Authors: Marieta Dumitrache, Miruna Cioboat.
Vision loss in the elderly is caused by: physiological aging of the eye, eye disease specific in the elderly (cataract, DMLV, NO impairments), non-age specific eye disease similar to adult disease and multiple general pathology determination given by aging. Vision in the elderly declines over time, through an inevitable evolutionary process, aggravated by the involution of senescence. Ocular change with age affected: cornea, the trabecular meshwork lens, retina, choroid, vitreous, sclera and NO. Vision loss in elderly patients is often chronic, binocular, asymmetric. Presbyopia represents the physiological disorder of the eye, with on onset around the age of 45 which is manifested by the progressive decrease of the accommodative amplitude in near vision (the accommodation deficit by emmetrope is +0,5D at 45 years old, and 70 years the accommodation power of the lens is 0, needs +3,5 +4D for near vision.
Acute vision loss unilateral in amaurosis fugax, vitreous hemorrhage, AMD, ACR, VCR obst DRR, bilateral in: trachoma, AMD, diabetic hypertensive, retinopathy, infiltrative optic, neuropathy, cortical infarction, hemorrhage. Chronic vision loss in elderly unilateral in: cataract, DMLV, RD, keratopathies, uveitis, DR, glaucoma, trauma macular disease, affects of NO, and bilateral in: GPUD decompensated, secondary glaucoma, maculopathy, papillary edema in HIC. Decreased vision in age related eye pathology in: cataract (senile, pathological, complicated), glaucoma (GPUD, GSUD), DMLV atrophic, exudative), pathological change of NO (NOIA), artetitic (Horton’s disease), nonarteritic. The general cause of AV decrease cause: systemic diseases: DM, HTN, ASC, stroke, mental illnesses (depression, dementia).
The management of vision loss must begin with the earliest possible diagnosis of the eye disease and the establishment of preventive and curative therapeutic opportunities – each age decade being evolutionary and nonregressive.