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Ocular Block 8 > Senescence And The Eye > Flashcards

Senescence And The Eye Flashcards

1
Q

Aging changes in the cornea

A
  • DECREASED WOUND HEALING (long revocery from surgery)
  • breakdown in the barrier function of the corneal epithelium
  • decreased sensitivity
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2
Q

Aging changes in corneal endothelium

A
  • DECREASE IN CELL DENSITY
  • polymegathism (greater than normal variation in size)
  • pleomorphism (increased variability in size and shape)
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3
Q

Hassall-Henle bodies

A 
Endothelial indentations 
Decemets membrane thinckens
Peripheral 
Use retro or specular 
Assymptomatic 
Rule out Fuch's
Drop out of endothelial
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4
Q

Hudson-Stahli line

A

Iron deposits in epithelial cell cytoplasm

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5
Q

Limbal girlde of Vogt

A

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

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6
Q

The most common aging change in the cornea

A

Corneal arcus

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7
Q

What are the deposits in corneal arcus

A

Cholesterol and cholesterol esters

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8
Q

Clinical significance of corneal arcus

A

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

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9
Q

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

A

About 100%

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10
Q

Is corneal arcus bilateral or ipsilateral

A

Bilateral

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11
Q

Krukenberg’s spindle

A

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

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12
Q

Aging changes in the sclera

A
  • 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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13
Q

Anterior chamber changes with age

A
  • 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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14
Q

Age related IOP *

A

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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15
Q

Aging changes in the iris

A

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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16
Q

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

A

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

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17
Q

Aging changes in ciliary body

A
  • CT increases
  • no significant correlation between loss of ciliary muscle contractile ability and age**
  • aqueous decreases
  • volume of anterior chamber decreases
18
Q

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

A

There is no correlation!

19
Q

Aging changes in the crystalline lens

A
  • clinical manifestations of aging are presbyopia and cataract formation
  • use UVR-absorbing lenses
20
Q

When are cataracts expected to more common

A

In those exposed to greater levels of sunlight

21
Q

When does the crystalline lens stop growing

A

Never, grows throughout life

22
Q

When does the increase in the lens size occur the most

A

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

23
Q

Age related changes in the vitreous

A

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

24
Q

What forms floaters with age

A

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

25
Q

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

A

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

26
Q

What happens when the vitreous pulls away from the optic nerve

A

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

27
Q

What is responsible for the clinical appearance of drusen

A

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

28
Q

Age changes in lamina cribrosa

A

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

29
Q

Aging changes in the retina

A
  • 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
30
Q

Ganglion cells loss and aging

A

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

31
Q

The number of retinal pigmented epithelial cells and aging

A

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

32
Q

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

A

Peripapillary choroidoretinal atrophy

-caused by attenuation of the peripapillary circulation

33
Q

Neuroretinal rim tissue and age

A

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

34
Q

Aging changes in the EOMS

A

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

35
Q

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

A

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

36
Q

Aging changes in the orbital adnexa

A

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

37
Q

Aging changes in the lacrimal system

A

-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

38
Q

Tear secretion and age

A

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

39
Q

Vascular engorgment at lid margin and age

A

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

40
Q

Effect of aging on ocular circulation

A

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

41
Q

Aging and VF

A

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

42
Q

Determining speed of moveing objects and age

A

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

Ocular Block 8 (6 decks)

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