing to an increased susceptibility to glaucomatous damage

Aging changes in the retina

- the foveal reflex dims because the ILM thickens - the accumulation of debris in drusen are located in Bruch's membrane of the choroid but are observed as pinpoint deposits in the retina

Ganglion cells loss and aging

Because an estimated 33-50% of CNS neurons are lost during lifetime, the number of retinal neurons will decrease, with ganglion cell loss especially noted in the fovea

The number of retinal pigmented epithelial cells and aging

Reduced from 4000/mm^2 to 2000/mm^2

What is an age related degeneration of RPE and Bruch's membrane and what is the cause of it

Peripapillary choroidoretinal atrophy | -caused by attenuation of the peripapillary circulation

Neuroretinal rim tissue and age

Decreases and ther vertical optic cup diameter and the area of the optic cup both increases -needs to be considered when assessing the optic nerve head for glaucoma

Aging changes in the EOMS

Both horizontal rectus muscles are displaced inferiroly with age, with the medial rectus displaced more than the lateral rectus

What is the cause of a constant partial depression and may contribute to the imparted ability to elevate the eyes often observed in elderly persons, predisposing them to an incomitant strabismus

Both horizontal muscles are displaced inferiorly with age, with the medial rectus displaced more than the lateral rectus

Aging changes in the orbital adnexa

The eyebrow position heightens in both genders with increasing age, skin looses elasticity in the lids -more pronounced changes in lid margin position, including ectropion and entropion, increase in incidence with age related changed in the orbicularis muscle tone

Aging changes in the lacrimal system

-tearing may be caused by eversion of the lower punctum due to eyelid position or by stenosis of the passages in the lacrimal drainage systems; bot occur more frequently in elderly persons

Tear secretion and age

Some studies find that basal rate of tear secretion diminishes after age 40, contributing to dry eye, the incidence of which increases with age

Vascular engorgment at lid margin and age

The incidence of vascular engorgemtn at the lid margin and plugged meibomian gland pores also increases with age

Effect of aging on ocular circulation

Endothelial dysfunction can occur with age and can result in increased vascular tone, a reduction in vessel distensibility, and a decrease in tissue perfusion

Aging and VF

Age is accompanied by a decrease in the extent of the VF, caused both by loss of cells and by a decrease in the transparency of the ocular media

Determining speed of moveing objects and age

The inability to accurately determine the speed of moving objects contributes to a higher incidence of car accidents among the elderly