Senescence And The Eye - Block 8

Question 1

What is not a reason to put in the chart when the patient is having visual issues

Answer 1

Old age

Question 2

Age is accompanied by a increase/decrease in the extent of the what??

Answer 2

Decrease in visual field

Question 3

What is the decrease in visual fields due to age caused by?

Answer 3

• loss of cells

- decrease in transparency of the ocular media

Question 4

What contributes to a higher incidence of car accidents among the elderly?

Answer 4

The inability to accurately determine the speed of moving objects due to aging within the visual pathway

Question 5

What effect would aging have on the cornea?

Answer 5

Decreased wound healing

Question 6

What effect would aging having on the corneal endothelium?

Answer 6

Decrease in cell density

Question 7

The most common aging change in the cornea

Answer 7

Corneal arcus

Question 8

Coronal arcus are what kind of deposits?

Answer 8

Cholesterol and cholesterol esters

Question 9

Is there a clinical significance in elderly persons?

Answer 9

No

Question 10

In people under the age of 40, what should be suspected when you see corneal arcus?

Answer 10

Hyperlipidemia

Question 11

What are the aging changes in the sclera?

Answer 11

Fatty deposits may cause the sclera to appear yellow

Concentration of certain proteoglycans is decreased, causing scleral thinning and loss of elasticity

Question 12

What are the age related changes in the anterior chamber?

Answer 12

Anterior chamber width narrows

Question 13

In who is the narrowing of the anterior chamber angle most significant?

Answer 13

In women

May be related to the higher incidence of angle-closure glaucoma in elderly women

Question 14

Is there an age-related change in IOP?

Answer 14

No age-related increase in IOP is seen in healthy individuals with pressures below 22 mmHg

Question 15

What happens to the sphincter and dilator muscles of the iris in regards to aging changes?

Answer 15

Dilator = becomes atrophic
Sphincter = becomes sclerotic

Question 16

When the dilator muscle of the iris becomes atrophic and the sphincter muscle becomes sclerotic due to aging, what becomes more difficult?

Answer 16

Makes it more difficult to dilate the older pupil pharmacologically

Question 17

What’s the significance between loss of ciliary muscle contractile ability and age?

Answer 17

No significant correlation

Question 18

What are some age-related changes of the crystalline lens?

Answer 18

Presbyopia

Cataract formation

Question 19

What do you recommend the pt to use when they ask how they can prevent cataracts

Answer 19

-can’t prevent, but can try to wear UVR-absorbing lenses when outdoors to help b/c incidence of cataracts is higher in those exposed to greater levels of sunlight

Question 20

Does the lens grow throughout life?

Answer 20

Yes

Question 21

When does the majority of the increase in thickness of the crystalline lens occur? What accompanies it?

Answer 21

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

Question 22

Age related changes in the vitreous, where the gel volume decreases and the liquid volume increases

Answer 22

Vitreous liquifaction or vitreous syneresis

Question 23

What happens to the hyaluronic acid-collagen complex in the vitreous, due to age?

Answer 23

The complex goes through dissolution, the macromolecule moves out of the collagen network, causing the fibrils to coalesce into fibers and then into bands

Question 24

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

Answer 24

Posterior vitreous detachment caused by traction

Question 25

This becomes visible within the vitreous when the glial tissue is torn away from the vitreous

Answer 25

A circular condensation, known as Weiss’ ring (senile annular ring)

Question 26

What is responsible for the clinical appearance of drusen?

Answer 26

Calcification and deposits in the inner collagenous layer of the choroid
Increases in number with age

Question 27

As lysosomal activity in the RPE decreases with age, what happens?

Answer 27

Atypical material (including libofuscin) may accumulate in Bruch’s membrane

Question 28

What effects will happen to the nerve fibers that pass through the lamina cribrosa when the change in the laminar pores due to age occur?

Answer 28

The become more susceptible to injury, contributing to an increased susceptibility to glaucomatous damage

Question 29

Why does the foveal reflex dim?

Answer 29

B/c the internal limiting membrane thickens

Question 30

What are observed as pinpoint deposits in the retina?

Answer 30

Accumulations of debris in drusen that are located in Bruch’s membrane of the choroid

Question 31

How many neurons of the CNS are lost during lifetime? What will happen to retinal neurons?

Answer 31

33%-50% are lost

Retinal neurons will decrease, with ganglion cell loss especially noted in the fovea

Question 32

Number of retinal pigmented epithelial both before and after age-related changes to the retina

Answer 32

4000/mm^2 to 2000/mm^2

Question 33

Pale, temporal crescent, that’s an age-related degeneration of RPE and Bruch’s membrane, and may be caused by attenuation of the peripapillary circulation

Answer 33

Peripapillary chorioretinal atrophy

Question 34

What needs to be considered when assessing the optic nerve head for glaucoma?

Answer 34

Decrease in neuroretinal rim tissue, and the vertical optic cup diameter and the area of the optic both increase

Question 35

What can be the cause of aging in the extraocular muscles?

Answer 35

Constant partial depression
May contribute to the impaired ability to elevate the eyes often observed in elderly persons, predisoing them to an incomitant (noncomitant) strabismus